BACKGROUND & AIMS: OBJECTIVE:This study reviewed whether participants who were given a continence education package, which included a Continence Educational Brochure (CEB), and who indicated that they were bothered by incontinence symptoms changed health-seeking behaviors about their incontinence problem because of being given the brochure. METHOD:This study used a descriptive and exploratory design. Participants were given the CEB and asked to read the information. They were also asked to complete a continence questionnaire and mail this back to the research team. Participants who indicated that they were bothered by a continence problem and consented to being interviewed were telephoned 2 to 3 months later. They were asked questions to determine their actions and progress in relation to managing their continence problem and whether the CEB had influenced their behavior. SETTING AND SUBJECT:A total of 631 participants (352 females, 55.8%; 279 males, 44.2%) from 4 rural and regional settings in Victoria, Australia, participated. Of this sample, 111 participants (78 females, 70.3%; 33 males, 29.7%) who reported that they were bothered by a continence problem were interviewed 3 months after being given the CEB. RESULTS:Two thirds of the total sample of participants (n=111) sought help for their continence problem. Approximately 70.3% (n=78) continued to have a continence problem. Of this group, 84.6% were still bothered by the continence problem and 65.4% had taken action to treat their incontinence. Forty-nine participants (44.1%) indicated that they had discussed the issue of bladder or bowel problems with someone directly because of this study or the information contained in the brochure. More than 94% of participants who remembered the CEB indicated that they believed the brochure would be helpful if given to other people. CONCLUSIONS:These findings suggest that the CEB prompted individuals to discuss their continence problem and in fewer cases to seek professional help. Given these findings, distribution of a continence education package is advocated as a continence health promotion strategy.

背景与目标： 目的：本研究回顾了参加者的节制教育包，其中包括节制教育手册（CEB），并指出他们因节制失禁症状而受到困扰，从而改变了他们对失禁问题的健康寻求行为，因为他们获得了手册。
方法：本研究采用描述性和探索性设计。参加者获得了CEB的邀请，并要求阅读信息。还要求他们填写节制问卷并将其邮寄回研究团队。 2至3个月后打电话给表示自己受到节制问题困扰并同意接受采访的参与者。他们被问到问题，以确定他们在处理自控问题方面的行动和进展，以及CEB是否影响了他们的行为。
地点和主题：来自澳大利亚维多利亚州4个农村和地区性地区的631名参与者（352名女性，占55.8％； 279名男性，占44.2％）参加了该项目。在该样本中，有111名参与者报告他们受到节制问题困扰，其中有78名女性，占70.3％； 33名男性，占29.7％，在接受CEB后三个月进行了访谈。
结果：参与者（n = 111）的总样本的三分之二寻求帮助，以解决他们的节制问题。大约70.3％（n = 78）仍然存在尿失禁问题。在这一组中，仍有84.6％的人患有尿失禁问题，还有65.4％的人已经采取了行动来治疗他们的尿失禁。 49名参与者（44.1％）表示，由于该研究或小册子中包含的信息，他们直接与某人讨论了膀胱或肠道问题。记得CEB的参与者中，超过94％的参与者表示，他们认为该手册对其他人有帮助。
结论：这些发现表明，CEB促使个人讨论他们的节制问题，并在较少的情况下寻求专业帮助。鉴于这些发现，提倡分发节制教育一揽子计划作为节制健康促进策略。

BACKGROUND & AIMS: :The infection rate after primary hip arthroplasty lies at 1-2%. In the past few years, a two-stage protocol with the implantation of an antibiotic-loaded spacer has become a popular procedure in the treatment of infected hip joint arthroplasties. In this review, we pay special attention to the elution characteristics of the spacers, their mechanical stability and the clinical response. We conclude that hip spacers are an effective method in the treatment of hip joint infections, with success rates of over 90%.

