BACKGROUND & AIMS: :Five hundred eighty-nine dog blood samples from the small animal hospital of Chiang Mai University were examined for Dirofilaria immitis prevalence using a microhematocrit tube technique for microfilaria detection. In parallel, a once a month follow-up study on 36 D. immitis negative dogs was conducted to detect the time of acquiring infection in each animal. The diagnostic criteria for the incidence study was based on microfilaria detection or on positive findings against D. immitis antigen using the Witness commercial kit. The estimated prevalence was 18.2% (15-21%; 95% CI). There was no statistical difference between male and female infection rates. The age-specific prevalence of dogs under 2 years old was 6.4%, which was lower than the 2-4 year old group and all the other age groups at a 95% confidence level. In older dogs the prevalence reached 41.5%. Most of the dogs housed outdoors had a statistically higher infection rate than the dogs housed indoors (chi-square = 9.662, 1 df, p = 0.002). Only 109 dogs received chemoprophylaxis resulting in a significantly lower infection rate than in the non-heartworm prevention dogs (chi-square =14.424, 1 df, p = 0.000). The overall incidence density and the incidence during the rainy, cool and hot seasons were 5.2, 6.9, 3.5, and 2.7 animals per 100 animal-months, respectively. The incidence rate ratio between wet/dry, rainy/cool, rainy/summer, and cool/hot seasons were 2.18, 1.98, 2.59 and 1.30, respectively. The 95% confidence interval revealed no difference among seasons. In conclusion, dogs in D. immitis endemic northern Thailand contract infection in about 2 years.

背景与目标： : 使用微血细胞比容管技术检测微丝虫，检查了清迈大学小动物医院的五百八十九只狗血样的双丝虫患病率。同时，对36 D. immitis阴性犬进行了每月一次的随访研究，以检测每只动物感染的时间。发病率研究的诊断标准基于微丝虫检测或使用Witness商业试剂盒针对D. immitis抗原的阳性结果。估计患病率为18.2% (15-21%; 95% CI)。男性和女性感染率之间没有统计学差异。2岁以下狗的特定年龄患病率为6.4%，低于2-4岁组和所有其他年龄组的95% 置信度。在年长的狗中，患病率达到41.5%。大多数室外饲养的狗比室内饲养的狗具有统计学上更高的感染率 (卡方 = 9.662，1 df，p = 0.002)。仅109只狗接受了化学预防，导致与非心丝虫预防犬的感染率显着降低 (卡方 = 14.424，1 df，p = 0.000)。总发病率密度和雨季，凉爽季节和炎热季节的发病率分别为每100动物月5.2，6.9，3.5和2.7只动物。湿/干、雨/凉、雨/夏和凉/热季节之间的发病率比分别为2.18、1.98、2.59和1.30。95% 的置信区间显示季节之间没有差异。总之，泰国北部流行的D. immitis犬在大约2年内感染。

BACKGROUND & AIMS: :Organophosphate and carbamate pesticides have been widely used by farmers for crop protection and pest control. Inhibition of acetylcholinesterase (AChE) in erythrocyte and butyrylcholinesterase (BChE) in plasma is the predominant toxic effect of organophosphate and carbamate pesticides. Mae Taeng District, Chiang Mai Province, is one of the large areas of growing vegetables and fruits. Due to their regular exposure to these pesticides, the farmers are affected by this toxicity. The objective of the study was to examine the AChE and the BChE activity levels in the blood of 102 farmers for comparison of exposure in two cropping seasons, winter and hot. Blood samples were collected in December 2013 (winter) and April-June 2014 (hot). A total of 102 farmers joined the study, represented by 76 males (74.5 %) and 26 females (25.5 %). The age of most of the farmers was 53.4 ± 8.7 years. Out of 102, 21 farmers used carbamate pesticides. The results showed that the AChE and the BChE activity levels of all the farmers were 3.27 ± 0.84 Unit/mL and 2.15 ± 0.58 Unit/mL, respectively. The AChE and the BChE activity levels in males were 3.31 ± 0.88 Unit/mL and 1.97 ± 0.60 U/mL, respectively, during winter and 3.27 ± 0.82 Unit/mL and 2.15 ± 0.58 U/mL, respectively, during the hot season, and AChE and the BChE activity levels in females were 3.27 ± 0.82 U/mL and 2.44 ± 0.56 U/mL, respectively, during the hot season. The cholinesterase activity levels, both AChE and BChE, in the male farmers' blood had significant difference between the two seasons, while in the case of the female farmers, there was significant difference in the BChE activity levels, at p < 0.05. The BChE activity level was found to significantly correlate with self-spray (p < 0.05), which implies that the BChE activity decreased when they sprayed by themselves. The cholinesterase activity levels of the present study were lower than those of the other studies, which may be an indication of some chronic effect of exposure to anticholinesterase pesticides. Thus, it is recommended that the use of pesticides be decreased, together with increase in the awareness of the impact of pesticides on health; also recommended is regular monitoring of blood cholinesterase.

