• 【加拿大安大略省旧秩序门诺教徒中的母乳喂养做法:多种方法研究。】 复制标题 收藏 收藏
    DOI:10.1177/0890334413498305 复制DOI
    作者列表:Norris S,Collin SM,Ingram J
    BACKGROUND & AIMS: BACKGROUND:The Old Order Mennonites (OOM) of rural Ontario have a lifestyle that is very distinct from the rest of Canada. Breastfeeding practices among this community have not been described previously. OBJECTIVES:This study aimed to estimate the prevalence of exclusive breastfeeding (EBF) at 2, 4, and 6 months; to compare the prevalence of EBF among OOM and Canadian women; to investigate factors associated with EBF at 6 months; and to gain qualitative insight into the breastfeeding practices of OOM women. METHODS:Data on maternal characteristics, delivery factors, and infant feeding methods at birth and at 2, 4, and 6 months were obtained from medical records at the Elmira Medical Centre for all births to OOM women between January 2006 and December 2011. Semi-structured interviews were carried out with 2 lactation consultants working at the Elmira Medical Centre. RESULTS:Complete breastfeeding data were available for 195 of 225 OOM women (77.4%). The majority of OOM women initiated breastfeeding (87.9%); 81.4% continued to breastfeed exclusively at 2 months, 74.0% to 4 months, and 36.8% to 6 months. Women who had a homebirth (12.3%) had 2.6-fold higher odds of EBF at 6 months (odds ratio, 2.59; 95% confidence interval, 1.03-6.53) compared with women who delivered in a hospital. Cultural and religious influences and community support were suggested as reasons for the relatively high prevalence of EBF. CONCLUSION:Breastfeeding rates among OOM women are consistently higher in the first 6 months of life compared to the general Canadian population. Homebirth independently predicted increased odds of EBF at 6 months.
    背景与目标: 背景:安大略省农村地区的老门诺诺特人(OOM)的生活方式与加拿大其他地区截然不同。先前没有描述该社区的母乳喂养做法。
    目的:本研究旨在评估纯母乳喂养(EBF)在2、4、6个月时的患病率。比较OOM和加拿大女性中EBF的患病率;调查与6个月时EBF相关的因素;并获得有关OOM妇女的母乳喂养习惯的定性见解。
    方法:从Elmira医学中心的医学记录中获得了2006年1月至2011年12月间所有OOM妇女的孕产妇特征,分娩因子和婴儿喂养方法的数据。在Elmira医疗中心与两名泌乳顾问进行了结构化访谈。
    结果:225名OOM妇女中有195名获得了完整的母乳喂养数据(77.4%)。大部分OOM妇女开始母乳喂养(87.9%); 81.4%的婴儿仅在2个月,74.0%到4个月以及36.8%到6个月期间继续纯母乳喂养。与在医院分娩的妇女相比,有分娩的妇女(12.3%)在6个月时的EBF几率高2.6倍(优势比为2.59; 95%的置信区间为1.03-6.53)。有人认为,文化和宗教影响以及社区的支持是EBF患病率较高的原因。
    结论:与加拿大普通人群相比,OOM妇女在出生后的头6个月内的母乳喂养率一直较高。家庭出生独立地预测6个月时EBF的几率会增加。
  • 【在11个国家提供咨询服务后,影响妇女选择激素结合避孕方法的因素:《选择》研究的亚分析结果。】 复制标题 收藏 收藏
    DOI:10.3109/13625187.2013.819077 复制DOI
    作者列表:Bitzer J,Cupanik V,Fait T,Gemzell-Danielsson K,Grob P,Oddens BJ,Pawelczyk L,Unzeitig V
    BACKGROUND & AIMS: OBJECTIVES:To investigate which characteristics of women and healthcare professionals (HCPs) were associated with changing to another combined hormonal contraceptive (CHC) method after contraceptive counselling. METHODS:CHOICE was a cross-sectional survey in which 18,787 women were counselled about combined hormonal contraceptives, during which their contraceptive methods preferred both prior to and after counselling were recorded. In this subanalysis, characteristics associated with changing the method after counselling were determined using logistic regression models. RESULTS:The probability of intending to change from the pill to another method was associated with being older; university-educated; being in a steady relationship; a prior unintended pregnancy; a younger HCP or one who recommended methods other than the pill. Changing to the patch was associated with a female HCP or a HCP who recommended the patch or an injectable. Changing to the ring was associated with being over 21 years; university-educated; being in a relationship; previous hormonal method use; and counselling by a female HCP, a HCP < 60 years old, or a HCP who recommended the ring or an implant. The country of residence influenced these changes in a complex pattern. CONCLUSIONS:Women's choice of CHC methods after contraceptive counselling are influenced by their age, educational background, relationship status, prior unplanned pregnancies and country of residence, as well as age, gender and preferences of their HCP.