背景与目标： ：原发性髋关节置换术后的感染率为1-2％。在过去的几年中，采用两阶段方案植入载有抗生素的间隔物已成为治疗感染性髋关节置换术的流行方法。在这篇综述中，我们特别注意间隔物的洗脱特性，它们的机械稳定性和临床反应。我们得出的结论是，间隔垫片是一种治疗髋关节感染的有效方法，成功率超过90％。

BACKGROUND & AIMS: :The vitamin B12 status of 20 subjects who were on home parenteral nutrition after surgical or functional small bowel resection and were given 1000 micrograms cyanocobalamin every 3 mo was studied by comparing their plasma vitamin B12, homocysteine (HS), and methylmalonic acid (MMA) concentrations. The plasma vitamin B12 concentration (median 145 pmol/L, 95% confidence interval: 123-217) was subnormal in four cases and borderline in four others. In the "4low B12" group, the concentrations of the markers of vitamin B12 deficiency were in the normal range; HS 10.7 mumol/L (8.0-12.3); and MMA, 0.15 mumol/L (0.09-0.19). References values were HS, 10.0 mumol/L (9.4-12.6); and MMA, 0.16 mumol/L (0.10-0.19). Thus, there were no metabolic signs of vitamin B12 deficiency in these subjects on parenteral nutrition, despite the fact that their plasma vitamin B12 levels were low. Analysis of individual data showed that the four patients with low circulating B12 had markers of intracellular vitamin B12 deficiency in the normal range.

背景与目标： ：通过比较血浆中维生素B12，高半胱氨酸（HS）和甲基丙二酸（MMA）的研究，研究了20名接受手术或功能性小肠切除术后家庭肠胃外营养并每3个月接受1000微克氰钴胺素治疗的受试者的维生素B12状况浓度。血浆维生素B12浓度（中位数145 pmol / L，95％置信区间：123-217）在4例中低于正常，在其他4例中处于临界水平。在“ 4low B12”组中，维生素B12缺乏症标志物的浓度在正常范围内。 HS 10.7摩尔/升（8.0-12.3）;和MMA，0.15摩尔/升（0.09-0.19）。参考值为HS，10.0 mumol / L（9.4-12.6）；和MMA，0.16摩尔/升（0.10-0.19）。因此，尽管血浆维生素B12水平较低，但这些受试者在肠外营养方面没有维生素B12缺乏症的代谢迹象。对个人数据的分析显示，四名循环血B12低的患者在正常范围内具有细胞内维生素B12缺乏症的标志。

BACKGROUND & AIMS: :The health issues of young adulthood have received relatively little attention compared with those of adolescence, although the critical issues in young adulthood parallel those of adolescence. Young adults often fare worse than adolescents on health indicators, with many measures of negative outcomes--including rates of injury, homicide, and substance use--peaking during the young adult years. The contextual factors shaping health status and access to care in young adulthood differ significantly from the context of adolescence. This article synthesizes national data to present a health profile of young adults, reviewing social indicators that describe the context of young adulthood and presenting measures of health status. We examine mortality, morbidity, risky behaviors, and health care access and utilization, identifying the most significant gender and racial/ethnic disparities. The article also identifies limitations of existing data and offers suggestions for future research and health monitoring in this area. We conclude with a discussion of current efforts to address the health and well-being of young adults and argue for creating a national health agenda for young adults that includes research, programs and policies to address health issues during this period of the lifespan.

背景与目标： ：与青春期相比，青年期的健康问题受到的关注相对较少，尽管青年期的关键问题与青春期的问题平行。在健康指标上，年轻人通常比青少年情况更糟，在年轻人成年时期，有很多负面结果的衡量指标，包括伤害率，杀人率和药物使用率。决定健康状况和成年后获得医疗服务的情境因素与青春期有很大不同。本文综合了国家数据，以介绍年轻人的健康状况，回顾了描述年轻人成年背景的社会指标，并提出了健康状况的衡量指标。我们检查了死亡率，发病率，危险行为以及医疗保健的获取和利用，确定了最重要的性别和种族/族裔差异。本文还指出了现有数据的局限性，并为该领域的未来研究和健康监测提供了建议。最后，我们讨论了当前为解决年轻人的健康和福祉所做的努力，并争辩了制定一项针对年轻人的国家健康议程，其中包括研究，计划和政策，以解决这一时期的健康问题。

BACKGROUND & AIMS: :The yeast S. cerevisiae is a central model organism in eukaryotic cell studies and a major component in many food and biotechnological industrial processes. However, the wide knowledge regarding genetics and molecular biology of S. cerevisiae is based on an extremely narrow range of strains. Studies of natural populations of S. cerevisiae, not associated with human activities or industrial fermentation environments, are very few. We isolated a panel of S. cerevisiae strains from a natural microsite, "Evolution Canyon" at Mount Carmel, Israel, and studied their genomic biodiversity. Analysis of 19 microsatellite loci revealed high allelic diversity and variation in ploidy level across the panel, from diploids to tetraploids, confirmed by flow cytometry. No significant differences were found in the level of microsatellite variation between strains derived from the major localities or microniches, whereas strains of different ploidy showed low similarity in allele content. Maximum genetic diversity was observed among diploids and minimum among triploids. Phylogenetic analysis revealed clonal, rather than sexual, structure of the triploid and tetraploid subpopulations. Viability tests in tetrad analysis also suggest that clonal reproduction may predominate in the polyploid subpopulations.

