BACKGROUND & AIMS: :Chromosome inversions suppress genetic recombination and establish co-adapted gene complexes, or supergenes. The 2La inversion is a widespread polymorphism in the Anopheles gambiae species complex, the major African mosquito vectors of human malaria. Here we show that alleles of the 2La inversion are associated with natural malaria infection levels in wild-captured vectors from West and East Africa. Mosquitoes carrying the more-susceptible allele (2L+a) are also behaviorally less likely to be found inside houses. Vector control tools that target indoor-resting mosquitoes, such as bednets and insecticides, are currently the cornerstone of malaria control in Africa. Populations with high levels of the 2L+a allele may form reservoirs of persistent outdoor malaria transmission requiring novel measures for surveillance and control. The 2La inversion is a major and previously unappreciated component of the natural malaria transmission system in Africa, influencing both malaria susceptibility and vector behavior.

背景与目标： : 染色体倒位抑制遗传重组并建立共同适应的基因复合物或超基因。2La反转是冈比亚按蚊物种复合体 (人类疟疾的主要非洲蚊子媒介) 中广泛存在的多态性。在这里，我们显示2La反转的等位基因与来自西非和东非的野生捕获载体中的自然疟疾感染水平有关。携带更敏感的等位基因 (2L a) 的蚊子在行为上也不太可能在房屋内被发现。针对室内静止蚊子的病媒控制工具，如蚊帐和杀虫剂，目前是非洲疟疾控制的基石。2L a等位基因水平高的人群可能会形成持续的室外疟疾传播库，需要采取新的监测和控制措施。2La倒置是非洲自然疟疾传播系统的主要且以前未被重视的组成部分，影响疟疾的易感性和媒介行为。

BACKGROUND & AIMS: :Recent field studies on the reproductive ecology of western diamond-backed rattlesnakes (Crotalus atrox) from populations in southern Arizona showed significant differences in the concentration of plasma sex steroids (testosterone, T; 5alpha-dihydrotestosterone, DHT; and 17beta-estradiol, E2) throughout the active season (March-October), and peak levels were coincident with the two mating periods (late summer and early spring). There is, however, no information on levels of sex steroids during winter. Similar to most snakes, hibernating individuals of C. atrox are typically inaccessible, but in southern Arizona, where environmental conditions are typically mild during winter, adult males frequently bask at or near the entrances of communal dens. Basking activity, therefore, offers a unique logistical opportunity to assess the complete annual profile of plasma sex steroid levels in males of a temperate reptile in nature. From November to February, we measured levels of plasma T, DHT, and E2 in adult male C. atrox that were located basking at communal dens. Additionally, cloacal, core body, and ambient air temperatures were obtained to investigate potential relationships between body temperatures and levels of sex steroids. Mean levels of T, DHT, and E2 were relatively high, and the concentration hierarchy was T>DHT>E2. Mean levels of T, DHT, and E2 showed no significant variation across the four months of sampling; however, E2 levels decreased progressively. In the annul cycle, sex steroid levels during winter were not basal when compared to values obtained during the active season. Mean cloacal temperatures of basking males were significantly higher than core body temperatures of non-basking males (inside dens) from November-December, and in February, which suggests that one function of winter basking is to elevate body temperatures. Steroid levels, nonetheless, were not significantly correlated with cloacal temperatures. We suggest that future field studies of male C. atrox should: (a) investigate sex steroid levels in non-basking individuals and (b) test whether elevated levels of sex steroids during winter facilitate the large increases that occur in early spring, which are coincident with the second mating season. Our findings on the reproductive biology of C. atrox and other viperids are discussed in the context of the associated-dissociated model of reproduction.

