BACKGROUND & AIMS: This study was designed to validate the utility of a commercial portable clinical blood analyzer (PCBA) in ground-based studies and on the space shuttle. Ionized calcium, pH, electrolytes, glucose, and hematocrit were determined. Results agreed well with those from traditional laboratory methods, and the PCBA demonstrated good between-day precision for all analytes. In-flight analysis of control samples revealed differences in one analyte (sodium). There were few changes in crew members' results during flight, and these were expected. Potassium increased in flight compared with before flight, and potassium, pH, and hematocrit decreased after flight. Ionized calcium was decreased in flight and on landing day. Changes during flight were likely related to sample collection technique. Postflight changes likely reflected the fluid redistribution that occurs after exposure to weightlessness. These data confirm that the PCBA is a reliable instrument for most analytes, and can provide important medical data in remote locations, such as orbiting spacecraft.

背景与目标： 这项研究旨在验证商用便携式临床血液分析仪 (PCBA) 在地面研究和航天飞机上的实用性。测定了离子钙，pH，电解质，葡萄糖和血细胞比容。结果与传统实验室方法的结果非常吻合，并且PCBA对所有分析物均显示出良好的日间精度。对照样品的飞行分析显示一种分析物 (钠) 存在差异。在飞行过程中，机组人员的结果几乎没有变化，这是可以预料的。与飞行前相比，飞行中钾增加，飞行后钾，pH和血细胞比容降低。在飞行中和着陆日，离子钙减少。飞行过程中的变化可能与样品收集技术有关。飞行后的变化可能反映了失重后发生的流体重新分布。这些数据证实了PCBA对于大多数分析物来说是一种可靠的仪器，并且可以在偏远的地方提供重要的医学数据，例如绕行航天器。

BACKGROUND & AIMS: STUDY OBJECTIVE:To assess the prognostic performance of general severity systems (APACHE II [acute physiology and chronic health evaluation], simplified acute physiology score [SAPS II], and mortality probability models [MPM II]) in coronary patients and to derive new customized indexes for coronary patients using a reduced number of variables.

DESIGN:Inception cohort.

SETTING:Adult medical and surgical ICUs in 17 hospitals in Catalonia and the Balearic Islands.

PATIENTS:Four hundred fifty-six patients with acute myocardial infarction.

MEASUREMENTS AND RESULTS:The APACHE II, SAPS II, and MPM II variables and survival status at hospital discharge have been collected. Performance of the severity systems was assessed by evaluating calibration and discrimination. Logistic regression was used to customize the MPM II(24) and SAPS II indexes. Discrimination was high enough for all of the models. However, calibration of the MPM II(24) was not as satisfactory as for the other models. The MPM II(24) and SAPS II were both reduced to five variables (MPM II(24 cor:) age, PaO2, continuous vasoactive drugs, urinary output, and mechanical ventilation; SAPS II(cor:) age, PaO2/FI(O2) ratio, systolic BP, Glasgow coma score, and urinary output). Both models showed better calibration and discrimination than the original ones.

CONCLUSIONS:Prognostic indexes developed for multidisciplinary patients show good performance when applied to patients with acute myocardial infarction, but customization can reduce the number of variables necessary to compute them without a loss of, and a possible improvement in, prognostic accuracy.

背景与目标： 研究目标 : 评估一般严重程度系统 (APACHE II [急性生理学和慢性健康评估]，简化的急性生理学评分 [SAPS II]，和冠心病患者的死亡率概率模型 [MPM II])，并使用减少的变量数量为冠心病患者推导新的定制指标。
设计 : 初始队列。
设置 : 加泰罗尼亚和巴利阿里群岛17家医院的成人医疗和外科重症监护医师。
患者 : 456例急性心肌梗死患者。
测量和结果 : 已收集APACHE II，SAPS II和MPM II变量以及出院时的生存状态。通过评估校准和判别来评估严重性系统的性能。Logistic回归用于定制MPM II(24) 和SAPS II指数。歧视对于所有模型来说都足够高。但是，MPM II(24) 的校准不如其他模型令人满意。MPM II(24) 和SAPS II均降低为五个变量 (MPM II(24 cor :) 年龄，PaO2，持续血管活性药物，尿量和机械通气; SAPS II(cor :) 年龄，PaO2/FI(O2) 比，收缩压，格拉斯哥昏迷评分，和尿量)。两种模型均显示出比原始模型更好的校准和区分度。
结论 : 为多学科患者开发的预后指标在应用于急性心肌梗死患者时显示出良好的表现，但是，自定义可以减少计算它们所需的变量数量，而不会损失预后准确性，并可能提高预后准确性。