背景与目标： ：酿酒酵母是真核细胞研究中的中心模型生物，在许多食品和生物技术工业过程中都是主要成分。但是，关于酿酒酵母的遗传学和分子生物学的广泛知识是基于非常狭窄的菌株。与人类活动或工业发酵环境无关的酿酒酵母自然种群研究很少。我们从以色列卡梅尔山的天然微型站点“进化峡谷”中分离出一组酿酒酵母菌株，并研究了它们的基因组生物多样性。对19个微卫星基因座的分析显示，从二倍体到四倍体，整个等位基因组中的高等位基因多样性和倍性水平存在差异，这已通过流式细胞仪进行了确认。在来自主要地区或微生态位的菌株之间，微卫星变异水平没有发现显着差异，而具有不同倍性的菌株在等位基因含量上的相似性很低。在二倍体中观察到最大的遗传多样性，而在三倍体中观察到了最小的遗传多样性。系统发育分析显示三倍体和四倍体亚群的克隆结构，而不是有性结构。四元分析中的生存力测试还表明，在多倍体亚群中克隆繁殖可能占主导地位。

BACKGROUND & AIMS: In almost all countries, the critical point for defining the nutritional status of a population is represented by the poor source of representative data of the whole population or of the main subgroups of the population. Also, in Italy, the sources of data on the nutritional status of biochemically evaluated macro- and micronutrients are scant in relation to specific groups of the population, mainly children and the elderly. In this short review, only the nutritional status for vitamins is considered. The existing limited data, however, indicate that clinical signs of severe deficiency are not observed in Italy and the incidence of vitamin malnutrition is moderate. This is probably due to the large availability and variety of food and to Italian eating habits which reflect the typical Mediterranean dietrich, for example, in cereals, fresh fruit and vegetables, and olive oil. However, there are particular conditions, linked to lifestyle, in which the risk of a mild or moderate vitamin malnutrition increases. These include a monotonous diet, drug interactions, smoking habits and alcohol consumption.

背景与目标： 在几乎所有国家中，界定人口营养状况的关键点是整个人口或人口主要子群体代表性数据的来源不多。同样，在意大利，与生化评估的大量和微量营养素的营养状况有关的数据来源相对于特定人群（主要是儿童和老年人）而言很少。在这篇简短的评论中，仅考虑了维生素的营养状况。然而，现有的有限数据表明，在意大利未观察到严重缺乏的临床迹象，维生素营养不良的发生率中等。这可能是由于食物的可获得性和种类繁多以及意大利人的饮食习惯，这些饮食习惯反映了典型的地中海饮食，例如谷物，新鲜水果和蔬菜以及橄榄油中的饮食。但是，在与生活方式相关的某些特殊条件下，轻度或中度维生素营养不良的风险会增加。这些包括单调饮食，药物相互作用，吸烟习惯和饮酒。

BACKGROUND & AIMS: :We investigated the ability of systolic and diastolic carotid artery longitudinal wall motion (CALM) to delineate expected differences in arterial health in individuals representing a range of both age and health status. We recruited 161 younger healthy adults (aged 24 ± 5 y), 51 older healthy adults (aged 70 ± 5 y) and 14 adults with coronary artery disease (aged 67 ± 8 y) for resting assessment of CALM and arterial stiffness. All CALM parameters were reduced in the old healthy adults and adults with coronary artery disease compared with the young healthy adults (p < 0.01), with diastolic velocity and maximum diastolic acceleration being further reduced in the adults with coronary artery disease than in the older healthy adults (p < 0.01). Diastolic CALM parameters were more strongly related to age (β range: -0.46 to -0.53) than systolic CALM parameters (β range: -0.24 to -0.44). In contrast to previous examinations of a variety of CALM parameters, diastolic CALM may provide superior promise in terms of characterizing arterial wall properties, with additional sensitivity to cardiovascular disease status.

