• 【透明质酸用于矫正一名18岁的中东男子的鼻子偏斜。】 复制标题 收藏 收藏
    DOI:10.1177/229255031101900404 复制DOI
    作者列表:Piggott JR,Yazdani A
    BACKGROUND & AIMS: :The use of fillers for nonsurgical rhinoplasty has advanced in both materials and methods, and continues to gain popularity in North America. This technique is most often used for secondary revisions, although reports of fillers used in primary rhinoplasty in selected patients have been recently described. The present report details the use of a hyaluronic acid dermal filler in a young Middle Eastern man for a post-traumatic crooked nose deformity. Primary correction of the patient's right-sided nasal bone deviation using hyaluronic acid as a soft tissue filler was achieved with excellent results and patient satisfaction. The current use of fillers in nasal contouring is reviewed.
    背景与目标: :填料在非手术隆鼻术中的使用在材料和方法上都取得了进步,并且在北美继续受到欢迎。该技术最常用于二次修订,尽管最近已报道了某些患者在原发性鼻整形术中使用填充剂的报道。本报告详细介绍了在一名年轻的中东男子中使用透明质酸真皮填充剂治疗创伤后弯曲鼻子畸形的情况。使用透明质酸作为软组织填充剂对患者的右侧鼻骨偏移进行了初步矫正,获得了出色的结果和患者满意度。综述了鼻轮廓术中填充剂的当前使用情况。
  • 【依赖地形的地震层析成像揭示了西藏东部的垂直地壳运动。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-017-03578-z 复制DOI
    作者列表:Zhang X,Wang Y,Gao R,Xu T,Bai Z,Tian X,Li Q
    BACKGROUND & AIMS: :Using a topography-dependent tomographic scheme, the seismic velocity structure of the Eastern Tibetan Plateau, including the uplifted Longmenshan (LMS) orogenic belt, is accurately imaged in spite of the extreme topographic relief in the LMS region and thick sedimentary covers in the neighbouring Sichuan Basin. The obtained image shows a high-resolution upper crustal structure on a 500 km-long profile that is perpendicular to the LMS. The image clearly shows that the crystalline basement was uplifted within the LMS orogenic belt, and that the neighbouring Songpan-Ganzi Terrane was covered by a thick flysch belt, with evidence of near-surface thrust faults caused by convergence between Eastern Tibet and the Sichuan Basin. The indication that the lower crust beneath the LMS was folded and pushed upwards and the upper crust was removed by exhumation, supports the concept of a lower crustal channel flow beneath Eastern Tibet. The image also reveals that the destructive Wenchuan earthquake of year 2008 occurred in the upper crust, directly at the structural discontinuity between Eastern Tibet Plateau and the Sichuan Basin.
    背景与目标: :尽管地形复杂,地形复杂,邻近地区厚厚的沉积物覆盖层,但仍采用与地形有关的层析成像方案,准确地成像了包括隆起的龙门山造山带在内的青藏高原东部的地震速度结构。四川盆地。所获得的图像在垂直于LMS的500?km长的剖面上显示了高分辨率的上地壳结构。该图像清楚地表明,LMS造山带内的晶体基底隆起,并且相邻的松潘-甘孜地貌被厚厚的复理带覆盖,并显示了西藏东部和四川盆地之间的辐合引起的近地表逆冲断层。 。 LMS下方的下部地壳已被折叠并向上推,而尸体被掘出后被去除了,这表明了藏东地区下部地壳通道流动的概念。该图还显示,2008年汶川特大地震发生在上地壳上,直接发生在青藏高原东部与四川盆地之间的构造不连续处。
  • 【al mena:综合了来自阿拉伯,中东和北非人口的基因组和外显子组的人类遗传变异的综合资源。】 复制标题 收藏 收藏
    DOI:10.1038/jhg.2017.67 复制DOI
    作者列表:Koshy R,Ranawat A,Scaria V
    BACKGROUND & AIMS: :Middle East and North Africa (MENA) encompass very unique populations, with a rich history and encompasses characteristic ethnic, linguistic and genetic diversity. The genetic diversity of MENA region has been largely unknown. The recent availability of whole-exome and whole-genome sequences from the region has made it possible to collect population-specific allele frequencies. The integration of data sets from this region would provide insights into the landscape of genetic variants in this region. We integrated genetic variants from multiple data sets systematically, available from this region to create a compendium of over 26 million genetic variations. The variants were systematically annotated and their allele frequencies in the data sets were computed and available as a web interface which enables quick query. As a proof of principle for application of the compendium for genetic epidemiology, we analyzed the allele frequencies for variants in transglutaminase 1 (TGM1) gene, associated with autosomal recessive lamellar ichthyosis. Our analysis revealed that the carrier frequency of selected variants differed widely with significant interethnic differences. To the best of our knowledge, al mena is the first and most comprehensive repertoire of genetic variations from the Arab, Middle Eastern and North African region. We hope al mena would accelerate Precision Medicine in the region.