BACKGROUND & AIMS: :Assessment of wound healing is a complex task, especially when the lesion is associated to significant (full thickness) loss of the skin. The clinical observation, essentially subjective and highly dependent on the observer's experience, creates difficulties in the comparison of results. Scoring scales were introduced in the clinical practice to create comparable semi-quantitative data and promote better management of resources, but its usefulness in a clinical perspective is still limited. New non-invasive biometric methodologies, although infrequently used, have opened new possibilities. While complementing the clinical observation and contributing to therapeutic decisions and prognosis, they may also help to look further into the pathophysiological mechanisms of scarring drugs rehabilitation. Following previous work in this arena, the authors review, the state-of-the-art of cutaneous wound healing clinical and biometric follow up, proposing a diagnosis correlation for the most relevant descriptors found in both strategies in order to fully characterise the different stages of the healing process.

背景与目标： : 评估伤口愈合是一项复杂的任务，尤其是当病变与皮肤的显着 (全层) 损失相关时。临床观察本质上是主观的，并且高度依赖于观察者的经验，因此在比较结果方面造成了困难。在临床实践中引入了评分量表，以创建可比较的半定量数据并促进更好的资源管理，但其在临床方面的实用性仍然有限。新的非侵入性生物识别方法虽然很少使用，但开辟了新的可能性。在补充临床观察并有助于治疗决策和预后的同时，它们也可能有助于进一步研究疤痕药物康复的病理生理机制。在这个领域的先前工作之后，作者回顾了皮肤伤口愈合的最新技术，临床和生物特征随访，提出了两种策略中最相关的描述符的诊断相关性，以便充分表征不同的特征愈合过程的阶段。

BACKGROUND & AIMS: :The work of the main European research teams in the field of thermal factors was coordinated in order to improve significantly the Required Sweat Rate model published as an international standard. Many significant modifications were brought, in particular concerning the effects of forced convection, body movements and exercise and the prediction of the skin temperature as a function of the rectal temperature and in case of severe conditions of radiation, humidity and clothing. The criteria for acceptable work durations in hot environments were updated concerning the maximum increase in core temperature and the acceptable water loss. The revised model, called Predicted Heat Strain model, was validated through a set of lab and field experiments involving stable and fluctuating conditions with high and low radiation, humidity and air velocity. It is meanwhile adopted as an ISO and CEN standard. In addition, a strategy was developed to assess the risks of heat disorders in any working situation. It is based on the three highest stages of the SOBANE strategy: an "Observation" method for improving simply the thermal conditions of work; an "Analysis" method to evaluate the magnitude of the problem and optimise the choice of solutions and an "Expert" method for in depth analysis of the working situation when needed.

背景与目标： : 协调了欧洲主要研究小组在热因素领域的工作，以显着改善作为国际标准发布的所需汗率模型。进行了许多重大修改，特别是在强迫对流，身体运动和运动的影响以及皮肤温度随直肠温度的变化以及在辐射，湿度和衣服的严酷条件下的预测方面。更新了在高温环境中可接受的工作持续时间的标准，涉及岩心温度的最大升高和可接受的水损失。修订后的模型称为预测热应变模型，已通过一系列实验室和现场实验进行了验证，这些实验涉及高辐射和低辐射，湿度和空气速度的稳定和波动条件。同时被采用为ISO和CEN标准。此外，还制定了一项战略，以评估任何工作情况下的热病风险。它基于SOBANE策略的三个最高阶段: 一种 “观察” 方法，用于简单地改善工作的热条件; 一种 “分析” 方法，用于评估问题的严重性并优化解决方案的选择，以及一种 “专家” 方法，用于在需要时深入分析工作情况。

BACKGROUND & AIMS: PURPOSE:A prospective evaluation of spiral CT angiography (SCTA) as the sole pre-operative imaging modality for abdominal aortic aneurysm repair.