背景与目标： : 有机磷和氨基甲酸酯农药已被农民广泛用于作物保护和病虫害防治。抑制红细胞中的乙酰胆碱酯酶 (AChE) 和血浆中的丁酰胆碱酯酶 (BChE) 是有机磷和氨基甲酸酯农药的主要毒性作用。清迈省湄登区是种植蔬菜和水果的大片地区之一。由于他们经常接触这些农药，农民受到这种毒性的影响。该研究的目的是检查102农民血液中的AChE和BChE活性水平，以比较冬季和炎热两个种植季节的暴露。在2013年12月 (冬季) 和2014年4月到6月 (炎热) 采集血样。共有102名农民参加了这项研究，其中76名男性 (74.5%) 和26名女性 (25.5%)。大多数农民的年龄为53.4   ±   8.7岁。在102中，有21个农民使用了氨基甲酸酯农药。结果表明，所有农户的AChE和BChE活性水平分别为3.27   ±   0.84单位/mL和2.15   ±   0.58单位/mL。冬季男性AChE和BChE活性水平分别为3.31   ±   0.88单位/mL和1.97   ±   0.60 U/mL，炎热季节分别为3.27   ±   0.82单位/mL和2.15   ±   0.58 U/mL，在炎热季节，女性的AChE和BChE活性水平分别为3.27   ±   0.82 U/mL和2.44   ±   0.56 U/mL。雄性农民血液中AChE和BChE的胆碱酯酶活性水平在两个季节之间存在显着差异，而在雌性农民中，BChE活性水平存在显着差异，在p  <  0.05。发现BChE活性水平与自喷显着相关 (p  <  0.05)，这意味着当它们自己喷时BChE活性降低。本研究的胆碱酯酶活性水平低于其他研究，这可能表明暴露于抗胆碱酯酶农药的某些慢性作用。因此，建议减少农药的使用，同时提高对农药对健康影响的认识; 还建议定期监测血液胆碱酯酶。

BACKGROUND & AIMS: :Radon is the leading source of lung cancer mortality after smoking in Chiang Mai, Thailand. Finding a source of carcinogens is one of the important measures for preventing the cancer risk for this region. Specific sites at Pa Miang, Doi Saket have the highest incidences of lung cancer and have a combination of factors that influence indoor radon concentration. Our study identified the sources of indoor radon within several houses. The results indicate that geological and topographic characteristics, including active faults and mountain terraces, are the main sources of indoor radon, especially for wooden houses. Besides building materials, the design of the houses, ventilation conditions, and lifestyle choices are all factors influencing indoor radon concentrations and its associated risk. Although radon levels (29-101 Bq m-3) and total indoor annual effective doses (0.9-3.8 mSv year-1) received from all sources at these sites have shown no significant health risk due to radon exposure , this investigation will be useful as a starting point to guide strategies to respond and prevent the risk of lung cancer, especially in Chiang Mai.

背景与目标： : 氡是泰国清迈吸烟后肺癌死亡的主要来源。寻找致癌物的来源是预防该地区癌症风险的重要措施之一。在Pa Miang，Doi Saket的特定部位具有最高的肺癌发病率，并且具有影响室内ra浓度的多种因素。我们的研究确定了几所房屋内室内ra的来源。结果表明，地质和地形特征 (包括活动断层和山地阶地) 是室内ra的主要来源，尤其是木屋。除建筑材料外，房屋的设计，通风条件和生活方式的选择都是影响室内ra浓度及其相关风险的因素。尽管从这些地点的所有来源获得的ra水平 (29-101 Bq m-3) 和室内年度总有效剂量 (0.9-3.8 mSv year-1) 没有显示出由于ra暴露而导致的重大健康风险，这项调查将作为指导应对和预防肺癌风险的策略的起点，尤其是在清迈。

