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: BACKGROUND:The Mediterranean diet is one of the healthier diet models. Mediterranean food patterns are suffering a deterioration that can especially affect children and adolescents. OBJECTIVE:Determine adherence to the Mediterranean diet in adolescents of southern Spain and its relationship with the residence area, sex, age, life satisfaction, anthropometry, and habits of physical activity and sedentary activities. METHODOLOGY:A total of 1973 adolescents (11-18 years) of southern Spain participated in this descriptive cross-sectional study. Cut-off value between rural and urban locations was 10000 inhabitants. Adherence to the Mediterranean diet was calculated from the KIDMED questionnaire. Life satisfaction, physical activity, and sedentary activities also were measured through valid and reliable questionnaires. Body mass index and % body fat were measured using the TANITA BC-420-S body analyzer. RESULTS:30.9% of the adolescents reported an optimal quality diet, percent higher in rural locations (P < 0.05). Adherence was lower in older adolescents (P < 0.001), it was not different between sexes or according to anthropometric variables. Adolescents more satisfied with their lives (P < 0.001), more active (P < 0.001), more studious (P < 0.001), and less sedentary in front of a screen (P < 0.001) showed greater adherence to the Mediterranean food pattern. CONCLUSION:The majority of adolescents need to improve their nutritional quality. Compared with these subjects, the adolescents most adherent to the Mediterranean diet had a healthier lifestyle and they showed greater life satisfaction. :Introducción: La dieta mediterránea es uno de los modelos más saludables de dieta. Los patrones alimentarios mediterráneos están sufriendo un deterioro que puede afectar especialmente a niños y adolescentes. Objetivo: Determinar la adherencia a la dieta mediterránea de los adolescentes del sur de España y su relación con el área de residencia, sexo, edad, satisfacción con la vida, características antropométricas y hábitos de actividad física y sedentaria. Métodos: Un total de 1.973 adolescentes (11-18 años) del sur de España participaron en este estudio descriptivo transversal. El punto de corte entre poblaciones rurales y urbanas fue 10.000 habitantes. La adherencia a la dieta mediterránea fue calculada a partir del cuestionario KIDMED. Satisfacción con la vida, actividad física y sedentarismo también mediante cuestionarios fiables y válidos. Índice de masa corporal y % de grasa corporal fueron medidos utilizando el analizador corporal TANITA BC-420-S. Resultados: El 30,9% de los adolescentes reportó una dieta de calidad óptima, porcentaje superior en poblaciones rurales (P < 0,05). La adherencia fue menor en los adolescentes de mayor edad (P < 0,001), sin diferir entre sexos ni según las variables antropométricas. Los adolescentes más satisfechos con sus vidas (P < 0,001), más activos (P < 0,001), más estudiosos (P < 0,001) y menos sedentarios delante de una pantalla (P < 0,001) mostraron mayor adherencia al patrón alimentario mediterráneo. Conclusión: La mayoría de adolescentes necesitan mejorar su calidad nutricional. En comparación con estos sujetos, los más adheridos a la dieta mediterránea llevaban un estilo de vida más saludable y mostraron mayor satisfacción con sus vidas.