背景与目标： : 最近对来自亚利桑那州南部种群的西方钻石支持响尾蛇 (Crotalus atrox) 的生殖生态学进行的实地研究表明，血浆性类固醇 (睾丸激素，T; 5α-二氢睾丸激素，DHT; 和17β-雌二醇，E2) 在整个活动季节 (3月-10月)，峰值水平与两个交配期 (夏末和初春) 一致。但是，没有关于冬季性类固醇水平的信息。与大多数蛇相似，通常无法进入冬眠的C. atrox个体，但在亚利桑那州南部，冬季环境条件通常温和，成年雄性经常在公共窝点的入口或附近晒太阳。因此，晒太阳活动提供了一个独特的后勤机会，可以评估自然界中温带爬行动物男性的血浆性类固醇水平的完整年度概况。从11月到2月，我们测量了位于公共窝点的成年男性C. atrox的血浆T，DHT和E2水平。此外，还获得了泄殖腔，核心体和环境空气温度，以研究体温与性类固醇水平之间的潜在关系。T，DHT和E2的平均水平相对较高，浓度等级为T>DHT>E2。在四个月的采样中，T，DHT和E2的平均水平没有显着变化; 但是，E2水平逐渐降低。在annul周期中，与活动季节获得的值相比，冬季的性类固醇水平不是基础。在11月12月和2月中，晒太阳的男性的平均泄殖腔温度显着高于非晒太阳的男性 (窝点内) 的核心体温，这表明冬季晒太阳的功能之一是提高体温。尽管如此，类固醇水平与泄殖腔温度没有显着相关。我们建议将来对雄性C. atrox进行实地研究 :( a) 调查非晒太阳个体的性类固醇水平，以及 (b) 测试冬季性类固醇水平升高是否会促进早春发生的大幅增加，这与第二个交配季节同时发生。我们在相关分离的生殖模型的背景下讨论了我们对C. atrox和其他生物的生殖生物学的发现。

BACKGROUND & AIMS: BACKGROUND:The World Health Organization estimates that there were 37 million blind people in 2002 and that the prevalence of blindness was 9% among adults in Africa aged 50 years or older. Recent surveys indicate that this figure may be overestimated, while a survey from southern Sudan suggested that postconflict areas are particularly vulnerable to blindness. The aim of this study was to conduct a Rapid Assessment for Avoidable Blindness to estimate the magnitude and causes of visual impairment in people aged > or = 50 y in the postconflict area of the Western Province of Rwanda, which includes one-quarter of the population of Rwanda. METHODS AND FINDINGS:Clusters of 50 people aged > or = 50 y were selected through probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Visual acuity (VA) was measured with a tumbling "E" chart, and those with VA below 6/18 in either eye were examined by an ophthalmologist. The teams examined 2,206 people (response rate 98.0%). The unadjusted prevalence of bilateral blindness was 1.8% (95% confidence interval [CI] 1.2%-2.4%), 1.3% (0.8%-1.7%) for severe visual impairment, and 5.3% (4.2%-6.4%) for visual impairment. Most bilateral blindness (65%) was due to cataract. Overall, the vast majority of cases of blindness (80.0%), severe visual impairment (67.9%), and visual impairment (87.2%) were avoidable (i.e.. due to cataract, refractive error, aphakia, trachoma, or corneal scar). The cataract surgical coverage was moderate; 47% of people with bilateral cataract blindness (VA < 3/60) had undergone surgery. Of the 29 eyes that had undergone cataract surgery, nine (31%) had a best-corrected poor outcome (i.e., VA < 6/60). Extrapolating these estimates to Rwanda's Western Province, among the people aged 50 years or above 2,565 are expected to be blind, 1,824 to have severe visual impairment, and 8,055 to have visual impairment. CONCLUSIONS:The prevalence of blindness and visual impairment in this postconflict area in the Western Province of Rwanda was far lower than expected. Most of the cases of blindness and visual impairment remain avoidable, however, suggesting that the implementation of an effective eye care service could reduce the prevalence further.

背景与目标：

BACKGROUND & AIMS: :The authors present a case series of 54 subjects of Rhinosporidium. They were reported in two years at a tertiary care hospital of Western Orissa. The clinically diagnosed cases by ophthalmologists were confirmed by histopathological samples following surgery. In our series, we noted Rhinosporidium seeberi organisms as the main causative agent. Males were affected three times more than females. Children less than 10 years of age comprised more than 50% of our series. In 91% of cases, the conjunctiva was the site of this infection. Total excision of fungal mass was carried out in all cases and two cases had recurrence between 9 and 12 months following intervention. Although this is an endemic area for such infestation, unilateral manifestation observed in all cases is interesting to note. Low recurrence rate in limited follow-up period could be due to early detection and standard management.