    背景与目标: 目的:调查在避孕咨询后,女性和医护人员(HCP)的哪些特征与改用另一种联合激素避孕(CHC)方法有关。
    方法:选择是一项横断面调查,其中向18,787名妇女提供了有关联合激素避孕药的咨询,在此期间,记录了她们在咨询之前和之后首选的避孕方法。在此子分析中,使用逻辑回归模型确定与咨询后更改方法有关的特征。
    结果:打算从药丸换成另一种方法的可能性与年纪大有关。受过大学教育;保持稳定的关系;先前的意外怀孕;较年轻的HCP或建议使用除药丸以外的方法的人。更换贴剂与女性HCP或推荐贴剂或注射剂的HCP有关。更换戒指的年龄超过21岁。受过大学教育;处于恋爱关系中;以前使用过的荷尔蒙方法;并由女性HCP,小于60岁的HCP或推荐环或植入物的HCP进行咨询。居住国以复杂的方式影响了这些变化。
    结论:避孕咨询后,妇女选择慢性丙型肝炎的方法受到其年龄,教育背景,人际关系,先前计划外的怀孕和居住国家,年龄,性别和他们的HCP偏好的影响。
  • 【不同灭活方法对口蹄疫病毒印度疫苗株稳定性的比较。】 复制标题 收藏 收藏
    DOI:10.1016/j.biologicals.2017.06.004 复制DOI
    作者列表:Sarkar A,Tamil Selvan RP,Kishore S,Ganesh K,Bhanuprakash V
    BACKGROUND & AIMS: :In this study, the efficiency of binary ethyleneimine (BEI) in combination with formaldehyde (FA) and glutaraldehyde (GTA) in inactivating the Indian FMDV vaccine strains is compared. The acceptable safety of virus inactivation was faster and the inactivation rates were increased many-folds with combination of inactivants than BEI alone. FMDV A was inactivated rapidly than the other two serotypes with BEI + FA combination. Inactivation plots were linear for all the serotypes irrespective of inactivation process. Further, the integrity studies on 146S using serotype specific ELISA indicated no significant change in the antigenic mass of all the serotypes throughout the inactivation process. However, the loss of 146S antigen occurred in the subsequent steps of downstream processing. Further, the studies on intactness of viral RNA using real time PCR indicated the amplification of 1D gene sequences in all the preparations of timed samples irrespective of serotypes/inactivation process. Further, inactivated virus preparation (146S) was more stable at lower temperatures for all the serotypes/inactivation process. Among the combinations of inactivants, BEI + FA out performed compared to BEI + GTA and BEI in terms of inactivation rates, 146S yield and its storage stability, irrespective of the serotypes.