BACKGROUND & AIMS: :The quantitative assays for house dust mite (HDM) allergens provide a valid index of exposure and can be used for risk evaluation. We assessed group I HDM allergen levels in mattress and living room floor dust from 35 Chiang Mai homes and identified factors associated with high allergen levels. One-third of mattress and living room floor dust had group I HDM allergen levels of between 2-10 microg/g. Two-thirds of mattress dust and a small amount of living room floor dust had group I HDM allergen levels of over 10 microg/g. The geometric means of Der p I, Der f I and total group I allergens in mattress and living room floor dust were 8.61, 2.88, and 15.81 microg/g and 1.61, 0.27 and 2.43 microg/g, respectively. Mattresses made of kapok and rugs kept in the living room were associated with high group I allergen levels.

背景与目标： : 室内尘螨 (HDM) 过敏原的定量测定提供了有效的暴露指标，可用于风险评估。我们评估了来自35个清迈家庭的床垫和客厅地板灰尘中的I组HDM过敏原水平，并确定了与高过敏原水平相关的因素。三分之一的床垫和客厅地板灰尘的I组HDM过敏原水平在2-10微g/g之间。三分之二的床垫灰尘和少量的客厅地板灰尘的I组HDM过敏原水平超过10微克/克。床垫和客厅地板灰尘中Der p I，Der f I和总I组过敏原的几何平均值分别为8.61，2.88和15.81微g/g和1.61，0.27和2.43微g/g。放在客厅里的木棉和地毯制成的床垫与I组过敏原水平较高有关。

BACKGROUND & AIMS: :Rai (ShcC) belongs to the family of Shc adaptor proteins and is expressed in neuronal cells, where it acts as a survival factor activating the PI3K/Akt survival pathway. In vivo, Rai protects the brain from ischemic damage. In this study, we show that Rai is expressed in T and B lymphocytes. Based on the finding that Rai(-/-) mice consistently develop splenomegaly, the role of Rai in lymphocyte homeostasis and proliferation was addressed. Surprisingly, as opposed to neurons, Rai was found to impair lymphocyte survival. Furthermore, Rai deficiency results in a reduction in the frequency of peripheral T cells with a concomitant increase in the frequency of B cells. Rai(-/-) lymphocytes display enhanced proliferative responses to Ag receptor engagement in vitro, which correlates with enhanced signaling by the TCR and BCR, and more robust responses to allergen sensitization in vivo. A high proportion of Rai(-/-) mice develop a lupus-like autoimmune syndrome characterized by splenomegaly, spontaneous peripheral T and B cell activation, autoantibody production, and deposition of immune complexes in the kidney glomeruli, resulting in autoimmune glomerulonephritis. The data identify Rai as a negative regulator of lymphocyte survival and activation and show that loss of this protein results in breaking of immunological tolerance and development of systemic autoimmunity.

背景与目标： : Rai (ShcC) 属于Shc衔接蛋白家族，在神经元细胞中表达，在那里它充当激活PI3K/Akt存活途径的存活因子。在体内，Rai保护大脑免受缺血性损伤。在这项研究中，我们表明Rai在T和B淋巴细胞中表达。基于Rai(-/-) 小鼠持续发展脾肿大的发现，讨论了Rai在淋巴细胞稳态和增殖中的作用。令人惊讶的是，与神经元相反，Rai被发现会损害淋巴细胞的存活。此外，Rai缺乏导致外周T细胞的频率减少，同时b细胞的频率增加。Rai(-/-) 淋巴细胞在体外对Ag受体参与表现出增强的增殖反应，这与TCR和BCR增强的信号传导以及体内对变应原致敏的更强大反应有关。高比例的Rai(-/-) 小鼠发展为狼疮样自身免疫综合征，其特征是脾肿大，自发外周T和b细胞活化，自身抗体产生以及免疫复合物在肾小球中的沉积，从而导致自身免疫性肾小球肾炎。数据将Rai确定为淋巴细胞存活和激活的负调节剂，并表明该蛋白的丢失导致免疫耐受的破坏和全身自身免疫的发展。