    背景与目标: :中东和北非(MENA)拥有非常独特的人口,有着悠久的历史,并拥有独特的种族,语言和遗传多样性。中东和北非地区的遗传多样性在很大程度上是未知的。来自该地区的全外显子组和全基因组序列的最新可用性使得收集特定人群的等位基因频率成为可能。来自该区域的数据集的整合将提供对该区域遗传变异的概况的见识。我们系统地整合了来自该地区的多个数据集的遗传变异,以创建一个超过2600万种遗传变异的纲要。系统对变体进行了注释,并计算了数据集中的等位基因频率,并将其用作可快速查询的网络界面。作为遗传流行病学纲要应用原则的证明,我们分析了转谷氨酰胺酶1(TGM1)基因变异的等位基因频率,与常染色体隐性层状鱼鳞病相关。我们的分析表明,所选变体的载波频率差异很大,种族间存在显着差异。据我们所知,almena是阿拉伯,中东和北非地区遗传变异的第一个也是最全面的库。我们希望,法医学将促进该地区的精准医学。
  • 【来自缅甸和印度东部的罗素蛇的毒液磷脂酶-克隆,鉴定和系统地理分析。】 复制标题 收藏 收藏
    DOI:10.1016/j.bbapap.2007.04.012 复制DOI
    作者列表:Tsai IH,Tsai HY,Wang YM,Tun-Pe,Warrell DA
    BACKGROUND & AIMS: :Venoms of Russell's vipers (genus Daboia) are known for their deadly coagulopathic and other effects. We herein studied various isoforms of venom phospholipases A(2) (PLAs) from two Daboia species at their geographic boundary. From Myanmar Daboia siamensis venom (designated as DsM), four PLAs (designated DsM-aI, aI', aII' and bI') were purified, and the cDNAs encoding two acidic (DsM-aI and aII) and two basic PLAs (DsM-bI and S1) were also cloned from its venom-glands. DsM-S1 is identical to the major venom PLA of southern India Daboia russelii, but the protein is absent from the venom. Additionally, four PLAs (designated DrK-aI, aII, bI and bII) were cloned from cDNA obtained from venom glands of a Kolkata D. russelii, and the PLAs were purified from the pooled venom (designated as DrK). The acidic DrK-aI is the most neurotoxic and lethal among these PLAs; DsM-aI which differs from DrK-aI by only the Phe2 substitution shows greatly reduced enzymatic activity and lethality. Both acidic PLAs do not form dimeric complex with basic PLAs in the same venoms. DsM-bI' is neurotoxic and lethal but its orthologous DrK-bI (97% identical to DsM-bI') is a much weaker toxin. Given the fact that most of the orthologous PLAs of DrK and DsM share 97-100% sequence identity, Daboia vipers of Myanmar and Kolkata must be closely related. Molecular phylogenetic analyses on 30 venom PLAs of Eurasian vipers' revealed co-evolution of five subtypes of venom PLAs in both Daboia and Vipera genera. Our results shed light on the intra- and inter-species variations and structure-function relationships of viperid venom PLAs.