MATERIALS AND METHODS:Spiral CT angiography was compared with conventional transfemoral angiography in 30 patients and results correlated with surgical findings in 22 patients. The following features were assessed: renal artery number and disease; upper and lower aneurysm extent; aneurysm size; perianeurysmal inflammation; iliac artery disease; radiation dose; and contrast usage.

RESULTS:Spiral CT angiography agreed with conventional angiography in all cases of severe stenosis or occlusion of renal arteries and had 90% agreement overall for renal artery disease. Two of nine accessory renal arteries seen at conventional angiography were missed. For showing aneurysm extent SCTA was 100% sensitive, and performed better than conventional angiography. Aneurysm size was better shown with SCTA. In iliac disease SCTA, as performed in this study, was poor for mild-moderate disease, but detected four of six severely stenosed/occluded iliac arteries seen at conventional angiography. Prospective sensitivity for perianeurysmal inflammation was 33%. Radiation dose for SCTA was approximately twice and contrast dose approximately three times that for conventional angiography.

CONCLUSION:Spiral CT angiography can provide all the necessary imaging information to plan aneurysm repair in the non-claudicant.

背景与目标： 目的 : 对螺旋ct血管造影 (SCTA) 作为腹主动脉瘤修复的唯一术前成像方式的前瞻性评估。
材料和方法 : 将30例患者的螺旋ct血管造影与常规经股动脉造影进行了比较，结果与22例患者的手术结果相关。评估了以下特征: 肾动脉数量和疾病; 上，下动脉瘤范围; 动脉瘤大小; 动脉瘤周围炎症; 髂动脉疾病; 辐射剂量; 和造影剂使用。
结果 : 在所有严重肾动脉狭窄或闭塞的病例中，螺旋ct血管造影与常规血管造影一致，并且在肾动脉疾病方面总体上90% 一致。在常规血管造影中观察到的9条副肾动脉中有2条被遗漏。对于显示动脉瘤范围，SCTA 100% 敏感，并且比常规血管造影更好。SCTA能更好地显示动脉瘤大小。在本研究中进行的SCTA在轻度-中度疾病中较差，但在常规血管造影术中发现了六个严重狭窄/闭塞的动脉中的四个。33% 了对动脉瘤周围炎症的前瞻性敏感性。SCTA的辐射剂量约为常规血管造影的两倍，造影剂剂量约为常规血管造影的三倍。
结论 : 螺旋ct血管造影可以提供所有必要的成像信息，以计划非幽闭者的动脉瘤修复。

BACKGROUND & AIMS: BACKGROUND:MR digital subtraction angiography (MR-DSA) is a contrast-enhanced MR angiographic sequence that enables time-resolved evaluation of the cerebral circulation. OBJECTIVE:We describe the feasibility and technical success of our attempts at MR-DSA for the assessment of intracranial pathology in children. MATERIALS AND METHODS:We performed MR-DSA in 15 children (age range 5 days to 16 years) referred for MR imaging because of known or suspected intracranial pathology that required a dynamic assessment of the cerebral vasculature. MR-DSA consisted of a thick (6-10 mm) slice-selective RF-spoiled fast gradient-echo sequence (RF-FAST) acquired before and during passage of an intravenously administered bolus of Gd-DTPA. The images were subtracted and viewed as a cine loop. RESULTS:MR-DSA was performed successfully in all patients. High-flow lesions were shown in four patients; these included vein of Galen aneurysmal malformation, dural fistula, and two partially treated arteriovenous malformations (AVMs). Low-flow lesions were seen in three patients, all of which were tumours. Normal flow was confirmed in eight patients including two with successfully treated AVMs, and in three patients with cavernomas. CONCLUSION:Our early experience suggests that MR-DSA is a realistic, non-invasive alternative to catheter angiography in certain clinical settings.