BACKGROUND & AIMS: :Vitamin A deficiency can occur during lactation and breast-milk vitamin A has been recommended for monitoring the vitamin A status of lactating women and their infants. This study aimed to investigate the vitamin A status of lactating women in relation to race, age, parity, duration of lactation and anthropometric status. A cross-sectional study was conducted among 262 lactating women in rural Chiang Mai, Thailand. Blood and breast-milk samples were collected. Serum retinol, carotene and breast-milk retinol concentrations were analysed by high-performance liquid chromatography. The results show that mean serum retinol and breast-milk retinol in hill tribes were significantly lower than in Thais, 1.91 (0.59) and 0.79 (0.52) compared with 2.10 (0.51) and 1.04 (0.58) mumol/L, respectively. Mean serum retinol and breast-milk retinol were highest during the 1st 3 months of lactation. Maternal age, parity and anthropometric status (BMI) were not associated with serum or breast-milk retinol concentrations. There was a significant relationship between serum and breast-milk retinol values in women who breastfed for 6 months or longer (regression co-efficients 0.30; 95% CI 0.16, 0.43). Breast-milk retinol levels declined significantly from 4 to 12 months after delivery, which could increase the risk of vitamin A deficiency in children who were exclusively breastfed or receiving inappropriate complementary foods during this period. Weaning foods which commence at 6 months and have an adequate vitamin A content should ensure that the vitamin A status of the young child is maintained.

背景与目标： : 维生素a缺乏症可能发生在哺乳期，母乳维生素a已被推荐用于监测哺乳期妇女及其婴儿的维生素a状况。这项研究旨在调查哺乳期妇女的维生素a状况与种族，年龄，胎次，哺乳期和人体测量状况的关系。在泰国清迈农村的262名哺乳期妇女中进行了一项横断面研究。收集血液和母乳样本。通过高效液相色谱法分析血清视黄醇，胡萝卜素和母乳视黄醇的浓度。结果表明，山地部落的平均血清视黄醇和母乳视黄醇显着低于泰国人，1.91 (0.59) 和0.79 (0.52)，分别低于2.10 (0.51) 和1.04 (0.58) mumol/L。哺乳期前3个月的平均血清视黄醇和母乳视黄醇最高。产妇年龄，胎次和人体测量状态 (BMI) 与血清或母乳视黄醇浓度无关。母乳喂养6个月或更长时间的妇女的血清和母乳视黄醇值之间存在显着关系 (回归系数0.30; 95% CI 0.16，0.43)。母乳视黄醇水平在分娩后4至12个月内显著下降，这可能会增加在此期间纯母乳喂养或接受不适当辅食的儿童维生素a缺乏症的风险。从6个月开始并具有足够维生素a含量的断奶食品应确保维持幼儿的维生素a状态。

BACKGROUND & AIMS: BACKGROUND:PPP1R13L gene has been found to be over-expressed in variety of cancers and its expression in p53 wild-type background is sufficient to promote tumor growth in vivo. However, in the non-transformed cells it acts as a tumor suppressor which suggests that the role of PPP1R13L is multifaceted. METHODS:We have used siRNA optimized for inhibition of p53, PPP1R13L, BAX and GADD45 alpha expression and investigated the role of those gene products for PPP1R13L expression and induction in a variety of mouse and human cells with different p53 status. In addition we have applied Western Blot, Q-PCR and proteasome inhibition analysis to further ascertain the link between PPP1R13L induction and p53 status. RESULTS:We show that the pattern and extent of the PPP1R13L expression depend on the presence of active p53. Downregulation of p53 target genes BAX and/or GADD45 alpha led to decreased in PPP1R13L activation after adriamycin and/or etoposide treatments. Treatment of the cells with the proteasome inhibitor MG-132 resulted in the accumulation of both p53 and PPP1R13L proteins. CONCLUSIONS:We have provided evidence that endogenous PPP1R13L acts as a negative regulator of p53 function, presumably by direct binding. p53 accumulation and activity after DNA damage is compromised by PPP1R13L expression. We suggest that PPP1R13L and p53 form a negative feedback loop which regulates their amount and activity. GENERAL SIGNIFICANCE:The profound modulatory effect of the PPP1R13L protein on the ability of p53 to cause cellular apoptosis has important implications in cancer and presents new therapeutic possibilities.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:This study assessed the validity of the Resident Assessment Instrument Minimum Data Set (RAI-MDS) Version 2.0 for diagnoses of diabetes and comorbid conditions in residents of long-term care facilities (LTCFs). METHODS:Hospital inpatient, outpatient physician billing, RAI-MDS, and population registry data for 1997 to 2011 from Saskatchewan, Canada were used to ascertain cases of diabetes and 12 comorbid conditions. Prevalence estimates were calculated for both RAI-MDS and administrative health data. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated using population-based administrative health data as the validation data source. Cohen's κ was used to estimate agreement between the two data sources. RESULTS:23,217 LTCF residents were in the diabetes case ascertainment cohort. Diabetes prevalence was 25.3% in administrative health data and 21.9% in RAI-MDS data. Overall sensitivity of a RAI-MDS diabetes diagnoses was 0.79 (95% CI: 0.79, 0.80) and the PPV was 0.92 (95% CI: 0.91, 0.92), when compared to administrative health data. Sensitivity of the RAI-MDS for ascertaining comorbid conditions ranged from 0.21 for osteoporosis to 0.92 for multiple sclerosis; specificity was high for most conditions. CONCLUSIONS:RAI-MDS clinical assessment data are sensitive to ascertain diabetes cases in LTCF populations when compared to administrative health data. For many comorbid conditions, RAI-MDS data have low validity when compared to administrative data. Risk-adjustment measures based on these comorbidities might not produce consistent results for RAI-MDS and administrative health data, which could affect the conclusions of studies about health outcomes and quality of care across facilities.