    背景与目标: :Russell的毒蛇(Daboia属)的毒液以致命的凝血病和其他功效而闻名。我们在这里研究了来自两个Daboia物种在其地理边界处的毒性磷脂酶A(2)(PLA)的各种同工型。从缅甸Daboia siamensis毒液(指定为DsM)中,纯化了四个PLA(指定为DsM-aI,aI',aII'和bI'),编码两个酸性(DsM-aI和aII)和两个碱性PLA(DsM)的cDNA。 -bI和S1)也从其毒腺中克隆得到。 DsM-S1与印度南部Daboia russelii的主要毒液PLA相同,但毒液中不存在该蛋白质。另外,从获自加尔各答罗氏沼虾的毒腺的cDNA克隆了四个PLA(命名为DrK-aI,aII,bI和bII),并从合并的毒液(命名为DrK)中纯化了PLA。在这些PLA中,酸性DrK-aI具有最高的神经毒性和致死性。 DsM-aI与DrK-aI的不同之处仅在于Phe2取代,显示酶活性和杀伤力大大降低。两种酸性PLA在同一毒液中均不会与碱性PLA形成二聚体复合物。 DsM-bI'具有神经毒性和致死性,但其直系同源的DrK-bI(与DsM-bI'同源97%)是一种弱得多的毒素。鉴于大多数DrK和DsM的直系同源PLA拥有97-100%的序列同一性,因此缅甸和加尔各答的Daboia蛇蝎必须紧密相关。对欧亚vi蛇的30种毒液PLA进行分子系统发育分析,揭示了Daboia和Vipera属中5种亚型毒液PLA的共同进化。我们的研究结果揭示了蛇毒PLA的种内和种间变异以及结构与功能的关系。
  • 【俄罗斯东部地区传播的重组诺如病毒的病毒性肠胃炎和遗传特征。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Phan TG,Yagyu F,Kozlov V,Kozlov A,Okitsu S,Müller WE,Ushijima H
    BACKGROUND & AIMS: :From November 2003 to March 2004 a total of 100 fecal specimens from infants and children with acute gastroenteritis in the city of Birobidzhan, Eastern Russia were tested for the presence of diarrheal viruses by RT-multiplex PCR. Of these, 74 fecal specimens were positive for diarrheal viruses and this represented 74%. Among the diarrheal viruses detected, group A rotavirus was the most prevalent (67%; 67 of 100), followed by norovirus (4%; 4 of 100), group C rotavirus (1%, 1 of 100), sapovirus (1%; 1 of 100), and hepatitis A virus (1%; 1 of 100). It was found that 86.6% (58 of 67) of group A rotavirus were serotyped as G3. Sapovirus and hepatitis A virus were genetically determined to belong to GI/1 and subgenotype 1A, respectively. Interestingly, all norovirus isolates in the study turned out to make a novel cluster when polymerase-based grouping was performed. It is noteworthy to point out that these norovirus isolates were further genetically characterized as naturally occurring recombinants, which were firstly found circulating in the Russian population studied. Breakpoint analysis of recombinant norovirus showed that the recombination site was at the open reading frame (ORF)1/ORF2 overlap. This is the first report of the existence of acute gastroenteritis caused by recombinant norovirus in Eastern Russia.
    背景与目标: :2003年11月至2004年3月,通过RT多重PCR检测了俄罗斯东部比罗比詹市的100例急性胃肠炎婴儿和儿童的粪便标本。其中,74份粪便标本的腹泻病毒呈阳性,占74%。在检测到的腹泻病毒中,A组轮状病毒最为流行(67%; 100分之67),其次是诺如病毒(4%; 100分之4),C组轮状病毒(1%,100分之一),沙波病毒(1%) ; 1/100)和甲型肝炎病毒(1%; 1/100)。发现A组轮状病毒的86.6%(67个中的58个)血清分型为G3。沙波病毒和甲型肝炎病毒在遗传上分别确定为GI / 1和亚型1A。有趣的是,当进行基于聚合酶的分组时,研究中的所有诺如病毒分离物都形成了一个新的簇。值得注意的是,这些诺如病毒的分离株在基因上进一步被鉴定为天然存在的重组体,它们首先在被研究的俄罗斯人群中发现。重组诺如病毒的断点分析表明重组位点在开放阅读框(ORF)1 / ORF2重叠处。这是俄罗斯东部重组诺如病毒引起的急性胃肠炎的首次报道。
  • 【来自澳大利亚东南部的s(Ixodes holocyclus)和角x(Ixodes cornuatus)内的遗传变异。】 复制标题 收藏 收藏
    DOI:10.1016/s0020-7519(00)00103-x 复制DOI
    作者列表:Jackson J,Chilton NB,Beveridge I,Morris M,Andrews RH
    BACKGROUND & AIMS: :Ticks from mainland Australia (Victoria, New South Wales and Queensland) and Tasmania, identified morphologically as either Ixodes holocyclus or Ixodes cornuatus, were compared genetically using 24 enzyme loci. The results showed that ticks from three localities in Victoria were genetically similar to I. cornuatus in Tasmania, but both groups had fixed genetic differences at >45% of loci compared with other ticks on the mainland. In addition, there were fixed genetic differences at 0-60% of loci among I. holocyclus from different localities on the mainland. Ixodes holocyclus samples could be divided into four distinct clusters (with fixed genetic differences >15%), three of which were represented by one or two specimens. Nonetheless, these electrophoretic data suggest that I. holocyclus represents a species complex. The results also showed that the morphological criteria used to identify specimens were not always accurate because several specimens had been mis-identified morphologically. Despite limitations with the morphological identification, this study has demonstrated that I. cornuatus can be distinguished from the I. holocyclus species complex using six enzyme loci, providing the foundation for a re-examination of morphological characteristics. The present study has shown that I. cornuatus and the I. holocyclus complexes have a greater distribution than previously reported, with both occurring in sympatry at Cape Patterson, on the southern coastline of Victoria.