背景与目标： 背景：地中海饮食是较健康的饮食模式之一。地中海的食物类型正在恶化，尤其会影响儿童和青少年。
目的：确定西班牙南部青少年对地中海饮食的依从性及其与居住地区，性别，年龄，生活满意度，人体测量学以及体育锻炼和久坐活动习惯的关系。
方法：西班牙南部的总共1973名青少年（11-18岁）参加了该描述性横断面研究。城乡之间的临界值是10000居民。从KIDMED调查表计算出对地中海饮食的坚持。生活满意度，身体活动和久坐活动也通过有效且可靠的问卷进行了测量。使用TANITA BC-420-S人体分析仪测量体重指数和体脂百分比。
结果：30.9％的青少年报告了最佳质量饮食，在农村地区则更高（P <0.05）。年龄较大的青少年的依从性较低（P <0.001），这在男女之间或根据人体测量学变量无差异。青少年对生活的满意度更高（P <0.001），更加活跃（P <0.001），勤奋好学（P <0.001），屏幕前久坐不动（P <0.001）显示出对地中海食物模式的依从性更高。
结论：大多数青少年需要提高营养质量。与这些受试者相比，最喜欢地中海饮食的青少年的生活方式更健康，生活满意度更高。
：饮食简介：饮食中的营养品。洛杉矶特别行政区营养不良儿童和青少年基金会。对象：确定居住在西班牙，西班牙，西班牙，西班牙，西班牙，西班牙，西班牙，西班牙，西班牙，西班牙，西班牙，西班牙，西班牙，西班牙，西班牙和西班牙的青少年。 Métodos：总共有1.973个青少年（11月18日至10月18日，西班牙人），横向学习是在España参加的。 El punto de corte entre poblaciones Rurales y urbanas fue 10.000 habitantes。死者复审和死刑复审。满足您的要求，请先确认您的行为，然后再执行中止诉讼。 TANDES BC-420-S的商标为masa下士和fueron medidos utilizando el analizador下士为下装。结果：30.9％的青少年青少年报告说，农村地区的上等饮食者（P <0.05）。埃德斯市长青年队参议员（P <0,001），性变量。美国青少年洛杉矶（P <0,001），青少年活动（P <0,001），青少年工作室（P <0,001）和西班牙裔白人（P <0,001）都参加了中产阶级运动。结论：青少年市长需要营养。在墨西哥的最保守的情况下，最有价值的市长和在维斯塔斯的最优秀的市长都应受到赞扬。

BACKGROUND & AIMS: AIM:The aim of this study was to determine maternal and neonatal outcomes of less than recommended or excess gestational weight gain (GWG) based on the recommended Institute of Medicine (IOM) guidelines. MATERIAL AND METHODS:Using a cross-sectional study design, GWG was assessed for 1462 pregnant women presenting to a tertiary care perinatal institute in India. Body mass index at baseline, co-existing morbidities, fetal growth, details of delivery, and maternal and fetal outcomes were determined and documented. Appropriate GWG for each woman was determined based on the revised IOM guidelines. Outcome measures included the proportion of pregnant women compliant with IOM guidelines for GWG and associations of less than recommended or excess GWG with maternal and neonatal outcomes. RESULTS:A total of 547 (37.41%, 95% confidence interval [CI]: 34.96-39.92) pregnant women gained less than recommended and 313 (21.41%, 95%CI: 19.36-23.57) pregnant women gained more than the recommended weight. Preterm deliveries were associated with less than optimal weight gain (adjusted odds ratio 3.58, 95%CI: 1.75-7.32) after adjusting for gestational age at delivery. GWG was not associated with neonatal outcomes in this population. CONCLUSIONS:The lack of associations with perinatal outcomes indicates that the IOM guidelines may not be the appropriate standard for monitoring GWG in this population.

背景与目标： 目的：本研究的目的是根据推荐的医学研究所（IOM）指南确定孕产妇和新生儿的结局低于建议的或超过的妊娠体重增加（GWG）。
材料与方法：采用横断面研究设计，对印度的三级围产期研究所就诊的1462名孕妇进行了GWG评估。确定并记录基线时的体重指数，并存发病率，胎儿生长，分娩细节以及母婴结局。根据修订的IOM指南确定每位妇女的适当GWG。结果指标包括符合IOM GWG指导原则的孕妇比例，以及低于或超过GWG推荐值的孕妇和新生儿结局。
结果：共有547名（37.41％，95％置信区间[CI]：34.96-39.92）孕妇体重增加低于建议值，而313名（21.41％，95％CI：19.36-23.57）孕妇体重增加超过建议体重。调整分娩时的胎龄后，早产会导致体重增加不理想（调整后的比值比为3.58，95％CI：1.75-7.32）。 GWG与该人群的新生儿结局无关。
结论：缺乏与围产期结局的联系表明，IOM指南可能不是监测该人群GWG的合适标准。