背景与目标：

BACKGROUND & AIMS: :Simulium (Nevermannia) chomthongense sp. nov. is described from female, male, pupal and larval specimens collected from Doi Inthanon National Park and Doi Phahompok National Park, Chiang Mai, Thailand. This new species, first reported as S. (Eusimulium) sp. A, and later regarded as S. (N.) caudisclerum Takaoka & Davies, described from peninsular Malaysia, is distinguished from S. (N.) caudisclerum in the male by the number of enlarged upper-eye facets and the relative size of the hind basitarsus against the hind tibia and femur, and in the pupa by the relative length of the stalks of paired filaments against the common basal stalk and the color of the dorsal surface of abdominal segments 1- 3 (or 4). Taxonomic and molecular notes are provided to separate this new species from four other known species of the vernum species-group, which share an accessory sclerite on the larval abdomen, a rare characteristic in this species-group.

背景与目标： : Simulium (Nevermannia) chomthongense sp.11月描述自泰国清迈的Doi Inthanon国家公园和Doi Phahompok国家公园收集的雌性，雄性，p和幼虫标本。这个新物种，首次报道为S。(Eusimulium) sp。A，后来被视为S。(N。) 来自马来西亚半岛的caudiscleum Takaoka & Davies与S.(N。) 男性的caudisclearum，通过扩大的上眼小平面的数量以及后腿basitarsus对后腿胫骨和股骨的相对大小，而在蛹中由成对的细丝相对于共同的基柄的茎的相对长度和腹部节段1- 3 (或4) 的背表面的颜色。提供了分类学和分子注释，以将这种新物种与vernum物种组的其他四个已知物种分开，后者在幼虫腹部共享一个辅助巩膜，这是该物种组中罕见的特征。

BACKGROUND & AIMS: A new type of rodent babesia, which resembled Babesia microti but was phylogenetically placed closest, with the highest level of statistical support, to Babesia canis, a canine babesia, was identified in Thai Bandicota indica in Thai provinces to which malaria is endemic. Close watch should be kept on human babesiosis in Thailand.

背景与目标： 在泰国疟疾流行的泰国省的泰国Bandicota indica中发现了一种新型的啮齿动物巴贝斯犬，类似于巴贝斯犬，但在系统发育上与统计支持水平最高。应密切注意泰国的人类巴贝西虫病。

BACKGROUND & AIMS: BACKGROUND:We investigated the clinical relevance of classic and new prognostic markers, immunoglobulin heavy-chain variable (IGHV) gene mutational status, and chromosomal abnormalities in clinical monoclonal B lymphocytosis (cMBL) compared with chronic lymphocytic leukemia (CLL) Rai stage 0. PATIENTS AND METHODS:We analyzed the clinical outcomes in terms of the time to the first treatment (TTFT) of a prospective cohort, including 125 patients with cMBL and 197 patients with CLL Rai stage 0. RESULTS:In the overall patient population, prognostic parameters such as IGHV gene mutational status (P < .0001), CD38 expression (P < .0001), 70-kDa zeta-associated protein (ZAP-70) expression (P < .0001), and cytogenetic abnormalities (P = .01) predicted for TTFT on univariate analysis. IGHV gene identity was significant on multivariate analysis (P < .0001), regardless of the B-cell cutoff (5.0 or 10 × 10(9) B cells/L). A prognostic stratification using the combination of IGHV mutational status and absolute B-cell lymphocytosis identified 3 different groups that were significantly different with respect to the TTFT (P < .0001). CONCLUSION:In the present series of patients with cMBL and CLL Rai stage 0, we have confirmed that IGHV mutation status appeared to be the best predictor of TTFT. In addition, when associated with the B-cell count, IGHV mutational status might help to better stratify patients into more precise subgroups.

