BACKGROUND & AIMS: OBJECTIVES:There are no direct comparisons of blood glucose values in samples collected with barrier serum tubes (SST) and NaF/potassium oxalate (NaF/KOx) plasma tubes. Collection of samples in SST tubes can offer considerable savings and specimen processing advantages for national level surveys. DESIGN AND METHODS:Serum and plasma samples were collected under 'field conditions' from a single draw of 3692 individuals participating in the Canadian Health Measures Survey. The samples were analyzed retrospectively using the VITROS GLU Slide method (glucose oxidase-based). RESULTS:There was a high rate of hemolysis in the NaF/KOx tubes (86.2%) while hemolysis was infrequently observed with the SST tubes (2%). Comparing only blood draws where no hemolysis was observed in both tubes (n=495; paired t-test) showed no effect of tube type on serum/plasma glucose concentrations. This was also observed when data was restricted to cases when only SST samples were not hemolyzed (n=3546; paired t-test). CONCLUSIONS:These data show that both collection tubes can be used under survey collection and processing conditions to measure glucose with our assay system with no difference in reported results.

背景与目标： 目的：尚无直接比较采用屏障血清试管（SST）和NaF /草酸钾（NaF / KOx）血浆试管收集的样本中血糖值的方法。在SST管中收集样品可以为国家级调查提供大量的节省和样品处理的优势。
设计与方法：在“现场条件”下从参加加拿大卫生措施调查的3692个人中抽取了血清和血浆样品。使用VITROS GLU Slide方法（基于葡萄糖氧化酶）对样品进行回顾性分析。
结果：NaF / KOx管的溶血率很高（86.2％），而SST管的溶血率很少（2％）。仅比较在两个试管中均未观察到溶血的抽血情况（n = 495；配对t检验）显示试管类型对血清/血浆葡萄糖浓度无影响。当数据仅限于仅不对SST样品进行溶血的情况时（n = 3546；配对t检验），也可以观察到这一点。
结论：这些数据表明，在我们的测定系统中，两个收集管均可在调查收集和处理条件下用于测量葡萄糖，报道的结果没有差异。

BACKGROUND & AIMS: :In this research, the creation of optimum conditions for the formation of sodium hyaluronate-TiO2 bionanocomposite and its antibacterial effect on gram positive and gram negative bacteria was evaluated. The Fourier transform infrared spectroscopy spectra, scanning electron microscopy images and energy dispersive X-ray spectroscopy pattern confirmed the formation of the bionanocomposite. Thermogravimetric analysis and differential thermal analysis indicated that the thermal stability rate had significantly improved with formation of the bionanocomposite. Nine experiments were designed based on the Taguchi method by applying different proportions of sodium hyaluronate biopolymer and TiO2 nanoparticles at different stirring times. Bionanocomposite produced under conditions of experiment 5 (TiO2 4mg/ml, sodium hyaluronate 1mg/ml and stirring time of 90min) and experiment 9 (TiO2 8mg/ml, sodium hyaluronate 2mg/ml and stirring time of 60min) completely prevented the growth of Staphylococcus aureus and Escherichia coli. It can be concluded that sodium hyaluronate-TiO2 bionanocomposite can be used as an effective antimicrobial compound in food, pharmaceutical, medical and environmental sectors.

背景与目标： ：在这项研究中，评估了透明质酸钠-TiO2纳米复合材料形成的最佳条件的创建及其对革兰氏阳性和革兰氏阴性细菌的抗菌作用。傅里叶变换红外光谱，扫描电子显微镜图像和能量色散X射线光谱图证实了仿生纳米复合材料的形成。热重分析和差示热分析表明，热稳定性速率随着生物纳米复合材料的形成而显着提高。基于Taguchi方法设计了九个实验，分别在不同的搅拌时间下应用不同比例的透明质酸钠生物聚合物和TiO2纳米颗粒。在实验5（TiO2 4mg / ml，透明质酸钠1mg / ml，搅拌时间90min）和实验9（TiO2 8mg / ml，透明质酸钠2mg / ml，搅拌时间60min）的条件下生产的Bionanocomposite完全阻止了葡萄球菌的生长。金黄色葡萄球菌和大肠杆菌。可以得出结论，透明质酸钠-TiO2纳米复合材料可以在食品，制药，医疗和环境领域用作有效的抗菌化合物。

BACKGROUND & AIMS: GENERAL PURPOSE:To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). TARGET AUDIENCE:This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES:After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. ABSTRACT:BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. OBJECTIVE:The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. DATA SOURCES:Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. DATA EXTRACTION:Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. DATA SYNTHESIS:The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. CONCLUSIONS:Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review revealed a need for additional high-quality studies that adhere to commonly used standards of both currently utilized and emerging ways to prevent hospital-acquired PIs.