背景与目标： ：我们研究了代表年龄和健康状况范围的个体的收缩和舒张颈动脉纵向壁运动（CALM）描绘动脉健康预期差异的能力。我们招募了161名较年轻的健康成年人（24岁±5岁），51名较健康的成年人（70±5岁）和14名患有冠心病的成年人（67±8岁）进行了CALM和动脉僵硬度的静息评估。与年轻健康成年人相比，老年健康成年人和患有冠状动脉疾病的成年人的所有CALM参数均降低（p <0.01），与老年健康成年人相比，冠状动脉疾病的成年人的舒张速度和最大舒张加速进一步降低成人（p <0.01）。舒张期CALM参数与年龄（β范围：-0.46至-0.53）的相关性比收缩期CALM参数（β范围：-0.24至-0.44）更密切。与以前对各种CALM参数的检查相比，舒张期CALM在表征动脉壁特性方面可能具有更好的前景，并且对心血管疾病的状态更加敏感。

BACKGROUND & AIMS: :The TIM (T cell/transmembrane, immunoglobulin and mucin) proteins are crucial regulators of Th1/Th2 immune responses and have been implicated in several diseases including HIV-1/AIDS. The TIM1 exon 4 that codes for mucin domain is highly diverse, with sequence variants associated with varying phenotypes. In this study, TIM1 exon 4 was sequenced among 227 HIV-1 seroprevalent and 288 healthy non infected individuals from North Indian population and haplotypes established. A novel but rare haplotype D1(∗) was identified among the healthy and differed from D1 by a synonymous substitution G>T at Thr208Thr. The TIM1 haplotype diversity showed no association with susceptibility to HIV-1 infection. The seroprevalent individuals carrying D3A had relatively higher median CD4+T cell counts (368/μl) than those without (313/μl; p=0.02). A comparison of CD4+T counts between D3-A individuals on ART or ART naïve did not show any significant difference plausibly due to confounding nature of ART and other factors.

背景与目标： TIM（T细胞/跨膜，免疫球蛋白和粘蛋白）蛋白是Th1 / Th2免疫反应的关键调节剂，并与包括HIV-1 / AIDS在内的多种疾病有关。编码粘蛋白结构域的TIM1外显子4高度多样化，具有与不同表型相关的序列变体。在这项研究中，TIM1外显子4在来自北印度人口的227个HIV-1血清流行和288个健康的未感染个体中进行了测序，并建立了单倍型。在健康人群中鉴定出一种新颖但罕见的单倍型D1（∗），与D1的区别在于在Thr208Thr处的同义替代G> T。 TIM1单倍型多样性表明与HIV-1感染的易感性无关。携带D3A的血清流行个体的CD4 T细胞计数中位数相对较高（不含313 /μl； p = 0.02）。由于ART和其他因素的混杂，D3-A个体或未接受过ART的D3-A个体之间CD4 T计数的比较似乎没有显示任何显着差异。

BACKGROUND & AIMS: :The effect of ascorbic acid on iron retention from a diet with predicted low iron bioavailability (containing minimal meat and ascorbic acid) was investigated in iron-depleted premenopausal women. Eleven women were depleted of storage iron (indicated by serum ferritin) through a combination of diet (5.0 mg Fe/2000 kcal for 67-88 d) and phlebotomy. They then consumed a diet containing 13.7 mg Fe/2000 kcal, supplemented with placebo or ascorbic acid three times daily (1500 mg total) with meals for 5.5 wk. Ascorbic acid improved apparent iron absorption (balance method) [38 +/- 2% (means +/- SEM) vs 27 +/- 2%]. Ascorbic acid also improved hemoglobin, erythrocyte protoporphyrins, and serum iron but not hematocrit, serum ferritin, iron-binding capacity, or transferrin saturation. In iron-depleted women consuming a diet with predicted poor iron availability, ascorbic acid supplementation enhanced body iron retention for 5.5 wk.