背景与目标： : 作者介绍了54例鼻孢子虫的病例系列。他们在两年内被报告在西部奥里萨邦的一家三级护理医院。眼科医生的临床诊断病例在手术后通过组织病理学样本证实。在我们的系列中，我们注意到鼻孢子虫是主要的病原体。男性受到的影响是女性的三倍。10岁以下的儿童占我们系列的50% 以上。在91% 情况下，结膜是这种感染的部位。所有病例均进行了真菌肿块的完全切除，其中2例在干预后9至12个月之间复发。尽管这是这种侵扰的流行地区，但在所有情况下观察到的单方面表现都值得注意。在有限的随访期内复发率低可能是由于早期发现和标准管理。

BACKGROUND & AIMS: OBJECTIVES:To assess the proportion of patients lost to programme (died, lost to follow-up, transferred out) between HIV diagnosis and start of antiretroviral therapy (ART) in sub-Saharan Africa, and determine factors associated with loss to programme. METHODS:Systematic review and meta-analysis. We searched PubMed and EMBASE databases for studies in adults. Outcomes were the percentage of patients dying before starting ART, the percentage lost to follow-up, the percentage with a CD4 cell count, the distribution of first CD4 counts and the percentage of eligible patients starting ART. Data were combined using random-effects meta-analysis. RESULTS:Twenty-nine studies from sub-Saharan Africa including 148,912 patients were analysed. Six studies covered the whole period from HIV diagnosis to ART start. Meta-analysis of these studies showed that of the 100 patients with a positive HIV test, 72 (95% CI 60-84) had a CD4 cell count measured, 40 (95% CI 26-55) were eligible for ART and 25 (95% CI 13-37) started ART. There was substantial heterogeneity between studies (P < 0.0001). Median CD4 cell count at presentation ranged from 154 to 274 cells/μl. Patients eligible for ART were less likely to become lost to programme (25%vs. 54%, P < 0.0001), but eligible patients were more likely to die (11%vs. 5%, P < 0.0001) than ineligible patients. Loss to programme was higher in men, in patients with low CD4 cell counts and low socio-economic status and in recent time periods. CONCLUSIONS:Monitoring and care in the pre-ART time period need improvement, with greater emphasis on patients not yet eligible for ART.

背景与目标：

BACKGROUND & AIMS: :South Africa has long recognized partnerships between the public and private sectors as a policy objective in health, but experience is still limited and poorly documented. The objectives of this article are to understand the factors that increase the likelihood of success of public-private interactions in South Africa, and identify and discuss opportunities for them to be scaled up. There is a strong legislative framework and a number of guidelines and tools that have been developed by the Treasury for managing partnerships. The review of literature confirmed the need for the state to have effective regulations in order to oversee quality and standards and to provide stewardship and oversight. The public sector requires sufficient capacity not only to manage relationships with the private sector but also to enable innovation and experimentation. Evaluation is an integral part of all interactions not only to learn from successes but also to identify any perverse incentives that may lead to unintended consequences. Four case studies show that the private for-profit sector is already engaged in a number of projects that are closely aligned to current health system reform priorities. Factors that increase the likelihood of interactions being successful include: increasing the government's capacity to manage public-private relationships; choosing public-private interactions that are strategically important to national goals; building a knowledge base on what works, where and why; moving from pilots to large scale initiatives; harnessing the contracting expertise in private providers; and encouraging innovation and learning.

背景与目标： : 南非长期以来一直承认公共部门和私营部门之间的伙伴关系是卫生方面的政策目标，但经验仍然有限，而且文献记载很少。本文的目的是了解增加南非公私互动成功可能性的因素，并确定和讨论扩大它们的机会。财政部为管理伙伴关系制定了强有力的立法框架和许多准则和工具。对文献的审查证实，国家需要制定有效的法规，以监督质量和标准，并提供管理和监督。公共部门不仅需要足够的能力来管理与私营部门的关系，而且还需要创新和实验。评估是所有互动的组成部分，不仅要从成功中学习，而且要确定可能导致意外后果的任何不正当激励措施。四个案例研究表明，私营营利部门已经参与了许多与当前卫生系统改革优先事项密切相关的项目。增加互动成功可能性的因素包括: 提高政府管理公私关系的能力; 选择对国家目标具有战略重要性的公私互动; 建立有效的知识基础，在何处以及为什么; 从试点转向大规模计划; 利用私人供应商的合同专业知识; 鼓励创新和学习。

BACKGROUND & AIMS: :Solar drying is one of the most efficient and cost-effective, renewable, and sustainable technologies to conserve agricultural products in Asian and sub-Saharan African (SSA) countries. This review paper presents the different types of solar dryers that are widely used in Africa and Asia. In addition, the pre-eminent effects of their use on product quality, as well as their economic, environmental, and social impacts, are highlighted. Since financial, external, and structural factors play a key role in the adoption and scaling of solar dryers, this paper also discusses the impact of these factors on the effectiveness of solar drying technologies in selected Asian and SSA countries.