背景与目标： 一般目的：提供文献综述中有关压力伤害预防策略（PIs）的经济评估的信息。
目标听众：此继续教育活动面向医师，医师助理，护士从业人员以及对皮肤和伤口护理感兴趣的护士。
学习目标/结果：参加此教育活动后，参与者应能够：1。确定本研究的目的和方法2。比较与预防PI有关的成本和有效性。
摘要：背景：压力伤害（PI）是全球急诊医院普遍且资源密集的挑战。尽管许多预防策略都有可能降低医院获得的PI的成本，但尚不清楚哪种方法最有效。
目的：作者对预防策略的经济评估文献进行了叙述性回顾，以调查当前发现并确定经济评估中的重要因素。
数据来源：Ovid，MEDLINE，NHS经济评估数据库和Cochrane系统评价数据库选择标准：考虑了潜在相关的原始研究文章和系统评价。
数据摘录：选择标准包括英语撰写的文章，提供有关急性护理中PI预防策略的成本或经济评估的数据，并于2004年1月至2015年9月之间发表。如何处理《综合卫生经济评估报告标准》清单中的项目。
数据综合：这些搜索确定了192篇参考文献。选择了33篇原创文章进行全文审查。这些文章中有19个提供了对干预措施，研究方法和所考虑结果的清晰描述。
结论：现有文献的局限性阻止了关于预防PI的各种方法的相对经济价值的确切结论。作者的评论表明，有必要进行更多高质量的研究，这些研究既要遵循目前使用的标准，又要采用新的方法来预防医院获得的PI。

BACKGROUND & AIMS: We report the response to risperidone in seven hospitalized, adult patients who presented psychotic symptoms etiologically related to a general medical condition. The conditions included brain surgery in two, and anticardiolipin syndrome, renal failure, epilepsy, lupus, and metastatic carcinoma in one each. Four patients had failed previous treatment with at least one typical antipsychotic agent. Response to risperidone was assessed by the Brief Psychiatric Rating Scale (BPRS). Serum was collected for measurement of steady-state trough risperidone and 9-hydroxyrisperidone concentrations at effective doses in three patients. Amelioration of psychotic symptoms was noted in all seven patients. Mean (+/- SD) BPRS scores were reduced significantly from baseline (63.0 +/- 15.1) to endpoint (27.0 +/- 3.5; p < 0.01). The mean effective daily dose of risperidone was 3.1 +/- .7 mg and time to response was 4.7 +/- 2.4 days. Risperidone was not present at detectable concentrations in the three patients studied. The mean steady-state trough serum concentration of 9-hydroxyrisperidone in the three patients assessed was 20.3 +/- 9.8 ng/ml. These preliminary findings, which suggest that risperidone is a safe and effective agent in patients with psychotic symptoms due to various medical conditions, need to be confirmed by randomized, antipsychotic comparison trials involving a larger number of patients.

背景与目标： 我们报告了七名住院的成年患者对利培酮的反应，这些患者在病因学上呈现出与一般医疗状况相关的精神病症状。这些疾病包括脑外科手术两次，抗心磷脂综合症，肾衰竭，癫痫，狼疮和转移性癌各一次。四名患者先前接受了至少一种典型的抗精神病药治疗失败。通过简要精神病评定量表（BPRS）评估对利培酮的反应。收集血清用于在三位患者中以有效剂量测量稳态谷色利培酮和9-羟基利培酮的浓度。在所有七名患者中均发现精神病症状得到改善。从基线（63.0 /-15.1）到终点（27.0 /-3.5； p <0.01），平均（±SD）BPRS得分显着降低。利培酮的平均有效日剂量为3.1 /-.7 mg，响应时间为4.7 /-2.4天。在研究的三位患者中，未检测到利培酮的存在。在评估的三名患者中，9-羟基利培酮的平均稳态谷浓度为20.3 /-9.8 ng / ml。这些初步发现表明，利培酮是因各种医疗条件而出现精神病症状的患者的安全有效药物，需要通过涉及更多患者的随机抗精神病药物比较试验来证实。

BACKGROUND & AIMS: :Neuroimmunological diseases often have a chronic course and a high socio-economic impact, as most of them occur in younger patients and result in progressing disability and loss of work force. Although for many conditions different treatment strategies are available no sufficient data exist to give a reasonable account on the cost effectiveness of individual therapies. Treatment decision should primarily be guided by evidence from high quality clinical studies and-if available-from direct head-to-head trials and cost-effectiveness analysis.