BACKGROUND & AIMS: :Re-emerging human adenovirus types 14 (Ad14) and 55 (Ad55) have caused severe respiratory diseases and even deaths during recent outbreaks. However, the seroprevalence of neutralizing antibodies (nAbs) in healthy adults, which may reflect previous circulation and help to predict potential outbreaks, remains unclear. In this study, we established micro-neutralizing (MN) assays on the basis of recombinant Ad14 and Ad55 reporter viruses, and we investigated serum nAbs in healthy blood donors from Southern China. We found that the overall seropositive rates were 24.8% and 22.4% for Ad14 and Ad55 nAbs, respectively. The seropositive rates were low in individuals younger than 20, and they gradually increased with age. Ad55-seropositive individuals tended to have high nAb titers (>1000), while low (72-200) and moderate (201-1000) nAb levels were frequently observed in Ad14-seropositive ones. Surprisingly, the seropositive rates and nAb levels were associated with the blood type but not the gender of the blood donors, with type AB individuals displaying higher seropositive rates and nAb levels. Interestingly, a significant positive correlation was observed between Ad14 and Ad55 seroprevalence, and higher titers of nAbs were detected in double-positive individuals compared to single-positive ones. These results clarified the human humoral immune responses against Ad14 and Ad55 and revealed a low level of herd immunity in some subpopulations, which emphasized the importance of monitoring these two highly virulent adenoviruses and reinforced the development of prophylactic vaccines.

背景与目标： ：重新出现的14型（Ad14）和55型（Ad55）人腺病毒在最近的暴发中已引起严重的呼吸道疾病，甚至死亡。但是，尚不清楚健康成年人中的中和抗体（nAbs）的血清阳性率，这可能反映了以前的血液循环并有助于预测潜在的疾病爆发。在这项研究中，我们建立在重组Ad14和Ad55报告病毒的基础上的微中和（MN）分析，并研究了来自中国南方健康献血者的血清nAb。我们发现，Ad14和Ad55 nAb的总体血清阳性率分别为24.8％和22.4％。血清阳性率在20岁以下的人群中较低，并且随着年龄的增长而逐渐增加。 Ad55血清反应阳性的个体倾向于具有较高的nAb滴度（> 1000），而在Ad14血清反应阳性的个体中经常观察到低（72-200）和中等（201-1000）的nAb水平。出人意料的是，血清反应阳性率和nAb水平与血型有关，而与献血者的性别无关，AB型个体表现出较高的血清反应阳性率和nAb水平。有趣的是，在Ad14和Ad55血清阳性之间观察到显着的正相关性，与单阳性患者相比，双阳性患者中nAbs的滴度更高。这些结果阐明了人类针对Ad14和Ad55的体液免疫反应，并揭示了某些亚群中较低的畜群免疫力，这强调了监测这两种高毒力腺病毒的重要性，并加强了预防性疫苗的开发。

BACKGROUND & AIMS: BACKGROUND:The assessment of mood and anxiety disorders secondary to cancer by using easy-to-administer instruments has been the object of recent research. METHODS:The aim of this study was to examine the accuracy of the short screening tool developed by the National Comprehensive Cancer Network Clinical Practice Guidelines for Distress Management, (0-10 point-scale Distress Thermometer) (DT) in detecting affective syndrome disorders in Italian cancer patients. The sample consisted of 109 cancer outpatients who were administered the ICD-10 psychiatric interview (CIDI), the DT and the Hospital Anxiety Depression Scale (HADS). RESULTS:Forty-four patients (40.4%) met the criteria for an ICD-10 diagnosis of affective syndromes. The DT was significantly associated with HADS-Total score (r=0.66, p=0.001). A cut-off > or = 4 on the DT showed a sensitivity of 79.5% and a specificity of 75.4% (positive predictive value--PPV = 68.6%; negative predictive value--NPV = 84.5%). The cut-off score > or = 10 on the HADS was associated with a sensitivity of 86% and a specificity of 81.5% (PPV = 76%; NPV = 89.9%). A cut-off score > or = 5 on DT and > or = 15 on HADS maximized sensitivity (78.6% and 85%, respectively) and specificity (83.1% and 96%, respectively) for patients with more severe affective syndromes (major depression, persistent depressive disorders). CONCLUSIONS:The results suggest that simple instruments can be used as feasible tools in the screening of mood and anxiety disorders among cancer patients.