背景与目标： ：在缺铁的绝经前妇女中研究了抗坏血酸对铁的生物滞留量具有预期低铁含量（含少量肉和抗坏血酸）的饮食中铁保留的影响。通过饮食（5.0 mg Fe / 2000 kcal，67-88 d）和静脉放血相结合，耗尽了11名妇女的铁储备（以血清铁蛋白表示）。然后，他们进食了含有13.7 mg Fe / 2000 kcal的饮食，每天补充3次（共1500 mg）安慰剂或抗坏血酸，每顿5.5周。抗坏血酸改善了表观铁的吸收（平衡法）[38 /-2％（平均值/-SEM）对27 /-2％]。抗坏血酸还可以改善血红蛋白，红血球原卟啉和血清铁，但不能改善血细胞比容，血清铁蛋白，铁结合能力或转铁蛋白饱和度。在饮食中铁含量低的女性中，铁的可利用性预计较差，补充抗坏血酸可增加体内铁保持5.5周。

BACKGROUND & AIMS: BACKGROUND:Optimal burn care is provided at specialized burn centers. Given the geographic location of these centers, many burn patients receive initial treatment at local emergency departments prior to transfer. The purpose of this study was to determine whether patients transferred from other facilities have worse outcomes than those admitted directly from the field. STUDY DESIGN:A retrospective cohort study was performed comparing the outcomes of patients admitted to our burn center directly from the field with patients requiring transfer from a preliminary care facility. The outcomes of interest were mortality, length of stay, length of stay/TBSA burned, number of operations and hospital charges. Poisson regression or Cox proportional hazards model was used to evaluate differences in outcomes after adjusting for potential confounders. RESULTS:From 2000 to 2003 a total of 1877 patients were admitted to our burn center and 953 (51%) were transferred from a preliminary care facility. No difference (p<0.05) was found in length of stay, number of operations, hospital charges and mortality between the two cohorts. CONCLUSIONS:This study demonstrates that patients transferred to a regional burn center from local hospitals have equivalent mortality, length of stay and hospital charges as those admitted directly from the field.

背景与目标： 背景：在专门的烧伤中心提供最佳烧伤护理。考虑到这些中心的地理位置，许多烧伤患者在转移之前会先在当地急诊科接受初步治疗。这项研究的目的是确定从其他机构转移来的患者是否比直接从现场接受的患者具有更差的结局。
研究设计：进行了一项回顾性队列研究，比较了直接从现场进入我们烧伤中心的患者与需要从初级保健机构转诊的患者的结局。感兴趣的结果是死亡率，住院时间，住院时间/ TBSA烧伤，手术次数和医院费用。泊松回归或Cox比例风险模型用于评估潜在混杂因素后评估结局的差异。
结果：从2000年到2003年，共有1877名患者被收录到我们的烧伤中心，其中953名（51％）从初级护理机构转入了治疗。两组的住院时间，手术次数，住院费用和死亡率均无差异（p <0.05）。
结论：这项研究表明，从当地医院转移到区域烧伤中心的患者的死亡率，住院时间和住院费用与直接从现场住院的患者相同。

BACKGROUND & AIMS: :Male breast cancer (MBC) is an uncommon neoplasm that shares several biologic characteristics with its female counterpart. In the latter, abnormalities in the expression and/or copy number of the ERBB2 gene are present in 10% to 30% of invasive carcinoma and behave as poor prognostic markers. ERBB2 abnormalities have also been reported in MBC, yet at lower frequency, but their prognostic significance remains controversial. Furthermore, no study has addressed the impact of chromosome 17 abnormalities in MBC survival. In this study, the ERBB2-gene status (overexpression and amplification) and chromosome 17 numerical abnormalities were investigated in a series of 50 archival cases of MBC. The results, together with patient's age, histologic grade, pathologic stage, and estrogen receptor status were correlated with overall survival. ERBB2-protein overexpression was present in 7 cases (14%), ERBB2-gene amplification in 4 (8%), and aneuploidy of chromosome 17 in 12 cases (33.3%). The pathologic stage, ERBB2 overexpression and ERBB2 amplification were significantly correlated with overall survival (P=0.002, 0.016, and 0.009, respectively). No correlation was observed between chromosome 17 aneuploidy and overall survival. Therefore, despite their low incidence in MBC, expression abnormalities of ERBB2 behave, together with the pathologic stage of the tumor, as predictors of overall survival, akin to what has been reported for its female counterpart.