    背景与目标: :使用24个酶基因座对来自澳大利亚大陆(维多利亚州,新南威尔士州和昆士兰州)和塔斯马尼亚州的Ti虫进行了形态学比较,这些Ti虫在形态学上被鉴定为全环凤仙或角须凤仙。结果表明,维多利亚州三个地方的tick在遗传上与塔斯马尼亚州的角I相似,但与大陆上的其他tick相比,两组的固定遗传差异均在> 45%的位点上。另外,来自大陆不同地区的全环金枪鱼在基因座的0-60%处存在固定的遗传差异。整轴虫的样本可分为四个不同的类群(固定的遗传差异> 15%),其中三个由一个或两个标本代表。尽管如此,这些电泳数据表明全环线虫代表一种物种复合体。结果还表明,用于鉴定标本的形态学标准并不总是准确的,因为一些标本在形态上被错误地鉴定。尽管在形态学鉴定上有局限性,但这项研究表明,可以使用六个酶基因座将角corn与全轮虫物种区分开,为形态特征的重新研究奠定了基础。本研究表明,角鬣狗和全环线虫的分布比以前报道的要大,它们都发生在维多利亚州南部海岸线的海角帕特森的交界处。
  • 【在北卡罗莱纳州东部农村地区未保险或医疗补助保险的青少年中增加人乳头瘤病毒疫苗接种的短信和电子邮件消息传递。】 复制标题 收藏 收藏
    DOI:10.1353/hpu.2019.0090 复制DOI
    作者列表:Richman AR,Torres E,Wu Q,Carlston L,O'Rorke S,Moreno C,Olsson J
    BACKGROUND & AIMS: :We sought to assess if electronic messaging/reminders could increase human papillomavirus (HPV) vaccine completion among adolescents and HPV knowledge among their parents. The study was conducted in two clinics in eastern North Carolina from March 2014-March 2016. Participants included English-speaking and/or Spanish-speaking, uninsured or Medicaid-insured parents and their children (ages 9-17). Intervention participants received text/email appointment reminders and education messages and controls received standard-of-care. The final sample included 257 parent-child dyads. Most identified as Black (60%) or Hispanic (28%). Completion rates for intervention and control groups were similar for HPV dose 2 (65% vs. 65%) and HPV dose 3 (35% vs. 30%), respectively. Although knowledge change was higher for the intervention group, this difference was not statistically significant. Those who reported provider vaccine recommendation were 1.8 times more likely to complete the series. Electronic reminders to promote vaccine completion were not effective in this population. More research is needed.