背景与目标： 神经免疫疾病通常具有慢性病程，并且对社会经济影响很大，因为它们大多发生在年轻的患者中，并导致残疾的发展和劳动力的丧失。尽管对于许多情况，可以使用不同的治疗策略，但没有足够的数据来合理说明各个疗法的成本效益。治疗决策应首先以高质量临床研究的证据为指导，如果可以的话，也应以直接的直接面对面试验和成本效益分析为依据。

BACKGROUND & AIMS: OBJECTIVES:To examine associations between sleep duration and health outcomes among distinct groups of sexual minority adults. METHODS:Using data from the 2014 Behavioral Risk Factor Surveillance System, we compared sleep duration (very short: ≤ 5 hr; short: 6 hr; normal: 7-8 hr; and long: ≥ 9 hr per day) between cisgender straight adults and distinct groups of sexual minorities. We further examined associations between sleep duration and 10 chronic health conditions among sexual minorities. RESULTS:Of 146,893 respondents, 142,507 (96.2%) were cisgender straight, and 4,386 (3.8%) were lesbian, gay, bisexual, transgender (LGBT). Overall, 17.3% of LGBT respondents reported very short sleep per day, compared with 12.2% for cisgender straight respondents (p < 0.0001). Among LGBT populations, the prevalence of very short sleep varied significantly among distinct groups, ranging from 13.2% among transgender female to male adults to 35.5% among transgender gender nonconforming adults. Very short sleep was further associated with increased odds of having stroke (aOR = 4.1, 95% CI [2.2-7.6]), heart attack (aOR = 3.0, CI [1.6-5.8]), coronary heart disease (aOR = 3.1, 95% CI [1.5-6.2]), asthma (aOR = 1.7, 95% CI [1.1-2.4]), chronic obstructive pulmonary disease (aOR = 2.5, CI [1.5-4.0]), arthritis (aOR = 2.1, CI [1.4-3.0]), and cancer (aOR = 1.8, 95% CI [1.0-3.2]) among sexual minorities. Disparities in the prevalence of stroke, heart attack, coronary health disease, COPD, diabetes, obesity, arthritis, and cancer were found among LGBT populations. CONCLUSIONS:Sexual minorities have a higher prevalence of sleep deprivation as compared with their straight counterparts. Sleep deprivation varies by sexual identity and gender. Very short sleep duration is associated with some chronic health conditions among LGBT populations. Promotion of sleep health education and routine medical assessment of sleep disorders are critically needed for sexual minority adults.

背景与目标： 目的：研究不同性别的成年少数群体的睡眠时间与健康结局之间的关联。
方法：使用2014年行为危险因素监测系统的数据，我们比较了直食成年成年直觉成年成年人的睡眠时间（非常短：≤5小时;短：6小时;正常：7-8小时;每天：≥9小时）以及不同性别的少数群体。我们进一步研究了性少数群体的睡眠时间与10种慢性健康状况之间的关联。
结果：在146,893名受访者中，有142,507名（96.2％）为顺性别，而有4,386名（3.8％）为女同性恋，男同性恋，双性恋和变性者（LGBT）。总体而言，LGBT受访者中有17.3％的人每天睡眠时间很短，而顺性别的受访者中有12.2％的人每天睡眠时间短（p <0.0001）。在LGBT人群中，不同组别的极短睡眠发生率差异显着，从跨性别女性到男性的13.2％，到跨性别性别不合格的成年人的35.5％。睡眠时间短还与中风（aOR = 4.1，95％CI [2.2-7.6]），心脏病发作（aOR = 3.0，CI [1.6-5.8]），冠心病（aOR = 3.1， 95％CI [1.5-6.2]），哮喘（aOR = 1.7、95％CI [1.1-2.4]），慢性阻塞性肺疾病（aOR = 2.5，CI [1.5-4.0]），关节炎（aOR = 2.1，CI [1.4-3.0]）和性少数人群中的癌症（aOR = 1.8，95％CI [1.0-3.2]）。在LGBT人群中发现中风，心脏病发作，冠心病，COPD，糖尿病，肥胖症，关节炎和癌症的患病率存在​​差异。
结论：与异性恋人群相比，性少数人群的睡眠剥夺患病率更高。睡眠剥夺因性别和性别而异。极短的睡眠时间与LGBT人群中的某些慢性健康状况有关。性少数成年人迫切需要促进睡眠健康教育和睡眠障碍的常规医学评估。

BACKGROUND & AIMS: INTRODUCTION:The role of botulinum toxin as a therapeutic agent for several conditions is expanding. We sought to determine if botulinum toxin is safe and effective in treating patients with cervical dystonia and maxillofacial conditions. Our purpose was to establish a safety and efficacy profile to determine whether or not this treatment may be used prophylactically in patients undergoing dental implant therapy. METHODS:We performed a systematic search of the literature to identify randomized clinical trials evaluating patients treated with botulinum toxin as an adjunct to dental implant therapy, maxillofacial conditions including temporomandibular disorders (TMD), and cervical dystonia. RESULTS:Four randomized controlled trials (RCTs) met our search criteria in the area of cervical dystonia and chronic facial pain. No RCTs were identified evaluating dental implant therapy. Patients with cervical dystonia exhibited significant improvements in baseline functional, pain, and global assessments compared to placebo. Adverse events were mild and transient with numbers needed to harm (NNH) ranging from 12 to 17. Patients with chronic facial pain improved significantly from baseline in terms of pain compared to placebo. Rates of adverse events were less than 1%. CONCLUSION:Botulinum toxin appears relatively safe and effective in treating cervical dystonia and chronic facial pain associated with masticatory hyperactivity. No literature exists evaluating its use in dental implantology. Randomized clinical trials are warranted to determine its safety and efficacy in dental implantology and other maxillofacial conditions such as bruxism.