背景与目标： ：男性乳腺癌（MBC）是一种罕见的肿瘤，与女性乳腺癌具有某些生物学特性。在后者中，ERBB2基因表达和/或拷贝数异常存在于10％至30％的浸润性癌中，并表现为不良的预后指标。在MBC中也有ERBB2异常的报道，但频率较低，但其预后意义仍存在争议。此外，还没有研究解决17号染色​​体异常对MBC生存的影响。在这项研究中，对一系列50例MBC存档病例中的ERBB2基因状态（过表达和扩增）和17号染色​​体数字异常进行了研究。结果，以及患者的年龄，组织学等级，病理分期和雌激素受体状态与总体生存率相关。 ERBB2蛋白过表达7例（14％），ERBB2基因扩增4例（8％），染色体17的非整倍性12例（33.3％）。病理分期，ERBB2过表达和ERBB2扩增与总生存率显着相关（分别为P = 0.002、0.016和0.009）。在第17号染色​​体非整倍性与总体存活率之间未发现相关性。因此，尽管其在MBC中的发病率较低，但ERBB2的表达异常以及肿瘤的病理阶段仍可作为总体存活率的预测指标，类似于其女性对应物的报道。

BACKGROUND & AIMS: :Polychromatic flow-cytometric assays were used to analyze paired intrahepatic and peripheral lymphocyte samples from 37 patients with chronic hepatitis C. Compared with peripheral cells, intrahepatic T cells were selectively enriched with CD45RO+ memory T cells but had a lower percentage of CD4+ T cells expressing the differentiation markers CD27 and CD28. The percentage of intrahepatic CD45RO+ and CD28+ T cells correlated with the degree of liver inflammation, which suggests that memory T cells at relatively early stages of differentiation are directly involved in liver inflammation. Despite their memory phenotype, intrahepatic T cells were defective in proliferation capability, produced less interferon- gamma in response to stimulation by T cell receptor, and contained less perforin but expressed higher levels of Fas and Fas ligand, compared with their counterparts in peripheral blood. The distinct characteristics of intrahepatic T cells suggest that they play an important role in the immunopathogenesis of chronic hepatitis C.

背景与目标： ：采用多色流式细胞术分析了37例慢性丙型肝炎患者的肝内和外周血淋巴细胞配对样本。与外周血细胞相比，肝内T细胞选择性富集了CD45RO记忆T细胞，但表达CD4 T细胞的百分比较低分化标记CD27和CD28。肝内CD45RO和CD28 T细胞的百分比与肝脏炎症程度相关，这表明处于分化早期的记忆T细胞直接参与肝脏炎症。尽管具有记忆表型，但与外周血中的肝细胞相比，肝内T细胞在T细胞受体的刺激下应答能力较弱，产生的干扰素γ较少，穿孔素含量较低，但表达的Fas和Fas配体水平较高。肝内T细胞的独特特征表明它们在慢性丙型肝炎的免疫发病机制中起着重要作用。

BACKGROUND & AIMS: :The hepatitis C virus (HCV) infects 3% of the world's population, or approximately 170 million people. Most of those acutely infected progress to chronic infection and are unresponsive to existing antiviral treatment. Over a 20-year period, chronic HCV infection leads to cirrhosis and the sequelae of end-stage liver disease, including hepatic encephalopathy, ascites, variceal haemorrhage and hepatocellular carcinoma. Orthotopic liver transplantation (OLT) is the optimal treatment for decompensated HCV cirrhosis, but is limited by organ availability and universal graft reinfection. This review discusses the results with OLT for HCV from the Dumont-UCLA Liver Transplant Center and discusses future directions in the management of HCV.

背景与目标： ：丙型肝炎病毒（HCV）感染了全球3％的人口，约有1.7亿人。大多数急性感染者会发展为慢性感染，并且对现有的抗病毒治疗无反应。在20年的时间里，慢性HCV感染会导致肝硬化和终末期肝病的后遗症，包括肝性脑病，腹水，静脉曲张出血和肝细胞癌。原位肝移植（OLT）是失代偿性HCV肝硬化的最佳治疗方法，但受到器官可用性和通用移植物再感染的限制。这篇综述讨论了Dumont-UCLA肝移植中心使用OLT进行HCV的结果，并讨论了HCV管理的未来方向。