    背景与目标: :我们试图评估电子消息传递/提醒是否可以提高青少年中人乳头瘤病毒(HPV)疫苗的接种率以及其父母中HPV的知识。该研究于2014年3月至2016年3月在北卡罗莱纳州东部的两家诊所进行。参与者包括讲英语和/或说西班牙语,没有保险或有医疗补助的父母及其子女(9-17岁)。干预参与者收到了文本/电子邮件约会提醒,教育信息和控件收到了护理标准。最终样本包括257个亲子二元组。多数被确定为黑人(60%)或西班牙裔(28%)。 HPV剂量2(65%比65%)和HPV剂量3(35%比30%)的干预组和对照组的完成率相似。尽管干预组的知识变化较高,但这种差异在统计学上并不显着。报告提供者疫苗推荐的人群完成该系列疫苗的可能性是其1.8倍。促进疫苗完成的电子提醒在该人群中无效。需要更多的研究。
  • 【对乍得东部三处世界卫生组织推荐的长效杀虫网的材料耐久性进行的观察性研究。】 复制标题 收藏 收藏
    DOI:10.4269/ajtmh.2012.11-0331 复制DOI
    作者列表:Allan R,O'Reilly L,Gilbos V,Kilian A
    BACKGROUND & AIMS: :A total of 876 nets (229 Interceptor(®), 363 Olyset(®), and 284 PermaNet(®)) were collected 14 months post-distribution of long-lasting insecticidal nets (LLINs) from 811 households of internally displaced and host communities in Dar Sila District in eastern Chad to examine their physical condition. Holes were recorded by using three hole categories (average diameter = 2, 3.5, and 15 cm) and a Proportionate Hole Index (pHI). A total of 69.5% were in poor or very poor condition. There was no significant difference in the performance between the polyester 75 denier LLINs, but they had 4.22 times the odds of having a pHI ≥ 175 (poor or very poor condition) than polyethylene 150 denier LLINs; and 39.2% were unserviceable (pHI ≥ 300) compared with only 7.7% of the polyethylene LLINs. These results provide the first comparative data on LLIN material durability to guide procurement and replacement practice, and to inform urgently needed changes in LLIN international minimum specifications and product standards.
    背景与目标: :在分发了811个内部流离失所者和寄主家庭的持久杀虫网(LLIN)之后14个月,共收集了876个蚊帐(229个Interceptor(®),363个Olyset(®)和284个PermaNet(®))。乍得东部达西拉区的社区,以检查他们的身体状况。通过使用三种孔类别(平均直径= 2、3.5和15 cm)和比例孔指数(pHI)记录孔。共有69.5%的人口处于贫困或非常贫困状态。聚酯75旦LLIN的性能之间没有显着差异,但与聚乙烯150旦LLIN相比,它们的pHI≥175(差或非常差)的几率是4.22倍。仅有39.7%的聚乙烯LLIN不可用(pHI≥300),而只有7.7%的聚乙烯LLIN不可用。这些结果提供了有关LLIN材料耐用性的首个比较数据,以指导采购和更换实践,并为LLIN国际最低规格和产品标准提供了急需的变更信息。
  • 【亚洲和非洲用于农产品的太阳能干燥机的回顾:一种创新的景观方法。】 复制标题 收藏 收藏
    DOI:10.1016/j.jenvman.2020.110730 复制DOI
    作者列表:Udomkun P,Romuli S,Schock S,Mahayothee B,Sartas M,Wossen T,Njukwe E,Vanlauwe B,Müller J
    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: :太阳能干燥是保护亚洲和撒哈拉以南非洲(SSA)国家农产品的最有效,最具成本效益,可再生和可持续的技术之一。这篇评论文章介绍了非洲和亚洲广泛使用的不同类型的太阳能干燥机。此外,还强调了其使用对产品质量的显着影响及其经济,环境和社会影响。由于财务,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某些亚洲国家和SSA国家中太阳能干燥技术有效性的影响。
  • 【南亚大喜马拉雅山上濒临灭绝的克什米尔麝香Moschus cupreus的预计分布和气候变迁。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-020-58111-6 复制DOI
    作者列表:Singh PB,Mainali K,Jiang Z,Thapa A,Subedi N,Awan MN,Ilyas O,Luitel H,Zhou Z,Hu H
    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,并且主要由最干燥季度的降水,年平均温度,水蒸气和最冷季度的降水决定。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至关重要。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展,但其他地方(克什米尔地区和巴基斯坦-阿富汗边境)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偷猎和栖息地退化以及长期的,长期的,相互影响的相互作用。气候变化的长期力量。
  • 【中国东部结核病医疗的自付费用和经济后果:收入不平等。】 复制标题 收藏 收藏
    DOI:10.1186/s40249-020-0623-8 复制DOI
    作者列表:Liu Y,Xu CH,Wang XM,Wang ZY,Wang YH,Zhang H,Wang L
    BACKGROUND & AIMS: BACKGROUND:Despite the availability of free tuberculosis (TB) diagnosis and treatment, TB care still generates substantial costs that push people into poverty. We investigated out-of-pocket (OOP) payments for TB care and assessed the resulting economic burden and economic consequences for those with varying levels of household income in eastern China. METHODS:A cross-sectional study was conducted among TB patients in the national TB programme networks in eastern China. TB-related direct OOP costs, time loss, and coping strategies were investigated across households in different economic strata. Analysis of Variance was used to examine the differences in various costs, and