背景与目标： 简介：肉毒杆菌毒素在多种情况下作为治疗剂的作用正在扩大。我们试图确定肉毒杆菌毒素在治疗患有颈肌张力障碍和颌面部疾病的患者中是否安全有效。我们的目的是建立安全性和有效性概况，以确定在接受牙种植体治疗的患者中是否可以预防性使用该治疗方法。
方法：我们进行了系统的文献检索，以鉴定评估用肉毒杆菌毒素作为牙科植入物治疗，颌面部疾病（包括颞下颌疾病（TMD）和颈肌张力障碍）的辅助治疗的患者的随机临床试验。
结果：四项随机对照试验（RCT）在宫颈肌张力障碍和慢性面部疼痛方面符合我们的搜索标准。未鉴定出评估牙种植体治疗的RCT。与安慰剂相比，宫颈肌张力障碍患者在基线功能，疼痛和整体评估方面表现出显着改善。不良事件是轻度和短暂的，需要伤害的数字（NNH）在12到17之间。与安慰剂相比，慢性面部疼痛患者在疼痛方面较基线有了显着改善。不良事件的发生率小于1％。
结论：肉毒杆菌毒素在治疗颈肌张力障碍和咀嚼亢进引起的慢性面部疼痛方面似乎相对安全有效。没有文献评估其在牙种植学中的用途。必须进行随机临床试验来确定其在牙种植术和其他颌面疾病（例如磨牙症）中的安全性和有效性。

BACKGROUND & AIMS: BACKGROUND:Palliative care is rarely being offered to patients with Parkinson's disease. AIM:To assess symptom prevalence, severity and palliative care needs in advanced stages of Parkinsonism. DESIGN:A cross-sectional survey using a palliative care assessment tool, the Palliative Outcome Scale was administered to patients. SETTING/PARTICIPANTS:Eight-two patients with a diagnosis of idiopathic Parkinson's disease, multiple systems atrophy or progressive supranuclear palsy were included in the study. RESULTS:Their mean age and disease stages 3-5 Hoehn and Yahr were 67 years and 4.1, respectively. Patients reported a mean of 10.7 (standard deviation = 3.9) physical symptoms. Over 80% had pain, fatigue, day time somnolence and problems with mobility. Other symptoms in 50%-80% included constipation, loss of bladder control, swallowing difficulties, drooling, breathlessness and sleep problems. Symptoms rated as causing severe problems were pain, fatigue, constipation and drooling. Assessment of mood revealed 70% of the patients felt anxiety and 60% had felt depressed. Eight-five per cent felt their families were anxious or worried about them. Thirty-eight per cent would have liked more information and 42% had practical problems that still needed to be addressed. There was a positive correlation between number of symptoms and disease severity (r = 0.39, p = 0.01). The total mean Palliative Outcome Scale score was 13.6 (standard deviation = 6.1), suggesting moderate palliative care needs. CONCLUSION:This is the first study to describe the care needs of people with Parkinson's disease using the Palliative Outcome Scale tool. The burden of symptoms and concerns was high in advanced stages of disease. It might be appropriate that people severely affected by these conditions should be considered for referral to specialist palliative care services.

背景与目标： 背景：帕金森氏病患者很少接受姑息治疗。
目的：评估帕金森病晚期患者的症状患病率，严重程度和姑息治疗需求。
设计：使用姑息治疗评估工具进行横断面调查，对患者进行“姑息治疗结果量表”。
设置/对象：本研究包括八十二名诊断为特发性帕金森氏病，多系统萎缩或进行性核上性麻痹的患者。
结果：他们的平均年龄和疾病阶段3-5 Hoehn和Yahr分别为67岁和4.1。患者报告的平均身体症状为10.7（标准差= 3.9）。超过80％的人有疼痛，疲劳，白天嗜睡和行动不便的问题。 50％-80％的其他症状包括便秘，失去膀胱控制，吞咽困难，流口水，呼吸困难和睡眠问题。被认为造成严重问题的症状是疼痛，疲劳，便秘和流口水。情绪评估显示70％的患者感到焦虑，60％的患者感到沮丧。百分之八十五的人认为他们的家人感到焦虑或担心。 38％的人希望获得更多信息，而42％的人有实际问题需要解决。症状数量与疾病严重程度之间呈正相关（r = 0.39，p = 0.01）。总体平均姑息治疗量表评分为13.6（标准差= 6.1），表明需要中等程度的姑息治疗。
结论：这是第一项使用姑息结果量表工具描述帕金森氏病患者护理需求的研究。在疾病的晚期阶段，症状和忧虑的负担很高。应当考虑将受这些疾病严重影响的人转介到专门的姑息治疗服务。

BACKGROUND & AIMS: :HSP90 is a molecular chaperone that participates in folding, stabilization, activation, and assembly of several proteins, all of which are key regulators in cell signaling. In dimorphic pathogenic fungi such as Paracoccidioides brasiliensis, the adaptation to a higher temperature, acid pH and oxidative stress, is an essential event for fungal survival and also for the establishing of the infectious process. To further understand the role of this protein, we used antisense RNA technology to generate a P. brasiliensis isolate with reduced PbHSP90 gene expression (PbHSP90-aRNA). Reduced expression of HSP90 decreased yeast cell viability during batch culture growth and increased susceptibility to acid pH environments and imposed oxidative stress. Also, PbHSP90-aRNA yeast cells presented reduced viability upon interaction with macrophages. The findings presented here suggest a protective role for HSP90 during adaptation to hostile environments, one that promotes survival of the fungus during host-pathogen interactions.