    背景与目标: :在这项研究中,比较了二元乙撑亚胺(BEI)与甲醛(FA)和戊二醛(GTA)组合在灭活印度FMDV疫苗株中的效率。病毒灭活的可接受安全性比单独的BEI更快,灭活剂组合的灭活率提高了许多倍。 FMDV A与BEI FA组合的其他两种血清型相比迅速失活。不论灭活过程如何,所有血清型的灭活图都是线性的。此外,使用血清型特异性ELISA对146S进行的完整性研究表明,在整个灭活过程中,所有血清型的抗原质量均无明显变化。但是,146S抗原的丢失发生在下游加工的后续步骤中。此外,使用实时PCR对病毒RNA的完整性进行的研究表明,在所有定时样品制备中,无论血清型/灭活过程如何,一维基因序列均会扩增。此外,对于所有血清型/灭活过程,灭活的病毒制剂(146S)在较低的温度下更稳定。在灭活剂组合中,无论血清型如何,在灭活率,146S收率及其储存稳定性方面,BEI的表现均优于BEI的GTA和BEI。
  • 【同时使用几种方法估算浮游生物量的有用性。】 复制标题 收藏 收藏
    DOI:10.1016/S0932-4739(88)80023-3 复制DOI
    作者列表:Aleya L,Devaux J,Magouri HE,Marvalin O,Amblard C
    BACKGROUND & AIMS: :The annual cycle of phytoplankton biomass was followed in a eutrophic lake (Lake Aydat, Massif Central, France), using classic descriptors (biovolumes and chlorophyll a) as well as adenosine-5'-phosphate (ATP) levels. ATP is the metabolite indicating living biomass. ATP/Cell count and ATP/Chlorophyll a ratios were elevated due to the presence of heterotrophic organisms, such as several species of ciliates. The first ratio is greater than the second. The difference can be explained either by an underestimation of the nanoplankton fraction through the cell count method, or by a lack of sedimentation in the settling chambers used for counting cells.
    背景与目标: :在富营养化湖泊(法国Massif Central,Aydat湖)中,使用经典描述符(生物量和叶绿素a)以及5'-磷酸腺苷(ATP)水平跟踪浮游植物生物量的年度循环。 ATP是代谢产物,指示生物量。由于存在异养生物,例如几种纤毛虫,ATP /细胞数和ATP /叶绿素a的比例增加。第一个比率大于第二个比率。可以通过通过细胞计数方法低估纳米浮游生物比例,或通过在用于计数细胞的沉降室中缺乏沉淀来解释这种差异。
  • 【甲基丙烯酸甲酯骨水泥制备过程中使用的采样和分析方法的比较。】 复制标题 收藏 收藏
    DOI:10.1080/15459620600732811 复制DOI
    作者列表:Ungers LJ,Vendrely TG
    BACKGROUND & AIMS: :Surgeons, surgical nurses, and other operating room staff are exposed to airborne concentrations of methyl methacrylate during the preparation of orthopedic bone cement. Three sampling and analysis methods have been used to measurement methyl methacrylate in this work environment: (1) direct-reading photoacoustic infrared spectrometry, (2) solid sorbent and gas chromatography with flame ionization detection, and (3) colorimetric detector tubes. Previous studies have measured operating room exposures and judged the efficacy of cement mixing wth little, if any, regard for method sensitivity, detection limits, precision, or accuracy. The present investigation was designed to allow concurrent monitoring of methyl methacrylate levels from the same air volume using each of the three methods. Three popular orthopedic bone cement products were mixed during a number of repeat preparations (n = 36). Airborne concentrations were monitored concurrently during each preparation. Attention was given to the proper treatment of detection limits, and the results are reported both as raw data and descriptive statistics. A one-way ANOVA using a Tukey-Kramer HSD comparison was performed on method-specific results indicating that the photoacoustic infrared spectrometry and solid sorbent, gas chromatography with flame ionization detection are in good agreement, but the colorimetric detector tube method reports significantly different airborne concentrations. It is concluded that previous assessments using the photoacoustic infrared spectrometry and solid sorbent, gas chromatography with flame ionization detection may be relied on, but the detector tube method underreports actual exposures. Accordingly, the results of past exposure assessments and mixing method efficacy studies using colorimetric detector tubes may not be reliable.