Kruskal-Wallis tests were used to compare the difference in total costs as a percentage of annual household income. RESULTS:Among 435 patients, the mean OOP total costs of TB care were USD 2389.5. In the lower-income quartile, OOP payments were lower, but costs as a percentage of reported annual household income were higher. Medical costs and costs prior to treatment accounted for 66.4 and 48.9% of the total costs, respectively. The lower the household income was, the higher the proportion of medical costs to total costs before TB treatment, but the lower the proportion of medical costs patients spent in the intensive phase. TB care caused 25.8% of TB-affected households to fall below the poverty line and caused the poverty gap (PG) to increase by United States Dollar (USD) 145.6. Patients in the poorest households had the highest poverty headcount ratio (70.2%) and PG (USD 236.1), but those in moderately poor households had the largest increase in the poverty headcount ratio (36.2%) and PG (USD 177.8) due to TB care. Patients from poor households were more likely to borrow money to cope with the costs of TB care; however, there were fewer social consequences, except for food insecurity, in poor households. CONCLUSIONS:Medical and pretreatment costs lead to high costs of TB care, especially among patients from the poorest households. It is necessary to train health system staff in general hospitals to promptly identify and refer TB patients. Pro-poor programmes are also needed to protect TB patients from the medical poverty trap.
    背景与目标: 背景:尽管有免费的结核病(TB)诊断和治疗方法,但结核病护理仍然产生大量的费用,使人们陷入贫困。我们调查了结核病护理的自付费用(OOP),并评估了中国东部家庭收入水平各异的人群所承受的经济负担和经济后果。
    方法:在中国东部国家结核病规划网络中对结核病患者进行了横断面研究。在不同经济阶层的家庭中调查了与结核相关的直接OOP成本,时间损失和应对策略。方差分析用于检查各种成本的差异,而Kruskal-Wallis检验用于比较总成本在家庭年收入中所占百分比的差异。
    结果:在435名患者中,结核病护理的平均OOP总费用为2389.5美元。在收入较低的四分位数中,OOP支付额较低,但成本占报告的家庭年收入的百分比较高。医疗费用和治疗前费用分别占总费用的66.4%和48.9%。家庭收入越低,结核病治疗前的医疗费用在总费用中所占的比例就越高,但在强化治疗阶段花费在患者身上的医疗费用所占的比例就越低。结核病护理使25.8%的受结核病影响的家庭降至贫困线以下,并使贫困差距(PG)增加了145.6美元。最贫困家庭的患者的贫困率最高(70.2%)和PG(236.1美元),而中度贫困家庭的患者由于结核病,贫困率最高(36.2%)和PG(177.8美元)关心。来自贫困家庭的患者更有可能借钱来应付结核病护理费用;但是,除了粮食不安全以外,贫困家庭的社会后果较少。
    结论:医疗和预处理费用导致结核病护理的高昂费用,尤其是在最贫困家庭的患者中。有必要对综合医院的卫生系统人员进行培训,以迅速发现并转诊结核病患者。还需要扶贫计划,以保护结核病患者免受医疗贫困陷阱的困扰。
  • 【美国陆军远程医疗计划:概述和西南亚的现状。】 复制标题 收藏 收藏
    DOI:10.1089/tmj.2006.12.396 复制DOI
    作者列表:Poropatich RK,DeTreville R,Lappan C,Barrigan CR
    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。
  • 【来自南亚和东南亚的侵入性肺炎克雷伯菌肺炎的高毒力和多药耐药性的基因组监测。】 复制标题 收藏 收藏
    DOI:10.1186/s13073-019-0706-y 复制DOI
    作者列表:Wyres KL,Nguyen TNT,Lam MMC,Judd LM,van Vinh Chau N,Dance DAB,Ip M,Karkey A,Ling CL,Miliya T,Newton PN,Lan NPH,Sengduangphachanh A,Turner P,Veeraraghavan B,Vinh PV,Vongsouvath M,Thomson NR,Baker S,Holt KE
    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,基于基因组学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。
  • 【苏丹东部新哈法的气候变量和恶性疟疾的传播。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Himeidan YE,Hamid EE,Thalib L,Elbashir MI,Adam I
    BACKGROUND & AIMS: :The study investigated the role of climatic variables and irrigated agricultural on the seasonality of malaria transmission in New Halfa, eastern Sudan. A time-series analysis was performed using monthly climatic variables, monthly water available for irrigation of crops and monthly slide positive rate of malaria during the period 1986-2002. Cases of malaria were reported every month of the year with a mean of 13.0/100 persons/month (95% CI: 11.9-14.2), and bimodal annual pattern in autumn and winter seasons. Rainfall was the significant climatic variable in the transmission of the disease, whereas heavy rainfall was found to initiate epidemics. Temperature, relative humidity and irrigation water were not significant factors.