背景与目标： : 太阳能干燥是亚洲和撒哈拉以南非洲 (SSA) 国家保护农产品的最有效，最具成本效益，可再生和可持续的技术之一。本文介绍了在非洲和亚洲广泛使用的不同类型的太阳能干燥器。此外，还强调了它们的使用对产品质量的突出影响，以及它们的经济、环境和社会影响。由于金融，外部和结构因素在太阳能干燥机的采用和扩展中起着关键作用，因此本文还讨论了这些因素对选定的亚洲和SSA国家太阳能干燥技术有效性的影响。

BACKGROUND & AIMS: :While adolescents have received increasing attention in the global HIV response and international strategies and commitments, adolescent mothers and their children remain largely overlooked in research, funding and, programming for health-related outcomes. We conducted an extensive scoping review of current evidence on the experiences of adolescent mothers affected by HIV and their children in this region. We included published literature and conference abstracts, complemented by consultations with key stakeholders, and a review of documents through grey literature searching. First, we summarise the experiences of adolescent mothers and their children related to HIV and key health and development indicators. The syndemic of early motherhood and HIV in sub-Saharan Africa increases the vulnerability of adolescent mothers and their children. We then highlight lessons from a series of promising programmes focused on supporting adolescent mothers through novel approaches. In sub-Saharan Africa, supporting adolescent mothers living in high HIV-risk communities is critical not only to eliminate HIV/AIDS, but also to attain the Sustainable Development Goals. While research on and programming for adolescent mothers and their children is growing, the complex needs for this vulnerable group remain unmet. We conclude with evidence gaps and programming priorities for adolescent mothers affected by HIV and their children.

背景与目标： : 尽管青少年在全球艾滋病毒应对措施以及国际战略和承诺中受到越来越多的关注，但青少年母亲及其子女在与健康有关的成果的研究，资金和方案编制方面仍然被忽视。我们对该地区受艾滋病毒影响的青春期母亲及其子女的经历的当前证据进行了广泛的范围界定审查。我们包括了已发表的文献和会议摘要，并与主要利益相关者进行了磋商，并通过灰色文献搜索对文件进行了审查。首先，我们总结了青春期母亲及其子女与艾滋病毒有关的经验以及关键的健康与发展指标。撒哈拉以南非洲地区早期孕产和艾滋病毒的共同感染增加了青春期母亲及其子女的脆弱性。然后，我们重点介绍了一系列有前途的计划的教训，这些计划侧重于通过新颖的方法支持青春期母亲。在撒哈拉以南非洲，支持生活在艾滋病毒高风险社区的青春期母亲不仅对消除艾滋病毒/艾滋病至关重要，而且对实现可持续发展目标也至关重要。尽管对青少年母亲及其子女的研究和规划正在增长，但对这一弱势群体的复杂需求仍未得到满足。最后，我们为受艾滋病毒影响的青春期母亲及其子女提供了证据空白和计划优先事项。

BACKGROUND & AIMS: :The introduction of new vaccines with much higher prices than traditional vaccines results in increasing budgetary pressure on immunization programs in GAVI-eligible countries, increasing the need to ensure their financial sustainability. In this context, the third EPIVAC (Epidemiology and Vaccinology) technical conference was held from February 16 to 18, 2012 at the Regional Institute of Public Health in Ouidah, Benin. Managers of ministries of health and finance from 11 West African countries (GAVI eligible countries), as well as former EPIVAC students and European experts, shared their knowledge and best practices on immunization financing at district and country level. The conference concluded by stressing five major priorities for the financial sustainability of national immunization programs (NIPs) in GAVI-eligible countries. - Strengthen public financing by increasing resources and fiscal space, improving budget processes, increasing contribution of local governments and strengthen efficiency of budget spending. - Promote equitable community financing which was recognized as a significant and essential contribution to the continuity of EPI operations. - Widen private funding by exploring prospects offered by sponsorship through foundations dedicated to immunization and by corporate social responsibility programs. - Contain the potential crowding-out effect of GAVI co-financing and ensure that decisions on new vaccine introductions are evidence-based. - Seek out innovative financing mechanisms such as taxes on food products or a national solidarity fund.