背景与目标： ：HSP90是一种分子伴侣，参与多种蛋白质的折叠，稳定，激活和组装，所有这些都是细胞信号传导中的关键调控因子。在双态致病性真菌（如巴西副球菌）中，适应更高的温度，酸性pH和氧化应激，是真菌存活和建立感染过程的重要事件。为了进一步了解该蛋白的作用，我们使用了反义RNA技术来生成具有降低的PbHSP90基因表达的巴西假单胞菌分离物（PbHSP90-aRNA）。 HSP90的表达降低会降低分批培养物生长过程中酵母细胞的活力，并增加对酸性pH环境的敏感性和施加的氧化应激。同样，PbHSP90-aRNA酵母细胞与巨噬细胞相互作用后，活力降低。此处提出的发现表明，HSP90在适应敌对环境期间具有保护作用，可在宿主与病原体相互作用期间促进真菌的存活。

BACKGROUND & AIMS: :In Chlamydomonas reinhardtii, the entire process of pattern formation was described, and the relation of pattern formation to external conditions was investigated. The typical pattern was a dot-like structure that formed during a series of changes in cellular behavior, and reappeared immediately and repeatedly after perturbation by mild agitation. Of the external conditions, cell density, depth of the cell suspension, and the vessel's wall are discussed mainly. Especially the vessel's wall may decide the position and whole shape of the pattern formation.

背景与目标： ：在莱茵衣藻中，描述了图案形成的整个过程，并研究了图案形成与外部条件的关系。典型的模式是在一系列细胞行为变化期间形成的点状结构，并在受到轻微搅动扰动后立即并反复出现。在外部条件中，主要讨论细胞密度，细胞悬浮液深度和血管壁。特别是容器壁可以决定图案形成的位置和整体形状。

BACKGROUND & AIMS: PURPOSE:The Department of Veterans Affairs (VA) Low Vision Intervention Trial (LOVIT) developed an outpatient low-vision programme for patients with macular diseases providing low-vision rehabilitation comparable to VA inpatient blind rehabilitation centres (BRCs). This programme targets veterans who do not need or chose not to participate in a comprehensive inpatient blind rehabilitation programme. We examined costs and consequences using veterans in LOVIT and comparable veterans in an inpatient BRC. METHODS:We compared costs and consequences between treatment patients who participated in LOVIT, a two-site randomized clinical trial, and a sample of comparable patients who received treatment at a VA inpatient BRC. We measured consequences as the change in functional visual ability from baseline to follow-up (LOVIT: 4 months after randomization; BRC: 3 months after discharge) using the VA Low Vision Visual Functioning Questionnaire (VA LV VFQ-48). RESULTS:There were 55 LOVIT and 121 BRC patients for our analyses. Average costs were $38,627.3 higher for BRC patients ($5,054.4 +/- $404.7 SD for LOVIT vs. $43,681.7 +/- $8,853.6 SD for BRC, p < 0.0001). Thus, the BRC cost $38,627.3 per patient more than the LOVIT programme (95% CI: $17,414 to $273,482). There was a greater improvement in overall visual ability, mobility, and visual motor skill scores for BRC patients; however, there was no significant difference in improvement in reading ability or visual information processing scores. CONCLUSIONS:As VA increases outpatient blind rehabilitation services, LOVIT provides a model for expanding outpatient low-vision rehabilitation services for veterans at substantially lower costs than current inpatient BRC services.

背景与目标： 目的：退伍军人事务部（VA）低视力干预试验（LOVIT）为黄斑疾病患者制定了门诊低视力计划，该计划可提供与VA住院盲人康复中心（BRC）相当的低视力康复服务。该计划针对不需要或选择不参加全面的住院盲人康复计划的退伍军人。我们使用LOVIT中的退伍军人和住院BRC中可比的退伍军人检查了成本和后果。
方法：我们比较了参加LOVIT的治疗患者，一项两点随机临床试验和在VA住院BRC接受治疗的可比较患者的样本之间的成本和后果。我们使用VA低视力视觉功能问卷（VA LV VFQ-48），测量了从基线到随访（LOVIT：随机分组后4个月； BRC：出院后3个月）的功能性视觉能力变化的后果。
结果：本研究共纳入55例LOVIT患者和121例BRC患者。 BRC患者的平均费用高出38,627.3美元（LOVIT为$ 5,054.4 /-$ 404.7 SD，而BRC为$ 43,681.7 /-$ 8,853.6 SD，p <0.0001）。因此，每位患者的BRC费用比LOVIT计划高出38,627.3美元（95％CI：17,414美元至273,482美元）。 BRC患者的整体视觉能力，活动能力和视觉运动技能得分有了更大的提高；但是，阅读能力或视觉信息处理得分的提高没有显着差异。
结论：随着VA增加门诊盲人康复服务，LOVIT提供了一种模式，可为退伍军人扩展门诊低视力康复服务，其成本远低于目前的住院BRC服务。