    背景与目标: :在骨科骨水泥的制备过程中,外科医生,外科护士和其他手术室工作人员暴露于空气中甲基丙烯酸甲酯的浓度。在此工作环境中,已使用三种采样和分析方法来测量甲基丙烯酸甲酯:(1)直读光声红外光谱法;(2)带有火焰离子化检测的固体吸附剂和气相色谱法;(3)比色检测管。先前的研究已经测量了手术室的暴露量,并判断了水泥混合的有效性,而很少考虑方法的灵敏度,检测限,精密度或准确性。本研究旨在使用三种方法中的每一种,从相同的空气量中同时监测甲基丙烯酸甲酯的含量。在多次重复准备过程中,将三种流行的骨科骨水泥产品混合在一起(n = 36)。在每次准备过程中同时监测空气中的浓度。注意对检出限的正确处理,其结果既报告为原始数据,也报告为描述性统计数据。使用Tukey-Kramer HSD比较法进行的单向方差分析是针对特定方法的结果,表明光声红外光谱法和固体吸附剂,气相色谱法与火焰电离检测法相吻合,但是比色检测管法报告的空气传播差异很大浓度。可以得出结论,以前可能使用光声红外光谱法和固体吸附剂进行的评估,以及采用火焰离子化检测的气相色谱法,但是检测器管法没有报告实际的暴露量。因此,使用比色检测管进行的以往暴露评估和混合方法功效研究的结果可能并不可靠。
  • 【妇女对计划生育方法作用机制的态度:在西班牙潘普洛纳的初级保健中心进行的调查。】 复制标题 收藏 收藏
    DOI:10.1186/1472-6874-7-10 复制DOI
    作者列表:de Irala J,Lopez del Burgo C,Lopez de Fez CM,Arredondo J,Mikolajczyk RT,Stanford JB
    BACKGROUND & AIMS: BACKGROUND:Informed consent in family planning includes knowledge of mechanism of action. Some methods of family planning occasionally work after fertilization. Knowing about postfertilization effects may be important to some women before choosing a certain family planning method. The objective of this survey is to explore women's attitudes towards postfertilization effects of family planning methods, and beliefs and characteristics possibly associated with those attitudes. METHODS:Cross-sectional survey in a sample of 755 potentially fertile women, aged 18-49, from Primary Care Health Centres in Pamplona, Spain. Participants were given a 30-item, self-administered, anonymous questionnaire about family planning methods and medical and surgical abortion. Logistic regression was used to identify variables associated with women's attitudes towards postfertilization effects. RESULTS:The response rate was 80%. The majority of women were married, held an academic degree and had no children. Forty percent of women would not consider using a method that may work after fertilization but before implantation and 57% would not consider using one that may work after implantation. While 35.3% of the sample would stop using a method if they learned that it sometimes works after fertilization, this percentage increased to 56.3% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization and those who consider it is important to distinguish between natural and induced embryo loss were less likely to consider the use of a method with postfertilization effects. CONCLUSION:Information about potential postfertilization effects of family planning methods may influence women's acceptance and choice of a particular family planning method. Additional studies in other populations are necessary to evaluate whether these beliefs are important to those populations.