背景与目标： : 采用价格比传统疫苗高得多的新疫苗，导致符合免疫联盟资格的国家预防接种计划的预算压力增加，增加了确保其财务可持续性的需求。在这方面，第三次EPIVAC (流行病学和疫苗学) 技术会议于2012年2月16日月18日至18日在贝宁Ouidah的区域公共卫生研究所举行。来自11个西非国家 (符合GAVI资格的国家) 的卫生和财政部经理以及前EPIVAC学生和欧洲专家分享了他们在地区和国家一级预防接种筹资知识和最佳做法。会议结束时强调了符合免疫联盟资格的国家国家预防接种方案财政可持续性的五个主要优先事项。-通过增加资源和财政空间，改善预算程序，增加地方政府的贡献并提高预算支出效率来加强公共融资。-促进公平的社区筹资，这被认为是对扩大免疫方案业务连续性的重大贡献。-通过致力于预防接种基金会和企业社会责任计划探索赞助提供的前景，扩大私人资金。-包含GAVI共同资助的潜在挤出效应，并确保有关新疫苗引进的决定是基于证据的。-寻找创新的融资机制，例如对食品征税或国家团结基金。

BACKGROUND & AIMS: :Stress proteins of the Hsp70 family induced in the blue mussel Mytilus edulis exposed in the laboratory to increased concentrations of cadmium (Cd) or tributhyltin (TBT) were analysed using Western blotting and/or ELISA tests. Statistical evaluation of results indicated that increased concentrations of Hsp70 were detected by means of the ELISA tests as compared with control organisms in extracts from the gills of mussels exposed to both Cd or TBT (p = 0.022). Results of analysis by means of Western blotting showed no differences in the levels of Hsp70 in the extracts (p = 0.151). It was concluded that the ELISA test allowed a more sensitive detection of Hsp70 than did Western blotting.

背景与目标： : 使用Western印迹和/或ELISA测试分析了在实验室中暴露于镉 (Cd) 或三丁锡 (TBT) 浓度增加的蓝贻贝中诱导的Hsp70家族的应激蛋白。结果的统计评估表明，与暴露于Cd或TBT的贻贝的鳃提取物中的对照生物相比，通过ELISA测试检测到Hsp70的浓度增加 (p = 0.022)。通过蛋白质印迹的分析结果显示提取物中Hsp70的水平没有差异 (p = 0.151)。结论是，与蛋白质印迹法相比，ELISA测试可以更灵敏地检测Hsp70。

BACKGROUND & AIMS: :Much of the recent debate over race, genetics, and health has focused on the extent to which typological notions of race have biological meaning. Less attention, however, has been paid to the assumptions about the nature of "populations" that both inform contemporary biological and medical research and that underlie the concept of race. Focusing specifically on Africa in the 1930s and 1940s, this paper explores the history of how fluid societies were transformed into bounded units amenable to scientific analysis. In the so-called "Golden Age of Ethnography," university-trained social anthropologists, primarily from Britain and South Africa, took to the field to systematically study, organize, and order the world's diverse peoples. Intent on creating a scientific methodology of neutral observation, they replaced amateur travelers, traders, colonial administrators, and missionaries as authoritative knowledge producers about the customs, beliefs, and languages of indigenous peoples. At the same time, linguists were engaged in unifying African languages and mapping language onto primordial "tribal" territories. We argue that the notion of populations or "tribes" as discrete units suitable for scientific sampling and classification emerged in the 1930s and 1940s with the ethnographic turn in social anthropology and the professionalization and institutionalization of linguistics in Western and South African universities. Once named and entered into international atlases and databases by anthropologists in the U.S., the existence of populations as bounded entities became self-evident, thus setting the stage for their use in large-scale population genetic studies and the contemporary reinvigoration of broad claims of difference based on population identification.