背景与目标：

BACKGROUND & AIMS: AIMS:In this multicentre prospective registry we sought to evaluate the immediate and midterm clinical outcomes following single or multiple overlapping bioresorbable vascular scaffold (BVS) implantation in the STEMI setting. METHODS AND RESULTS:A prospective cohort analysis was performed on all STEMI patients who underwent primary PCI with BVS implantation. Between December 2012 and February 2014, 1,232 STEMI patients underwent primary PCI at the participating centres. Of these, 74 (6.0%) received a BVS, 18 (24.3%) of them were multiple and overlapping. Procedural success was obtained in 72 (97.3%) cases without differences between the groups (overlapping BVS 100% vs. single BVS 96.4%, p=0.5). One patient experienced a reinfarction due to subacute BVS thrombosis which was successfully managed with balloon-only PCI while the other patient had a "slow-flow" phenomenon (final TIMI flow 2). At six-month follow-up, two non-fatal MI (2.7%), three target lesion revascularisations (4.1%), and one subacute BVS thrombosis were reported in three patients (one [5.6%] overlapping BVS and two [3.6%] in the single BVS group, p=0.5). All the events were successfully managed with re-PCI. CONCLUSIONS:BVS implantation in STEMI patients can be successfully performed with a high procedural success rate and encouraging midterm outcomes. Larger randomised trials and longer follow-up are needed to assess the potential clinical benefit of BVS versus new-generation DES in this setting.

背景与目标：

BACKGROUND & AIMS: :In many developing countries, labor force participation by women in the childbearing years has increased rapidly. Social and economic changes present new challenges for women attempting to combine their roles as workers and mothers. Little is known about how these challenges affect infant feeding choices. This multidisciplinary study investigated work and infant feeding decisions among 313 employed women in Chiang Mai, Thailand. Resumption of employment generally had negative affects on breastfeeding rates and duration. At 6 months postpartum, women who worked inside the home breastfed more than those working in the formal sector at jobs with inflexible hours (home, 80%; public sector, 37%; private sector, 39%). Women who were working outside the home for a long period or had shift jobs encountered many obstacles to maintaining breastfeeding, and most gave it up within 1 month after resuming employment. There is a need for multisectoral policies that address obstacles to breastfeeding among women in the paid labor force in Thailand.

背景与目标： : 在许多发展中国家，妇女在生育年龄的劳动力参与率迅速增加。社会和经济变化给试图将其作为工人和母亲的角色结合起来的妇女带来了新的挑战。对于这些挑战如何影响婴儿的喂养选择知之甚少。这项多学科研究调查了泰国清迈313名就业妇女的工作和婴儿喂养决定。恢复就业通常对母乳喂养率和持续时间产生负面影响。产后6个月，在家工作的妇女比在正规部门工作的妇女母乳喂养更多，工作时间不灵活 (家庭，80%; 公共部门，37%; 私营部门，39%)。长期在外工作或从事轮班工作的妇女在维持母乳喂养方面遇到了许多障碍，大多数人在恢复就业后的1个月内放弃了母乳喂养。需要制定多部门政策，解决泰国有偿劳动力中妇女母乳喂养的障碍。

BACKGROUND & AIMS: :For displaced and migrant women in northern Thailand, access to health care is often limited, unwanted pregnancy is common, and unsafe abortion is a major contributor to maternal death and disability. Based on a pilot project and situational analysis research, in 2015 a multinational team introduced the Safe Abortion Referral Programme (SARP) in Chiang Mai, Thailand, to reduce the socio-linguistic, economic, documentation, and transportation barriers women from Burma face in accessing safe and legal abortion care in Thailand. Our qualitative study documented the experiences of women with unwanted pregnancies who accessed the SARP in order to inform programme improvement and expansion. We conducted 22 in-depth, in-person interviews and analysed them for content and themes using deductive and inductive techniques. Women were overwhelmingly positive about their experiences using the SARP. They reported lack of costs, friendly programme staff, accompaniment to and interpretation at the providing facility, and safety of services as key features. Financial and legal circumstances shaped access to the programme and women learned about the SARP through word-of-mouth and community workshops. After accessing the SARP and receiving support, women became community advocates for reproductive health. Efforts to expand the programme and raise awareness in migrant communities appear warranted. Our findings suggest that referral programmes for safe and legal abortion can be successful in settings with large displaced and migrant populations. Identifying ways to work within legal constraints to expand access to safe services has the potential to reduce harm from unsafe abortion even in humanitarian settings.