    背景与目标: :这项研究调查了气候变量和灌溉农业对苏丹东部新哈法地区疟疾传播季节性的影响。使用1986-2002年期间的每月气候变量,每月可用于灌溉作物的水以及每月疟疾的滑动阳性率进行了时间序列分析。每年每个月报告的疟疾病例平均为13.0 / 100人/月(95%CI:11.9-14.2),并且在秋季和冬季均呈双峰模式。降雨是疾病传播的重要气候变量,而发现大雨引发了流行病。温度,相对湿度和灌溉水不是重要因素。
  • 【尼日利亚东南部一所乡村医院的常见老年病紧急情况。】 复制标题 收藏 收藏
    DOI:10.4103/1119-3077.100634 复制DOI
    作者列表:Iloh G,Amadi AN,Awa-Madu J
    BACKGROUND & AIMS: BACKGROUND:Geriatric population in rural Nigeria is often challenged by emergency health conditions that predispose them to higher risk of disability and mortality. OBJECTIVE:This study was aimed at describing the common geriatric emergencies in a rural hospital in South-Eastern Nigeria. MATERIALS AND METHODS:This was a descriptive hospital-based study of 216 geriatric patients who presented between June 2008 and June 2011 with emergency health conditions at St Vincent De Paul hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state, South-Eastern Nigeria. The geriatric patients seen within the study period who met the selection criteria were studied. Data extracted for analysis included biodata and diagnosis made. RESULTS:A total of 216 geriatric emergencies were seen during the study period. The ages of the patients ranged from 65 years to 98 years with mean age of 72 ± 1.14 years. There were 94 males and 122 females with a male to female ratio of 1: 1.3. The three most common causes of geriatric emergencies were acute malaria (33.8%), hypertensive crises syndrome (19.0%), and acute hypertensive heart failure (18.1%). CONCLUSION:This study has shown that the three most common geriatric emergencies were medical emergencies (acute malaria, hypertensive crises syndrome, and acute hypertensive heart failure). Improving the quality of geriatric medical care will help in reduction of these emergency medical conditions. Similarly, health education of the geriatric population to embrace early health-seeking behavior, health maintenance, and promotional practices that are needed to promote longevity is invariably advocated.
    背景与目标: 背景:尼日利亚农村地区的老年人口经常受到紧急卫生条件的挑战,这些条件使他们容易遭受残疾和死亡的危险。
    目的:本研究旨在描述尼日利亚东南部某乡村医院的常见老年病紧急情况。
    材料与方法:这是一项基于描述性医院的研究,研究对象是216位老年患者,这些患者在2008年6月至2011年6月期间在南艾莫州乡村宣教综合医院Amurie-Omanze的St Vincent De Paul医院就诊并出现了紧急医疗情况。尼日利亚东部。在研究期内发现符合选择标准的老年患者进行了研究。提取用于分析的数据包括生物数据和做出的诊断。
    结果:在研究期间共发现216例老年急症。患者的年龄为65岁至98岁,平均年龄为72±1.14岁。男94例,女122例,男女之比为1:1.3。老年人紧急情况的三种最常见原因是急性疟疾(33.8%),高血压危机综合征(19.0%)和急性高血压心力衰竭(18.1%)。
    结论:这项研究表明,三种最常见的老年急症是医疗急症(急性疟疾,高血压危机综合症和急性高血压心力衰竭)。改善老年医学护理的质量将有助于减少这些紧急医疗状况。同样,人们也始终倡导对老年人群进行健康教育,以使其早日寻求健康行为,健康维持和促进长寿所需的促进做法。

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