背景与目标： 背景：使用易于管理的仪器评估癌症继发的情绪和焦虑症已成为近期研究的目标。
方法：本研究的目的是检验由《国家综合癌症网络遇险管理临床实践指南》（0-10点规模遇险温度计）（DT）开发的短筛查工具在检测情感综合征中的准确性。意大利癌症患者。该样本包括109位接受过ICD-10精神病学访谈（CIDI），DT和医院焦虑抑郁量表（HADS）的癌症门诊患者。
结果：44名患者（40.4％）符合ICD-10诊断情感综合征的标准。 DT与HADS总分显着相关（r = 0.66，p = 0.001）。 DT的临界值>或= 4显示灵敏度为79.5％，特异性为75.4％（阳性预测值-PPV = 68.6％;阴性预测值--NPV = 84.5％）。 HADS的截止评分>或= 10与敏感性86％和特异性81.5％相关（PPV = 76％； NPV = 89.9％）。 DT的临界值>或= 5，HADS的> 15或15以上，对于患有更严重的情感综合征（重度抑郁）的患者，其敏感性最高（分别为78.6％和85％）和特异性（分别为83.1％和96％） ，持续性抑郁症）。
结论：结果表明，简单的仪器可用作筛查癌症患者情绪和焦虑障碍的可行工具。

BACKGROUND & AIMS: BACKGROUND:Human brucellosis is an infectious zoonotic disease caused by Brucella spp. It is one of the most public health problems that remains largely neglected in developing counties, including Saudi Arabia. Brucellosis is particularly prevalent among rural people who have constant contact with livestock. METHODS:A cross-sectional sero-epidemiological study conducted in Aseer Central Hospital, South Saudi Arabia, between 2014 and 2018 among 7567 patients. Serum samples were analyzed for Brucella antibodies using slide agglutination test. Serology results and patient's demographic data were analyzed by GraphPad Prism. Results were presented as mean ± SEM and differences between two groups were assessed by t-test and p < 0.05 was considered significant. RESULTS:The prevalence of brucellosis among the admitted suspected 7567 cases was 12.8% (10.4-15.7%; CI 95%). The highest prevalence rate was detected during 2015, the rate decreased to the lowest level during the last three years (p < 0.05). Higher rate of brucellosis was observed among males than females (p < 0.05) and most cases were reported during summer season (p < 0.05). The highest prevalence rate was observed in age group 21-40 year old (40.5%) followed by 41-60 years (27.7%). The lowest prevalence rate was noticed in old and young children (15 and 3%, respectively). Cross-transmission of brucellosis was seen within family (1%) and high titers (> 1280) was noticed in 22% of the hospitalized patients. The major symptoms were fatigue, hyperhidrosis, fever and joint pain. CONCLUSION:Our findings showed a high prevalence of human brucellosis among suspected patients in Aseer region. This indicates that clinical suspicion is a valid criterion and the endemic nature of the disease. The disease status requires early laboratory detection and confirmation to start prompt treatment to decrease patients suffering.

背景与目标： 背景：人类布鲁氏菌病是一种由布鲁氏菌属引起的传染性人畜共患病。它是最严重的公共卫生问题之一，在包括沙特阿拉伯在内的发展中国家中仍然被忽略。在与牲畜经常接触的农村人口中，布鲁氏菌病尤为普遍。
方法：2014年至2018年间，在南沙特阿拉伯的Aseer中心医院对7567名患者进行了横断面血清流行病学研究。使用玻片凝集试验分析血清样品中的布鲁氏菌抗体。通过GraphPad Prism分析血清学结果和患者的人口统计学数据。结果表示为平均值±SEM，并且通过t检验评估两组之间的差异，并且p <0.05被认为是显着的。
结果：在入院的疑似7567例病例中，布鲁氏菌病的患病率为12.8％（10.4-15.7％； CI为95％）。 2015年的患病率最高，最近三年降至最低水平（p decreased <0.05）。男性的布鲁氏菌病发生率高于女性（p <0.05），并且大多数病例在夏季报告（p <0.05）。患病率最高的年龄组是21-40岁（40.5％），其次是41-60岁（27.7％）。在年龄较大的儿童中患病率最低（分别为15％和3％）。在家庭中发现了布鲁氏菌病的交叉传播（1％），住院患者中有22％出现高滴度（> 1280）。主要症状是疲劳，多汗症，发烧和关节痛。
结论：我们的研究结果表明，在Aseer地区的可疑患者中，人类布鲁氏菌病的患病率很高。这表明临床怀疑是该疾病的有效标准和特有性。疾病状态需要及早进行实验室检查和确认，以开始迅速治疗，以减少患者的痛苦。