BACKGROUND & AIMS: INTRODUCTION:The objective of the present study was to evaluate, from an economic perspective, dabigatran etexilate in comparison to existing pharmaceutical therapeutic options available for the protection of moderate-to-high risk patients with non-valvular atrial fibrillation from cardioembolic risk. METHODS:An existing Markov model was adapted to the Greek setting to reflect the natural course of the disease and the management of patients with different therapies. The model predicts health and economic outcomes and the implications for the social security system during the course of a patient's lifetime. The data for the population of the model were derived from the international literature and local economic databases. RESULTS:The incremental cost per quality-adjusted life year (QALY) of dabigatran 150 mg twice daily relative to the other therapies varied from €5547 to €11,762 and that of dabigatran 110 mg twice daily from €7398 to €16,437. The incremental cost per QALY of dabigatran 150 mg relative to aspirin, the least costly option, was €11,762 and relative to warfarin and acenocoumarol, the local standards of care, it was €11,400 and €11,224 respectively, well below the local thresholds of acceptance. CONCLUSION:Dabigatran etexilate may represent a cost-effective option for the prevention of thromboembolic events in AF patients at moderate-to-high risk of stroke or systemic embolism.

背景与目标： 简介：本研究的目的是从经济角度评估达比加群酯与现有药物治疗方案的比较，以保护中至高危非瓣膜性心房颤动患者免受心脏栓塞风险。
方法：现有的马尔可夫模型适应希腊环境，以反映疾病的自然病程和采用不同疗法的患者的治疗。该模型可预测患者一生中的健康和经济状况以及对社会保障系统的影响。该模型的人口数据来自国际文献和当地经济数据库。
结果：相对于其他疗法，达比加群150 mg每天两次的每质量调整生命年（QALY）的增量成本从5547欧元到11762欧元不等，达比加群110 mg每天两次的费用从7398欧元到16437欧元。相对于阿司匹林（成本最低的选择），达比加群150 mg的每QALY增量成本为11,762欧元，而相对于华法林和醋香豆酚（当地护理标准），分别为11,400欧元和11,224欧元，远低于当地的接受阈值。
结论：达比加群酯可能是预防中风或全身性栓塞风险的中高风险房颤患者血栓栓塞事件的一种经济有效的选择。

BACKGROUND & AIMS: :We have assessed ectomycorrhizal fungi colonizing Norway spruce (Picea abies L.) seedlings in nine forest nurseries using restriction fragment length polymorphism (RFLP) and sequencing analyses of the internal transcribed spacers (ITS1-5.8S-ITS2) amplicons. Restriction analysis of the amplified DNA fragments with HinfI, MboI, and TaqI enzymes allowed the definition of 17 RFLP genotypes; five of them could be unambiguously assigned to Thelephora terrestris, Hebeloma longicaudum, H. crustuliniforme, Tricharina ochroleuca, and Cenococcum geophilum species by comparison with the sporocarp RFLP-pattern database. The remaining genotypes have been sequenced and compared with sequences deposited in the GenBank database. The phylogenetic analysis of resulting sequences and their identified matches indicated that isolated genotypes have formed seven clades. The ascomycetes were predominant: we have determined eight species--Wilcoxina mikolae, Phialophora finlandia, Tuber sp., Cenococcum geophilum, Tricharina ochroleuca, Pulvinula constellatio, and two unidentified ascomycetes--whereas the basidiomycetes were less common (four species denoted: Amphinema byssoides, Hebeloma crustuliniforme, H. longicaudum, and Thelephora terrestris). Wilcoxina mikolae and Phialophora finlandia were the most frequent fungi. Analysis of variance revealed that ascomycetes abundance was higher in nurseries that used organic fertilizer.