    背景与目标: 背景:计划生育中的知情同意包括对作用机制的了解。受精后,某些计划生育方法有时会起作用。在选择某种计划生育方法之前,了解受精后的影响对某些女性可能很重要。这项调查的目的是探讨妇女对计划生育方法受精后效果的态度,以及可能与这些态度相关的信念和特征。
    方法:对来自西班牙潘普洛纳的初级保健健康中心的755名年龄在18-49岁之间的潜在可育妇女进行了横断面调查。与会人员获得了关于计划生育方法以及药物和手术流产的30项自我管理的匿名问卷。 Logistic回归用于确定与女性对受精后效果的态度有关的变量。
    结果:有效率80%。大多数妇女已婚,拥有学历,并且没有孩子。 40%的女性不会考虑使用在受精后但在植入前可能起作用的方法,而57%的女性不会考虑使用在植入后可能会起作用的方法。如果35.3%的样本如果得知受精后有时仍会使用某种方法,则停止使用该方法,但当提及植入后有时仍可使用的方法时,该百分比增加至56.3%。认为人类生命始于受精的妇女,以及认为重要的是区分自然损失和诱发的胚胎损失的妇女,不太可能考虑使用具有受精后作用的方法。
    结论:有关计划生育方法潜在的受精后效果的信息可能会影响女性对某种计划生育方法的接受和选择。有必要在其他人群中进行其他研究,以评估这些信念是否对这些人群重要。
  • 【使用蛋白质微阵列和非参数方法进行预后的综合方法。】 复制标题 收藏 收藏
    DOI:10.1038/msb4100167 复制DOI
    作者列表:Knickerbocker T,Chen JR,Thadhani R,MacBeath G
    BACKGROUND & AIMS: :Over the past several years, multivariate approaches have been developed that address the problem of disease diagnosis. Here, we report an integrated approach to the problem of prognosis that uses protein microarrays to measure a focused set of molecular markers and non-parametric methods to reveal non-linear relationships among these markers, clinical variables, and patient outcome. As proof-of-concept, we applied our approach to the prediction of early mortality in patients initiating kidney dialysis. We found that molecular markers are not uniformly prognostic, but instead vary in their value depending on a combination of clinical variables. This may explain why reports in this area aiming to identify prognostic markers, without taking into account clinical variables, are either conflicting or show that markers have marginal prognostic value. Just as treatments are now being tailored to specific subsets of patients, our results show that prognosis can also benefit from a 'personalized' approach.
    背景与目标: :在过去的几年中,已经开发出多种方法来解决疾病诊断问题。在这里,我们报告了一种针对预后问题的综合方法,该方法使用蛋白质微阵列测量一组重点的分子标志物,并使用非参数方法来揭示这些标志物,临床变量和患者预后之间的非线性关系。作为概念验证,我们将我们的方法应用于开始肾脏透析的患者的早期死亡率的预测。我们发现分子标记物的预后并不统一,而是根据临床变量的组合而改变其价值。这可以解释为什么在不考虑临床变量的情况下,旨在鉴定预后标志物的该领域的报告要么矛盾,要么表明该标志物具有预后价值。正如现在针对特定患者子集调整治疗方法一样,我们的结果表明,“个性化”方法也可以使预后受益。
  • 【连续圆形撕囊术技术的发展,优势和方法。】 复制标题 收藏 收藏
    DOI:10.1016/s0886-3350(13)80870-x 复制DOI
    作者列表:Gimbel HV,Neuhann T
    BACKGROUND & AIMS: :The development of the continuous circular capsulorhexis (CCC) technique has contributed significantly to the safety and effectiveness of cataract extraction and intraocular lens implantation. This technique facilitates every size of smooth, circular, capsular opening, and it produces a strong capsular rim that resists tearing even when stretched during lens material removal or lens implantation. Maintaining the general integrity of the eye and facilitating such procedures as hydrodissection, endolenticular phacoemulsification, capsule polishing, and safe lens implantation in both adults and children are some of the advantages of CCC. This procedure can be performed in several ways, and it has been proven to be consistently reproducible by experienced surgeons.