背景与目标：

BACKGROUND & AIMS: :The aim of this pilot study was to investigate anaesthetists' assessment of the ability of patients to increase cardiac output over a range of clinical scenarios and of their perceived 'likelihood of transfusion' in these scenarios. Specialist anaesthetists were given a questionnaire with clinical cues in the form of diagnoses about theoretical patients. They were asked to use 100 mm visual analogue scales (VAS) for their assessments of each patient's cardiac reserve and their 'likelihood of transfusion' of these patients; the endpoints of the VAS being 'Very low' (0 mm) to 'High' (100 mm), and 'Do not transfuse' (0 mm) to 'Transfuse' (100 mm) respectively. The assessment of patients' cardiac output reserve by anaesthetists (n = 54) showed great variation; for example, a patient with severe aortic stenosis was perceived overall to have a limited ability to increase cardiac output (mean VAS 16 mm) but there was considerable variation between anaesthetists (25-75 percentiles 10 mm to 21 mm). Assessment of 'likelihood of transfusion' (n = 42) also had great variation; as an example a patient with 'angina' with a haemoglobin of 95 g l(-1) was perceived overall to have an average likelihood of transfusion of 50 mm, but the 25-75 percentiles ranged from 33 mm to 71 mm. This study suggests that inter-anaesthetist variability in the assessment of a patient's 'cardiac output reserve' and his 'likelihood of transfusion' is large.

背景与目标： : 这项初步研究的目的是调查麻醉师对患者在一系列临床情况下增加心输出量的能力的评估，以及他们在这些情况下感知到的 “输血可能性”。以理论患者的诊断形式向专科麻醉师提供了一份带有临床线索的问卷。他们被要求使用100毫米视觉模拟量表 (VAS) 来评估每个患者的心脏储备和这些患者的 “输血可能性”; VAS的终点是 “非常低” (0毫米) 到 “高” (100毫米)，和 “不输血” (0毫米) 分别转换为 “输血” (100毫米)。麻醉师 (n = 54) 对患者心输出量储备的评估显示出很大的差异; 例如，总体上认为患有严重主动脉瓣狭窄的患者增加心输出量的能力有限 (平均VAS 16毫米)，但麻醉师之间存在相当大的差异 (25-75个百分位数10毫米至21毫米)。“输血可能性” 的评估 (n = 42) 也有很大的差异; 例如，具有95g l(-1) 血红蛋白的 “angina” 患者总体上被认为平均输血可能性为50毫米，但25-75个百分位数范围为33毫米至71毫米。这项研究表明，在评估患者的 “心输出量储备” 和他的 “输血可能性” 时，麻醉师间的变异性很大。

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：

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带状疱疹 (SHEZ) 研究旨在阐明以社区为基础的日本人群中带状疱疹的发生率以及预测和免疫学因素。作为本系列的一部分，共有5683名年龄 ≥ 50岁的居民接受了VZV抗原的水痘病毒 (VZV) 皮肤测试，48小时后，通过测量最长直径来评估红斑和水肿。随着受试者年龄的增长，红斑和水肿的直径均减小。接受VZV皮肤测试后一年内，有63名受试者感染了带状疱疹。对带状疱疹发病率与皮肤测试反应的分析表明，红斑或水肿的直径越短，带状疱疹的可能性越大。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: :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： : 有关终末期肾病 (ESRD) 患者治疗率的统计数据表明，英国每百万人口中ESRD患者的数量近年来增长缓慢。英国移植学会1983年和1984发放了问卷，以确定移植的患者人数、合适的患者人数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患者的百分比却很低，并且在糖尿病患者和老年人的治疗方面存在 “社会上不可接受的缺陷”。