背景与目标： : 对于泰国北部的流离失所妇女和移民妇女来说，获得保健的机会往往有限，意外怀孕很普遍，不安全的堕胎是孕产妇死亡和残疾的主要原因。根据试点项目和情况分析研究，2015年一个跨国团队在泰国清迈推出了安全堕胎转诊方案，以减少缅甸妇女在泰国获得安全和合法堕胎护理时面临的社会语言、经济、文件和交通障碍。我们的定性研究记录了因意外怀孕而进入SARP的妇女的经历，以便为计划的改进和扩展提供信息。我们进行了22次深入的面对面访谈，并使用演绎和归纳技术对内容和主题进行了分析。女性对使用SARP的经历非常乐观。他们报告说，缺乏费用、友好的方案工作人员、提供设施的陪同和解释以及服务安全是主要特征。财务和法律环境影响了人们对该方案的了解，妇女通过口碑和社区讲习班了解了SARP。在获得SARP并获得支持后，妇女成为生殖健康的社区倡导者。似乎有必要努力扩大该方案并提高移民社区的认识。我们的发现表明，在流离失所者和移民人口众多的情况下，安全和合法堕胎的转诊计划可以成功。确定在法律约束下开展工作以扩大获得安全服务的方法，即使在人道主义环境中，也有可能减少不安全堕胎造成的伤害。

BACKGROUND & AIMS: :Efficacy of different schedules of HDR brachytherapy in concurrent chemoradiotherapy was evaluated. The study compared the effectiveness of the two HDR brachytherapy schedules which have the same Biological Effective Dose (BED) in locally advanced cervical carcinoma that was treated with concurrent chemoradiotherapy. Included in the study were 377 randomly selected patients with advanced carcinoma of the cervix uteri who were treated during the period 2004-2006. Patients were divided into Group I: 7.2 Gy × 3 fractions and Group II: 6 Gy × 4 fractions. With a median follow-up time of 35 months, local control, disease-free survival and overall survival rates were 80.8%, 63.4%, 98.8% in group I and 86.7%, 63.8%, 97.3% in group II, respectively. There was no statistical significance in terms of local control, disease-free survival, overall survival and complication rates between the two treatment schedules which could be observed. Seven patients in group I developed acute grade 2-4 GI toxicities and two patients in group II. In GU toxicities, there were three patients in group I and three patients in group II who developed grade 2-4 toxicities. In late toxicity, no patient developed grade 3-4 GU toxicities in group I while two patients developed grade 3-4 GU toxicities in group II. In GI toxicities, there were five and six patients in group I and group II, respectively, who developed grade 3-4 severity. Both HDR schedules seem to be safe and effective for the treatment of locally advanced cervical cancer.

背景与目标： : 评估了不同方案的HDR近距离放射治疗在同步放化疗中的疗效。该研究比较了两种具有相同生物有效剂量 (BED) 的HDR近距离放射治疗方案在同期放化疗治疗的局部晚期宫颈癌中的有效性。研究中包括377随机选择的在2004-2006期间接受治疗的晚期宫颈癌患者。患者分为I组: 7.2 Gy × 3级和II组: 6 Gy × 4级。中位随访时间为35个月，组I的局部控制率、无病生存率和总生存率分别为80.8% 、63.4% 、98.8%，组II的86.7% 、63.8% 、97.3%。在可以观察到的两种治疗方案之间，在局部控制，无病生存，总生存和并发症发生率方面没有统计学意义。第一组有7名患者出现2-4级急性胃肠道毒性，第二组有2名患者。在GU毒性中，第一组有3例患者，第二组有3例患者出现2-4级毒性。在晚期毒性中，第一组没有患者出现3-4级GU毒性，第二组有两名患者出现3-4级GU毒性。在胃肠道毒性方面，第一组和第二组分别有5和6名患者出现3-4级严重程度。两种HDR方案对于局部晚期宫颈癌的治疗似乎都是安全有效的。