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: :Given the clinical and social problems caused by the consumption of alcohol in most industrialised countries, there is a strong need to develop and evaluate the effectiveness of integrated care programmes. In this study, the authors describe the results observed in 124 sequentially admitted subjects at various points throughout the course of the first year after their discharge from the Southern Regional Alcohol-Abuse Treatment Centre (CRAS) in Lisbon, Portugal. An inpatient stay at this unit of CRAS lasts for between 5 and 7 weeks and implies that the patient must submit him/herself to a therapeutic model which has been adapted from the Minnesota model. At the end of the year under study 44.3% of the patients were still abstinent, 40.3% were consuming alcohol and 15.4% did not reply. 51 patients (41.1% of the initial sample) were still in regular contact with CRAS for further treatment at that point. The variable that was found to possess the most significant association with a favourable outcome was adherence to the therapeutic programme over the course of that year.

背景与目标： ：鉴于大多数工业化国家中饮酒引起的临床和社会问题，强烈需要制定和评估综合护理计划的有效性。在这项研究中，作者描述了在从葡萄牙里斯本南部区域酒精滥用治疗中心（CRAS）出院后的第一年中，在各个时间点在124个依次入组的受试者中观察到的结果。在CRAS的此单元住院的时间为5至7周，这意味着患者必须服从明尼苏达州模型改编的治疗模型。在研究的这一年年底，仍有44.3％的患者戒酒，40.3％的人饮酒和15.4％的患者未戒酒。在这一点上，仍有51名患者（占初始样本的41.1％）仍定期与CRAS接触以进行进一步治疗。在这一年中，发现与治疗方案的依从性最密切相关的变量是坚持治疗方案。

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:Renal transplant patients have a higher incidence of non-melanoma skin cancer (NMSC). Previous studies hypothesized that human leukocyte antigen (HLA), especially types DR1, DR4, and DR7, may influence the incidence of these tumors. This study investigates the association between NMSC and the presence of HLA DR1, DR4, and DR7 in renal transplant patients in southern Brazil. METHODS:In a historical cohort study, 1032 patients who underwent renal transplantation during the period from January 1993 to December 2006 were examined to identify occurrences of NMSC and HLA status prior to transplant. RESULTS:Of the 1032 patients examined, 59 (5.71%) developed NMSC (squamous cell carcinoma [SCC]: 2.42%; basal cell carcinoma [BCC]: 1.74%; both: 1.55%). The presence of HLA DR1 was associated with a higher probability of developing any NMSC and particularly with developing BCC (P < 0.05). There was no statistically significant association between the presence of HLA DR4 or DR7 and the occurrence of NMSC in this sample. CONCLUSIONS:HLA DR1 appears to be associated with the development of BCC, as well as with the higher number of NMSC lesions in renal transplant patients. This study supports the trend to associate the DR1 allele with BCC and not with SCC.

背景与目标： 背景：肾移植患者非黑素瘤皮肤癌（NMSC）的发生率较高。先前的研究假设，人类白细胞抗原（HLA），尤其是DR1，DR4和DR7型，可能会影响这些肿瘤的发病率。这项研究调查了巴西南部肾脏移植患者中NMSC与HLA DR1，DR4和DR7的相关性。
方法：在一项历史性队列研究中，对1993年1月至2006年12月期间接受肾移植的1032例患者进行了检查，以鉴定其在移植前是否发生了NMSC和HLA状态。
结果：在接受检查的1032例患者中，有59例（5.71％）发展为NMSC（鳞状细胞癌[SCC]：2.42％；基底细胞癌[BCC]：1.74％；两者：1.55％）。 HLA DR1的存在与发展任何NMSC的可能性更高，尤其是与发展BCC的可能性更高（P <0.05）。在此样品中，HLA DR4或DR7的存在与NMSC的发生之间没有统计学上的显着关联。
结论：HLA DR1似乎与肾移植患者BCC的发展以及NMSC病变的增多有关。这项研究支持将DR1等位基因与BCC而非SCC相关联的趋势。