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： : 进行了大规模研究，以确定药房中抗肿瘤药物的污染水平，并调查定期擦拭样品监测的适用性和效果。开发了一个特定的研究设计。将130家参与的药房分为研究组和对照组，分别进行了五个和两个擦拭采样周期。使用问卷调查对工作实践进行了分析，以确定影响污染水平的因素。从1269擦拭样品中，774 (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减少。药房擦拭采样方法的监测效果研究已被证明是控制污染的可靠且负担得起的工具。根据污染值的第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: :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体外正常，良性和癌性人肺组织通透性的影响，并找到与光学清除剂 (OCAs) 结合更有效的超声电泳 (SP) 递送方法，以区分正常和患病的肺组织。用傅里叶域光学相干断层扫描 (fd-oct) 测量SP与OCAs扩散在肺组织中的渗透系数。在3厘米探针上同时施加频率为1 MHz且强度为0.80   W w/cm2的30% 葡萄糖和SP 15分钟。实验结果表明，30% 葡萄糖/SP对正常肺 (NL) 组织的平均渗透系数为 (2.01 ± 0.21)× 10(-5)  cm cm/s，肺良性肉芽肿 (LBG) 组织 (2.75 ± 0.28)× 10(-5)  cm/s，肺腺癌肿瘤 (LAT) 组织 (4.53 ± 0.49)× 10(-5)  cm/s，和 (5.81 ± 0.62)× 10(-5)  cm cm/s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约36.8% 、125.4% 和189.1%。LBG与NL组织之间 (p<0.05)，LAT与NL组织之间 (p<0.05) 以及LSCC与NL组织之间 (p<0.05) 的30% 葡萄糖/SP的渗透系数差异有统计学意义。结果表明，OCT功能成像技术结合超声-OCAs组合方法可以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： : 正常 “健康” 儿童和成人的膳食蛋白质和氨基酸需求建议差异很大，2007粮农组织/世卫组织儿童的蛋白质需求估计值较低，但成人的膳食必需AA需求增加了一倍以上。所提出的需求估计数没有考虑到发展中国家普遍存在的共同生活条件，例如能源短缺，感染负担以及对蛋白质和AAs的功能需求增加。这项研究检查了调整膳食总蛋白质的质量和消化率 (PDCAAS) 以及纠正当前蛋白质和AA对感染和轻度能量不足的影响，以估计可利用的蛋白质 (根据生物学价值和消化率校正的总蛋白质) 和蛋白质不足的风险/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的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 (粮食供应) 、儿童基金会 (发育迟缓流行率) 、开发署 (国内生产总值) 和统计司 (IMR) 以及USDA营养表。统计分析包括Pearson相关性，配对样本/非参数t检验和线性回归。在使用总蛋白质和当前蛋白质需求与可利用蛋白质和所有区域的调整后蛋白质需求的风险/患病率估计中，观察到统计学上的显着差异 (p <0·05)。总蛋白质，可利用蛋白质，人均GDP和总能量均与发育迟缓的患病率高度相关。能量，蛋白质和可利用的蛋白质利用率与发育迟缓独立且负相关 (p <0·001)，分别解释了变异的41%，34% 和40%。控制能量，总蛋白不是统计学上的显着因素，但可利用的蛋白质仍然显着解释了约45% 的方差 (p = 0.017)。与粗蛋白摄入相比，饮食中可利用的蛋白质提供了更好的人口对蛋白质不足风险/患病率的影响指数。我们得出的结论是，在评估仍然存在这些疾病的人群的需求时，应适当考虑由于感染和轻度至中度能量不足而导致的蛋白质需求增加。

BACKGROUND & AIMS: :In the isolated rat heart perfused with glucose as substrate, measurements were made of perfusate and tissue lactate and pyruvate concentrations, and of tissue α-glycerophosphate and dihydroxyacetone phosphate concentrations. The conditions studied included increased heart work, anoxia, the addition of insulin, acute alloxan diabetes, chronic streptozotocin diabetes, and the addition of ketone bodies. True intracellular lactate values (estimated from the lactate and sorbitol spaces) and apparent tissue values exceeded perfusate values, showing the existence of a lactate concentration gradient. During anoxia, the lactate gradient diminished. Cytoplasmic free NAD+/NADH ratios calculated from the extracellular lactate/pyruvate ratio were similar to and changed in the same direction as the NAD+/NADH ratios calculated from the tissue α-glycerophosphate/dihydroxyacetone phosphate ratios in non-diabetic hearts. In diabetio hearts, extracellular and tissue lactate/pyruvate ratios gave different values for the cytoplasmic free NAD+/NADH ratios than did tissue α-glycero-phoaphate/dihydroxyacetone phosphate ratios. These discrepancies were associated with accumulation of pyruvate in the perfusate and the tissue. Changes in the extracellular lactate/pyruvate ratio gave a better differentiation between acute heart work and acute anoxia than did changes in the heart lactate/pyruvate ratio. The use of extracellular lactate/ pyruvate measurements in assessing the state of myocardial oxygenation is supported by these observations, provided that nutritional factors are taken into account and the diabetic state is excluded.