背景与目标： : 最近关于种族，遗传学和健康的许多辩论都集中在种族类型学概念在多大程度上具有生物学意义。然而，人们对 “人口” 性质的假设的关注较少，这些假设既为当代生物学和医学研究提供了信息，又为种族概念奠定了基础。本文特别关注20世纪30年代和20世纪40年代的非洲，探讨了流动社会如何转变为适合科学分析的有限单位的历史。在所谓的 “民族志的黄金时代” 中，主要来自英国和南非的受过大学训练的社会人类学家进入该领域，系统地研究，组织和秩序世界上的各个民族。为了建立一种科学的中立观察方法，他们取代了业余旅行者，商人，殖民地管理者和传教士，成为有关土著人民习俗，信仰和语言的权威知识生产者。同时，语言学家致力于统一非洲语言并将语言映射到原始的 “部落” 领土上。我们认为，人口或 “部落” 作为适合科学采样和分类的离散单位的概念出现在20世纪30年代中，并与社会人类学的人种学转向以及西方和南非大学语言学的专业化和制度化20世纪40年代。一旦被美国人类学家命名并进入国际地图集和数据库，种群作为有界实体的存在就变得不言而喻了，从而为它们在大规模种群遗传研究中的使用奠定了基础，并在当代重振了广泛的主张基于种群识别的差异。

BACKGROUND & AIMS: INTRODUCTION:KwaZulu-Natal (KZN), South Africa (SA) has the highest prevalence of pregnant women living with HIV in the world. Pregnancy and the postpartum period offer opportunities to engage women in HIV care, to prevent perinatal transmission and to optimise maternal and infant well-being. However, research suggests that remaining engaged in HIV care during this time can be challenging. METHODS AND ANALYSIS:We are conducting a 5-year prospective cohort study among pregnant women living with HIV in KZN to estimate the rates and factors associated with attrition from HIV care during this critical period. To determine who is most likely to fall out of care, we are examining a range of relevant variables informed by a socioecological model of HIV care, including individual, relational, community and healthcare system variables. We are enrolling 18-45-year-old women, at 28 weeks or more of pregnancy, who are living with HIV and currently taking antiretroviral therapies. Participants complete quantitative assessments at baseline (pregnancy) and at 6, 12, 18 and 24 months postpartum. A subset of women and their partners are invited to complete qualitative interviews to further explore their experiences in HIV care. The main study outcomes are suppressed HIV RNA and retention in care at each study assessment. Our understanding of the factors that drive postpartum attrition from HIV care will ultimately inform the development of interventions to facilitate continued engagement in postpartum HIV care. ETHICS AND DISSEMINATION:This protocol has been approved by the Human Research Ethics Committee (Medical) at The University of the Witwatersrand (Johannesburg, SA) and the Partners Human Research Committee at Partners HealthCare (Boston, Massachusetts, USA). Site support and approval were obtained from the District Hospital and the KZN Provincial Department of Health. Results will be disseminated through peer-reviewed manuscripts, reports and both local and international presentations (Ethics Registration #170 212).

背景与目标：

BACKGROUND & AIMS: :Little is known about the association of diet with risk of bladder cancer. This might be due to the fact that the majority of studies have focused on single food items, rather than dietary patterns, which may better capture any influence of diet on bladder cancer risk. We aimed to investigate the association between a measure of Western dietary pattern and bladder cancer risk. Associations between adherence to a Western dietary pattern and risk of developing bladder cancer were assessed by pooling data from 13 prospective cohort studies in the "BLadder cancer Epidemiology and Nutritional Determinants" (BLEND) study and applying Cox regression analysis. Dietary data from 580 768 study participants, including 3401 incident cases, and 577 367 noncases were analyzed. A direct and significant association was observed between higher adherence to a Western dietary pattern and risk of bladder cancer (hazard ratio (HR) comparing highest with lowest tertile scores: 1.54, 95% confidence interval (CI): 1.37, 1.72; P-trend = .001). This association was observed for men (HR comparing highest with lowest tertile scores: 1.72; 95% CI: 1.51, 1.96; P-trend = .001), but not women (P-het = .001). Results were consistent with HR above 1.00 after stratification on cancer subtypes (nonmuscle-invasive and muscle-invasive bladder cancer). We found evidence that adherence to a Western dietary pattern is associated with an increased risk of bladder cancer for men but not women.