    背景与目标: :连续圆形撕囊术(CCC)技术的发展对白内障摘除和人工晶状体植入的安全性和有效性做出了重大贡献。这项技术可促进各种大小的光滑,圆形囊膜开口,并产生坚固的囊膜边缘,即使在摘除晶状体材料或植入晶状体时将其拉伸也能抗撕裂。在成人和儿童中,保持眼睛的整体完整性并促进诸如水解剖,晶状体超声乳化,囊膜抛光和安全的晶状体植入等程序是CCC的一些优势。可以以多种方式执行此过程,并且经验丰富的外科医生已证明该过程可始终如一地重现。
  • 【社会行为的分子基础:模型,方法和进步。】 复制标题 收藏 收藏
    DOI:10.1016/j.conb.2012.08.008 复制DOI
    作者列表:LeBoeuf AC,Benton R,Keller L
    BACKGROUND & AIMS: :Elucidating the molecular and neural basis of complex social behaviors such as communal living, division of labor and warfare requires model organisms that exhibit these multi-faceted behavioral phenotypes. Social insects, such as ants, bees, wasps and termites, are attractive models to address this problem, with rich ecological and ethological foundations. However, their atypical systems of reproduction have hindered application of classical genetic approaches. In this review, we discuss how recent advances in social insect genomics, transcriptomics, and functional manipulations have enhanced our ability to observe and perturb gene expression, physiology and behavior in these species. Such developments begin to provide an integrated view of the molecular and cellular underpinnings of complex social behavior.
    背景与目标: :阐明复杂的社会行为(如公共生活,劳动分工和战争)的分子和神经基础,需要表现出这些多方面行为表型的模型生物。社会昆虫,如蚂蚁,蜜蜂,黄蜂和白蚁,是解决这一问题的诱人模型,具有丰富的生态和伦理学基础。但是,它们的非典型生殖系统阻碍了经典遗传方法的应用。在这篇综述中,我们讨论了社交昆虫基因组学,转录组学和功能操纵的最新进展如何增强了我们观察和干扰这些物种中基因表达,生理和行为的能力。这样的发展开始提供对复杂社会行为的分子和细胞基础的综合看法。
  • 【噬菌体分型,mecA基因的PCR扩增以及抗生素抗药性模式作为耐甲氧西林金黄色葡萄球菌医院内暴发的流行病学标记。】 复制标题 收藏 收藏
    DOI:10.1016/j.sjbs.2009.07.006 复制DOI
    作者列表:Al-Khulaifi Manal M,Amin Aref Nagwa M,Al Salamah AA
    BACKGROUND & AIMS: :Staphylococcus aureus is one of the major causes of community and hospital-acquired infections. Bacteriophage considered as a major risk factor acquires S. aureus new virulence genetic elements. A total number of 119 S. aureus isolated from different specimens obtained from (RKH) were distinguished by susceptibility to 19 antimicrobial agents, phage typing, and PCR amplification for mecA gene. All of MRSA isolates harbored mecA gene, except three unique isolates. The predominant phage group is belonging to the (mixed group). Phage group (II) considered as an epidemiological marker correlated to β-lactamase hyper producer isolates. MRSA isolates indicated high prevalence of phage group (II) with highly increase for phage types (Ø3A), which were correlated to the skin. Phage types (Ø80/Ø81) played an important roll in Community Acquired Methicillin Resistant S. aureus (CAMRSA). Three outpatients MRSA isolates had low multiresistance against Bacitracin (Ba) and Fusidic acid (FD), considered as CAMRSA isolates. It was detected that group I typed all FD-resistant MSSA isolates. Phage groups (M) and (II) were found almost to be integrated for Gentamycin (GN) resistance especially phage type (Ø95) which relatively increased up to 20% in MRSA. Tetracycline (TE) resistant isolates typed by groups (II) and (III) in MSSA. Only one isolate resistant to Sulphamethoxazole/Trimethoprim (SXT) was typed by (III/V) alone in MSSA. MRSA isolates resistant to Chloramphenicol (C) and Ba were typed by all groups except (V). It could be concluded that (PERSA) S. aureus isolates from the wound that originated and colonized, and started to build up multi-resistance against the topical treatment antibiotics. In this study, some unique sporadic isolates for both MRSA and MSSA could be used as biological, molecular and epidemiological markers such as prospective tools.