背景与目标： : 在以葡萄糖为底物灌注的离体大鼠心脏中，测量灌注液和组织乳酸和丙酮酸的浓度，以及组织 α-甘油磷酸和二羟基丙酮磷酸的浓度。研究的条件包括增加心脏工作，缺氧，添加胰岛素，急性四氧嘧啶糖尿病，慢性链脲佐菌素糖尿病和添加酮体。真实的细胞内乳酸值 (从乳酸和山梨醇空间估算) 和表观组织值超过灌注液值，表明存在乳酸浓度梯度。在缺氧期间，乳酸梯度减小。在非糖尿病心脏中，由细胞外乳酸/丙酮酸比率计算出的无细胞质NAD/NADH比率与由组织 α-甘油磷酸/二羟基丙酮磷酸盐比率计算出的NAD/NADH比率相似，并沿相同方向变化。在糖尿病心脏中，细胞外和组织乳酸/丙酮酸比率给出的细胞质游离NAD/NADH比率与组织 α-甘油磷酸酯/二羟基丙酮磷酸盐比率不同。这些差异与灌注液和组织中丙酮酸的积累有关。细胞外乳酸/丙酮酸比率的变化比心脏乳酸/丙酮酸比率的变化更好地区分了急性心脏工作和急性缺氧。这些观察结果支持使用细胞外乳酸/丙酮酸测量来评估心肌氧合状态，前提是要考虑营养因素并排除糖尿病状态。

BACKGROUND & AIMS: The recent ratification of the World Trade Organisation Agreement will arguably be the most important factor in developing new sanitary measures for the international trade in food over the next decade. There is a markedly increased desire for quantitative data on the microbial risks associated with different classes of foods, and traditional good manufacturing practice (GMP)-based food hygiene requirements are coming under increasing challenge. As the risk assessment paradigm is increasing applied and as decision-making criteria for risk management become established, more emphasis will be placed on predictive microbiology as a means of generating exposure data and establishing critical limits for Hazard Analysis Critical Control Point (HACCP) plans. In this respect, developing international guidelines for risk management arguably presents the greatest challenge in establishing and maintaining quantitative Sanitary and Phytosanitary (SP) measures for food in international trade, and for judging their equivalence. Where specific industry sectors and regulators do not have jurisdiction over the entire food chain, from production of raw materials through to consumption, it will be difficult to apply the risk assessment paradigm in the design of HACCP plans. Thus, it appears that default to food safety objectives for many segments of food production chains subject to application of HACCP plans is inevitable in the medium term.

背景与目标： 世界贸易组织最近批准的协议可以说是在未来十年为国际食品贸易制定新的卫生措施的最重要因素。对与不同类别食品相关的微生物风险的定量数据的需求明显增加，并且基于传统良好生产规范 (GMP) 的食品卫生要求正面临越来越大的挑战。随着风险评估范式的应用越来越多，随着风险管理决策标准的建立，将更加重视预测微生物学，作为生成暴露数据和建立危害分析关键控制点 (HACCP) 计划关键限值的一种手段。在这方面，制定国际风险管理准则可以说是建立和维持国际贸易中食品定量卫生和植物检疫措施以及判断其等效性的最大挑战。如果特定的行业部门和监管机构对从原材料生产到消费的整个食物链没有管辖权，那么将很难在HACCP计划的设计中应用风险评估范式。因此，在中期看来，受HACCP计划约束的食品生产链的许多部分默认食品安全目标是不可避免的。