背景与目标： : 对饮食与膀胱癌风险的关系知之甚少。这可能是因为大多数研究都集中在单一食物上，而不是饮食模式，这可能更好地捕捉饮食对膀胱癌风险的任何影响。我们的目的是调查西方饮食模式与膀胱癌风险之间的关系。通过汇总来自 “膀胱癌流行病学和营养决定因素” (BLEND) 研究中的13项前瞻性队列研究的数据并应用Cox回归分析，评估了对西方饮食习惯的依从性与患膀胱癌风险之间的关联。分析了来自580-768个研究参与者的饮食数据，包括3401个事件病例和577-367个非病例。观察到对西方饮食模式的较高依从性与膀胱癌风险之间存在直接且显着的关联 (风险比 (HR) 比较最高和最低的三元分数: 1.54，95% 置信区间 (CI): 1.37，1.72; P-趋势 = .001)。在男性中观察到这种关联 (HR比较最高和最低分数: 1.72; 95% CI: 1.51，1.96; P-趋势 = .001)，而女性则没有 (P-het = .001)。在癌症亚型 (非肌层浸润性和肌肉浸润性膀胱癌) 分层后，结果与1.00以上的HR一致。我们发现有证据表明，坚持西方饮食习惯与男性 (而非女性) 患膀胱癌的风险增加有关。

BACKGROUND & AIMS: :Drug utilization research describes the extent, nature and determinants of drug use in populations and aims to facilitate the more rational use of medicines. The departments of Pharmacology and Clinical Pharmacy at the Manipal College of Medical Sciences, Pokhara, Nepal are committed to promoting the more rational use of medicines. The departments run a Drug Information Center and a Pharmacovigilance Center in the teaching hospital. Over the last eight years, the departments have conducted drug utilization studies in the teaching hospital and the community. A few of these were of the intervention type and drug use was studied before and after the intervention. Members of the departments are on the hospital Drug and Therapeutics Committee. Educational initiatives to improve prescribing have been carried out in a few instances. Restricting the number of brands in the hospital pharmacy and creation of a hospital drug list has been carried out. The impact of these initiatives has been studied only in a few cases. Generic prescribing was found to be low. The educational initiatives to improve prescribing had only limited success. The hospital is in the process of framing antimicrobial use guidelines for various departments. A hospital formulary is under preparation. The influence of drug utilization studies on the prescribing patterns has been low to moderate. The department of Clinical Pharmacy runs a Medication Counseling Center in the hospital and teaches appropriate use of medicines to patients. The studies and initiatives to promote the more rational use of medicines should be continued and strengthened.

背景与目标： : 药物利用研究描述了人群中药物使用的程度，性质和决定因素，旨在促进更合理地使用药物。尼泊尔博克拉的Manipal医学院的药理学和临床药学系致力于促进药物的更合理使用。这些部门在教学医院设有药物信息中心和药物警戒中心。在过去的八年中，各部门在教学医院和社区进行了药物利用研究。其中一些属于干预类型，干预前后对药物使用进行了研究。这些部门的成员是医院药物和治疗委员会的成员。在一些情况下，已经开展了改善处方的教育举措。限制医院药房的品牌数量并创建医院药品清单。仅在少数情况下研究了这些举措的影响。通用处方被发现很低。改善处方的教育举措仅取得了有限的成功。医院正在为各个部门制定抗菌药物使用指南。医院处方集正在准备中。药物利用研究对处方模式的影响是低到中等的。临床药学系在医院经营药物咨询中心，并向患者教授药物的适当使用。应继续并加强促进更合理使用药物的研究和举措。

BACKGROUND & AIMS: BACKGROUND:Youth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. METHODS:Using data from the Botsha Bophelo Adolescent Health Survey (BBAHS), prevalence of "ever" experiencing a traumatic event among adolescents (aged 14-19) was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C) scale (19 items, study alpha = 0.63). We assessed self-reported number of potentially traumatic events (PTEs) experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of 'high PTE score' (≥7 PTEs). RESULTS:Overall, 767/830 (92%) participants were included (58% adolescent women). Nearly all (99.7%) reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19). Adolescent men reported more violent PTEs (e.g., "seen an act of violence in the community") whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., "family member or someone close died of HIV/AIDS"). High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively). For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63); and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76). Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03,) and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37). CONCLUSION:Nearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with depression and inconsistent condom use suggest pathways for HIV risk. HIV prevention interventions targeting adolescents must address the syndemics of trauma and HIV through the scale-up of gender-transformative, youth-centred, trauma-informed integrated HIV and mental health services.

背景与目标：