背景与目标： ：我们使用限制性片段长度多态性（RFLP）和内部转录间隔区（ITS1-5.8S-ITS2）扩增子的测序分析，评估了9个森林苗圃中挪威云杉（Picea abies L.）幼苗定植的外生菌根真菌。用HinfI，MboI和TaqI酶对扩增的DNA片段进行限制性分析，可以确定17种RFLP基因型。通过与子果皮RFLP模式数据库进行比较，可以明确地将它们中的5个明确地分配给Thelephora terrestris，Hebeloma longicaudum，H。crustuliniforme，Tricharina ochroleuca和Cenococcum geophilum物种。其余的基因型已经测序，并与GenBank数据库中保存的序列进行了比较。对所得序列及其鉴定的匹配进行系统发育分析表明，分离的基因型已形成七个进化枝。子囊菌占主导地位：我们已经确定了8种-麦考克单胞菌（Wilcoxina mikolae），费氏毛虫（Phialophora finlandia），块茎菌（Tuber sp。），地塞诺古球菌（Cenococcum geophilum），Tricharina ochroleuca，Pulvinula星座和两种未鉴定的子囊菌-其中，担子菌是少见的（以4种种表示为鳞茎鞘虫） ，铁锈菌，长假丝酵母和地雷希氏菌）。喜树Wilcoxina mikolae和芬兰Phialophora finlandia是最常见的真菌。方差分析表明，在使用有机肥料的苗圃中，子囊菌的丰度更高。

BACKGROUND & AIMS: :Research has shown that mothers often differentiate among their adult children in terms of closeness and support; however, studies have not addressed why some mothers report preferences among children and others do not. To distinguish between mothers who do and do not report favouring some of their adult children, we used data from a within-family study in which 553 older mothers were interviewed about each of their children. Almost all of the mothers reported differentiating among their children regarding emotional closeness, confiding, or preference among caregivers. Multivariate analyses revealed that mothers' values and mother-child value similarity predicted which mothers differentiated among their children regarding closeness and confiding, whereas mothers' and children's demographic characteristics predicted which mothers differentiated regarding preferred caregivers. Black mothers were less likely than white mothers to differentiate when seeking a confidant; however, race played no role in mothers' likelihood of differentiating regarding emotional closeness or help during illness. Taken together, these findings indicate that differentiating among adult children is common; further, family-level predictors of mothers' differentiating mirror the patterns shown in dyad-level analyses of mothers' favouritism.

背景与目标： 研究表明，母亲经常在成年子女之间在亲密和支持方面有所区别；但是，研究还没有解决为什么有些母亲报告说孩子中有孩子的偏爱，而另一些母亲却没有。为了区分哪些母亲不报告自己的成年子女，哪些不报告他们的偏爱，我们使用了一项家庭内部研究的数据，在该研究中，对553名年龄较大的母亲进行了访谈，询问了每个孩子的情况。几乎所有的母亲都报告说，他们的孩子在照顾者之间的情感亲密，自信或偏爱方面有所区别。多变量分析显示，母亲的价值观和母子价值观的相似性可以预测哪些母亲在孩子之间的亲密和交往方面有所区别，而母亲和儿童的人口统计学特征则可以预测哪些母亲在偏爱的照顾者方面有所区别。与白人母亲相比，黑人母亲寻求知己的可能性较小。然而，种族对母亲在生病期间在情感上的亲密或帮助方面的差异化没有任何作用。综上所述，这些发现表明在成年子女之间进行区分是很普遍的。此外，母亲差异化的家庭层面预测因素反映了母亲偏爱的二元分析中显示的模式。

BACKGROUND & AIMS: OBJECTIVES:To assess the clinical effectiveness and cost-effectiveness of central venous catheters (CVCs) treated with anti-infective agents in preventing catheter-related bloodstream infection (CRBSI). DATA SOURCES:Major electronic databases were searched from 1985 to August 2005. REVIEW METHODS:The systematic clinical and economic reviews were conducted according to accepted procedures. Only full economic evaluations (synthesis of costs and benefits) comparing the use of anti-infective central venous catheters (AI-CVCs) with untreated CVCs or other treated catheters were selected for inclusion in the economic review. RESULTS:A total of 32 trials met the clinical inclusion criteria. Seven different types of AI-CVC were identified, with the most frequently tested being chlorhexidine and silver sulfadiazine (CHSS) (externally treated), CHSS (externally and internally treated) and minocycline rifampicin (internally and externally treated). In general, the trials were of a poor quality in terms of reported methodology, microbiological relevance and control of confounding variables. The pooled result suggests a statistically significant advantage for AI-CVCs in comparison to standard catheters in reducing CRBSI [odds ratio (OR) 0.45, 95% confidence interval (CI) 0.34 to 0.60, 24 studies, I-squared = 0%, fixed effects]. Analysis by subgroups of catheters demonstrates that antibiotic-treated catheters and catheters treated internally and externally decrease CRBSI rates significantly (OR 0.26, 95% CI 0.15 to 0.46, six studies, I-squared = 0%, fixed effects, and OR 0.43, 95% CI 0.26 to 0.70, nine studies, I-squared = 0%, fixed effects, respectively). Catheters treated only externally demonstrate a wider CI and non-significant effect (OR 0.67, 95% CI 0.43 to 1.06, nine studies, I-squared = 0%, fixed effects). A treatment effect was also found for trials with an average duration of between 5 and 12 days, and for the one study with a mean duration of over 20 days. There was a statistically significant treatment effect for both femoral and jugular insertion sites and for those studies reporting a mix of insertion sites. The treatment effect was not observed in trials using exclusively subclavian insertion sites. Of the four trials that compared treated catheters, one reported a benefit of antibiotic-treated catheters over catheters treated externally with CHSS. All three sensitivity analyses testing for study design differences reported a statistically significant treatment effect. The review was limited owing to the quality of the trials included, marked differences in the definitions and methods of diagnosis of CRBSI, and inconsistent reporting of risk factors and patient population factors. Furthermore, two-thirds of trials were commercially funded. The economic performance (cost-effectiveness and potential cost-savings) of using AI-CVCs to reduce the number of CRBSIs in patients requiring a CVC was also reviewed. Results show that the use of AI-CVCs instead of standard CVCs can lead to a reduction in CRBSIs and decreased medical costs. To complement the reviews, a basic decision-analytic model was constructed to explore a range of possible scenarios for the NHS in England and Wales. Results show that for every patient who receives an AI-CVC there is an estimated cost-saving of 138.20 pounds. The multivariate sensitivity analyses estimate potentially large cost-savings, depending on the size of the population, under a wide range of cost and clinical assumptions. However, those considering the purchase of AI-CVCs should ensure that their patient populations and the important characteristics of local clinical practice are indeed similar to those described in this economic evaluation. CONCLUSIONS:Overall, AI-CVCs are clinically effective and relatively inexpensive and therefore their integration into clinical practice can be justified. However, the use of these anti-infective catheters without the appropriate use of other practical care initiatives will have only a limited success on the prevention of CRBSIs. Comparative trials are required to determine which, if any, of the treated catheters is the most effective. Pragmatic research related to the effectiveness of bundles of care that may reduce rates of CRBSI is also warranted.