BACKGROUND & AIMS: BACKGROUND:The relationship between bone health and adiposity and how it may be affected in people with chronic metabolic conditions is complex. METHODS:Seventeen women with type 1 diabetes mellitus (T1DM) and nine age-matched healthy women with a median age of 22.6 years (range, 17.4, 23.8) were studied by 3T MRI and MR spectroscopy to assess abdominal adiposity, tibial bone microarchitecture and vertebral bone marrow adiposity (BMA). Additional measures included DXA-based assessments of total body (TB), femoral neck (FN) and lumbar spine (LS) bone mineral density (BMD) and fat mass (FM). RESULTS:Although women with T1DM had similar BMI and BMA to the controls, they had higher visceral and subcutaneous adiposity on MRI (P<.05) and total body FM by DXA (P=.03). Overall, in the whole cohort, a clear inverse association was evident between BMA and BMD at all sites (P<.05). These associations remained significant after adjusting for age, BMI, FM and abdominal adiposity. In addition, visceral adiposity, but not subcutaneous adiposity, showed a positive association with BMA (r, .4, P=.03), and a negative association with total body BMD (r, .5, P=.02). Apparent trabecular separation as assessed by MRI showed an inverse association to total body BMD by DXA (r, -.4, P=.04). CONCLUSION:Irrespective of the presence of an underlying metabolic condition, young women display a negative relationship between MRI-measured BMA and DXA-based assessment of BMD. Furthermore, an association between BMA and visceral adiposity supports the notion of a common origin of these two fat depots.

背景与目标： 背景：在慢性代谢疾病患者中，骨骼健康与肥胖之间的关系及其可能受到的影响是复杂的。
方法：通过3T MRI和MR光谱法研究了17位1型糖尿病（T1DM）妇女和9位年龄相匹配的健康女性（中位年龄为22.6岁，范围分别为17.4、23.8），以评估腹部肥胖，胫骨微结构和椎骨肥胖症（BMA）。其他措施包括基于DXA的全身（TB），股骨颈（FN）和腰椎（LS）骨矿物质密度（BMD）和脂肪量（FM）评估。
结果：尽管患有T1DM的女性的BMI和BMA与对照组相似，但其MRI的内脏和皮下脂肪率较高（P <.05），而DXA显示的全身FM较高（P = .03）。总体而言，在整个队列中，BMA和BMD在所有位点之间均存在明显的逆相关性（P <.05）。在调整了年龄，BMI，FM和腹部肥胖后，这些关联仍然很显着。此外，内脏脂肪而不是皮下脂肪与BMA呈正相关（r，.4，P = .03），与全身BMD呈负相关（r，.5，P = .02）。 MRI评估的表观小梁分离显示，DXA与全身BMD呈负相关（r，-。4，P = .04）。
结论：无论是否存在潜在的代谢状况，年轻女性在MRI测量的BMA与基于DXA的BMD评估之间均显示负相关。此外，BMA和内脏肥胖之间的联系支持了这两个脂肪库的共同起源这一概念。

BACKGROUND & AIMS: BACKGROUND:A growing body of literature shows that many universities and colleges are making educational portfolios part of their faculty assessment and student's learning plan for both undergraduate and graduate programs. We provide an outline for the development of a medical educator's portfolio, including an electronic version. DESCRIPTION:Guidelines for the development of an educational portfolio focusing on medical education are provided, including design, format, and content. An electronic version of the portfolio, which combines flexibility and ease of revision, is also described, including formats for publication and distribution. Student reflections on the e-portfolio are presented, and potential applications of the e-portfolio in medical education are described. CONCLUSION:We believe that portfolio development is a valuable application that provides rich documentation of participants' educational history, accomplishments, and intellectual property as related to their professional learning and growth.

背景与目标： 背景：越来越多的文献表明，许多大学和学院正在将教育档案袋作为其本科和研究生课程教师评估和学生学习计划的一部分。我们为医学教育者的档案袋的发展提供了一个大纲，包括电子版本。
描述：提供了针对医学教育的教育档案袋的开发指南，包括设计，格式和内容。还介绍了组合的灵活性和易于修改的电子版本，包括发布和分发的格式。介绍了学生对电子档案夹的思考，并描述了电子档案夹在医学教育中的潜在应用。
结论：我们认为，档案袋开发是一个有价值的应用程序，它为参与者的教育历史，成就和与他们的专业学习和成长有关的知识产权提供了丰富的文档。