BACKGROUND & AIMS: BACKGROUND/AIMS:The difficulty in establishing early definitive diagnosis and treatment of primary small bowel malignancy (PSBM) is a challenge for clinicians. This study aimed to analyze the symptomatology, diagnosis and outcomes of PSBM. METHODOLOGY:A retrospective chart review study was conducted on 49 patients who underwent surgical treatment for PSBM at a tertiary hospital between May 2000 and January 2010. RESULTS:The patients with PSBM had non-specific clinical symptoms. Major diagnostic tools in the current study were computed tomography (CT) (n=40), gastrointestinal series radiography (n=10), angiography (n=5), double-balloon enteroscopy (n=3), gastroduodenoscopy (n=2), magnetic resonance imaging (n=1) and exploratory laparotomy (n=8). Gastrointestinal stromal tumor (GIST) was the most common PSBM (n=21), followed by lymphoma (n=14), adenocarcinoma (n=8), leiomyosarcoma (n=3) and sarcoma (n=3). The overall 5-year cumulative survival rate of the patients with PSBM was 57.1% with a mean survival time of 31.8±7.8 months. The 5-year cumulative survival rates for the different PSBMs were 79.1%, 46.9% and 33.2% for GIST, adenocarcinomas and lymphomas, respectively (p=0.087). CONCLUSIONS:CT is very useful in detecting PSBM. Poor prognosis in PSBM patients detected by CT or angiography could be the result of delayed diagnosis prior to the procedure.

背景与目标： 背景/目的：建立早期明确诊断和治疗原发性小肠恶性肿瘤（PSBM）的困难是临床医生面临的挑战。这项研究旨在分析PSBM的症状，诊断和结局。
方法：对2000年5月至2010年1月间在三级医院接受PSBM手术治疗的49例患者进行了回顾性图表审查研究。
结果：PSBM患者具有非特异性的临床症状。当前研究的主要诊断工具是计算机断层扫描（CT）（n = 40），胃肠道放射照相（n = 10），血管造影（n = 5），双气囊肠镜检查（n = 3），胃十二指肠镜检查（n = 2） ），磁共振成像（n = 1）和探查性剖腹手术（n = 8）。胃肠道间质瘤（GIST）是最常见的PSBM（n = 21），其次是淋巴瘤（n = 14），腺癌（n = 8），平滑肌肉瘤（n = 3）和肉瘤（n = 3）。 PSBM患者的总体5年累计生存率为57.1％，平均生存时间为31.8±7.8个月。对于不同的PSBMs，GIST，腺癌和淋巴瘤的5年累积生存率分别为79.1％，46.9％和33.2％（p = 0.087）。
结论：CT在检测PSBM中非常有用。通过CT或血管造影检查发现PSBM患者的预后不良可能是手术前诊断延迟的结果。

BACKGROUND & AIMS: :Determining the postmortem interval (PMI) is strongly impacted by several variables, which consequently results in inaccuracy in the estimation of PMI used in court trials. A PMI experiment was conducted in Kaohsiung County by disposing a burned pig corpse in the woods. One month later, unexpectedly and interestingly, a homicide case, very similar to this mock study, occurred at a distance of 6 km away from the experimental site. The female victim had been killed and burned. The maggots collected from the victim were identified to be Chrysomya megacephala by morphologic observation and were then confirmed by mitochondrial DNA sequence. A PMI of 50 hours was concluded for the burned human body, based on the information of the maggots from the pig corpse. The murderer was eventually arrested and confessed to the crime. According to his statement, the elapsed time since death was calculated to have been 46 hours. In this case, the PMI was estimated successfully and it was almost precise. It would appear that the more similar the surrounding environment between the mock study and the actual case, the more precise can be the PMI estimation.

背景与目标： ：确定事后间隔（PMI）受几个变量的强烈影响，因此导致法庭审判中使用的PMI估算不准确。在高雄县，通过将烧过的猪尸体放在树林里进行了PMI实验。一个月后，出乎意料且有趣的是，在距实验地点6公里的地方发生了与该模拟研究非常相似的凶杀案。女受害者被杀害并被烧死。通过形态学观察，从受害人身上收集到的identified被鉴定为巨头Chrysomya megacephala，然后通过线粒体DNA序列对其进行了确认。根据来自猪尸体的信息，得出燃烧后人体的PMI为50小时。凶手最终被捕并认罪。根据他的陈述，自死亡以来经过的时间经计算为46小时。在这种情况下，PMI已成功估算，并且几乎是精确的。看起来模拟研究和实际案例之间的周围环境越相似，PMI估算就越精确。

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