背景与目标： 目的：评估用抗感染剂治疗的中心静脉导管（CVC）在预防导管相关的血流感染（CRBSI）方面的临床效果和成本效益。
数据来源：从1985年到2005年8月，检索了主要的电子数据库。
审查方法：根据公认的程序进行系统的临床和经济审查。只有将将抗感染中心静脉导管（AI-CVC）与未经治疗的CVC或其他经过治疗的导管进行比较的全面经济评估（成本和收益的综合）才被选入经济评估。
结果：总共32项试验符合临床纳入标准。鉴定出七种不同类型的AI-CVC，最常测试的是洗必太和磺胺嘧啶银（CHSS）（外部治疗），CHSS（外部和内部治疗）和米诺环素利福平（内部和外部治疗）。总体而言，就报告的方法学，微生物学相关性和混杂变量的控制而言，这些试验的质量较差。汇总结果表明，与标准导管相比，AI-CVC在降低CRBSI方面具有统计学上的显着优势[比值比（OR）0.45，95％置信区间（CI）0.34至0.60，24个研究，I平方= 0％，固定效果]。导管亚组的分析表明，抗生素治疗过的导管和内外治疗过的导管显着降低了CRBSI率（OR 0.26，95％CI 0.15至0.46，六项研究，I平方= 0％，固定效应，OR 0.43，95 ％CI 0.26至0.70，九项研究，I平方= 0％，分别为固定效应）。仅在外部进行治疗的导管显示出较宽的置信区间，且无显着影响（OR为0.67，95％置信区间为0.43至1.06，九项研究，I平方= 0％，固定效应）。对于平均持续时间为5至12天的试验以及平均持续时间超过20天的一项研究，也发现了治疗效果。股骨和颈静脉插入部位以及报告混合插入部位的研究在统计学上均具有显着的治疗效果。在仅使用锁骨下插入位点的试验中未观察到治疗效果。在比较经治疗的导管的四项试验中，有一项报告指出，与经CHSS外部治疗的导管相比，经抗生素治疗的导管有益处。针对研究设计差异的所有三个敏感性分析测试均报告了统计学上显着的治疗效果。由于包括的试验质量，CRBSI的诊断定义和诊断方法存在明显差异以及危险因素和患者人群因素的报告不一致，因此该审查受到了限制。此外，三分之二的试验是由商业资助的。还回顾了使用AI-CVC减少需要CVC的患者的CRBSI数量的经济表现（成本效益和潜在的成本节省）。结果表明，使用AI-CVC代替标准CVC可以减少CRBSI并降低医疗成本。为了补充评论，构建了基本的决策分析模型，以探索英格兰和威尔士的NHS的各种可能方案。结果表明，每位接受AI-CVC的患者估计可节省138.20磅。多元敏感性分析估计，在广泛的成本和临床假设下，取决于人群的规模，可能会节省大量成本。但是，考虑购买AI-CVC的人员应确保其患者人数和当地临床实践的重要特征确实与本经济评估中所述的相似。
结论：总体而言，AI-CVC具有临床效果且相对便宜，因此可以证明将其整合到临床实践中是合理的。但是，在没有适当使用其他实践护理措施的情况下使用这些抗感染导管在预防CRBSI方面仅会取得有限的成功。需要进行比较试验，以确定哪一种治疗过的导管最有效。还必须进行与可能降低CRBSI发生率的护理捆绑的有效性相关的务实研究。