    背景与目标: 金黄色葡萄球菌是社区和医院获得性感染的主要原因之一。被认为是主要危险因素的噬菌体获得了金黄色葡萄球菌新的毒力遗传成分。从(RKH)的不同标本中分离出的总共119株金黄色葡萄球菌通过对19种抗菌药的敏感性,噬菌体分型和mecA基因的PCR扩增来区分。除三个独特的分离株外,所有的MRSA分离株均带有mecA基因。主要噬菌体基团属于(混合基团)。噬菌体组(II)被认为是与β-内酰胺酶高产分离株相关的流行病学标记。 MRSA分离物表明噬菌体组(II)的流行率很高,而与皮肤相关的噬菌体类型(Ø3A)则大大增加。噬菌体类型(Ø80/Ø81)在社区获得的耐甲氧西林金黄色葡萄球菌(CAMRSA)中起着重要作用。三名门诊MRSA分离株对杆菌肽(Ba)和梭链孢酸(FD)的多重耐药性较低,被认为是CAMRSA分离株。检测到第一组键入了所有耐FD的MSSA分离株。发现噬菌体组(M)和(II)几乎对庆大霉素(GN)具有抵抗力,特别是在MRSA中相对增加高达20%的噬菌体类型(Ø95)。在MSSA中按(II)和(III)组分类的四环素(TE)耐药菌株。在MSSA中,仅通过(III / V)分型了一种对Sulphamethoxazole / Trimethoprim(SXT)有抗性的菌株。除(V)外,所有组均对氯霉素(C)和Ba具有抗性的MRSA分离株进行了分型。可以得出结论,(PERSA)金黄色葡萄球菌从起源和定殖的伤口中分离出来,并开始建立对局部治疗抗生素的多重耐药性。在这项研究中,MRSA和MSSA的一些独特的零星分离株可用作生物学,分子和流行病学标记,例如前瞻性工具。
  • 【评价用于测量眼底照片上视网膜血管图像宽度的测微法和微光密度法。】 复制标题 收藏 收藏
    DOI:10.1007/BF02172974 复制DOI
    作者列表:Delori FC,Fitch KA,Feke GT,Deupree DM,Weiter JJ
    BACKGROUND & AIMS: :The width of retinal vessel images on fundus photographs was determined by projection micrometry and microdensitometry. These methods were evaluated on 12 retinal vessels using the negatives of 570-nm monochromatic fundus photographs. For projection micrometry, the intraobserver reproducibility of vessel width measurements was 1.6%-2.9%, depending upon the experience of the observer. Significant interobserver differences in the measured widths were demonstrated. For microdensitometry, three distinct measurement criteria were used. Significant differences in width as measured by the three criteria were found, but there were no interoperator differences for each criterion. The intraoperator reproducibility of vessel width measurements by microdensitometry was 2.1%-2.5%. Significant differences were found in the vessel widths determined by the micrometry and densitometry methods, and results obtained by micrometry are discussed in terms of edge-detection phenomena.
    背景与目标: :通过投影显微术和显微光密度法确定眼底照片上的视网膜血管图像的宽度。使用570 nm单色眼底照片的底片在12个视网膜血管上评估了这些方法。对于投影显微术,根据观察者的经验,观察者在血管宽度测量中的可重复性为1.6%-2.9%。观察者之间的测量宽度差异显着。对于微光密度测定法,使用了三种不同的测量标准。发现了通过三个标准测量的宽度上的显着差异,但是每个标准都没有互操作性差异。通过微光密度法测量的术中血管宽度的可重复性为2.1%-2.5%。在通过测微法和光密度法确定的血管宽度上发现了显着差异,并就边缘检测现象讨论了通过测微法获得的结果。
  • 【法国国家医疗保健系统数据库(SNDS)中基于案例的方法鉴定与上消化道出血相关的药物的经验评估。】 复制标题 收藏 收藏
    DOI:10.1002/pds.5038 复制DOI
    作者列表:Thurin NH,Lassalle R,Schuemie M,Pénichon M,Gagne JJ,Rassen JA,Benichou J,Weill A,Blin P,Moore N,Droz-Perroteau C
    BACKGROUND & AIMS: PURPOSE:Upper gastrointestinal bleeding (UGIB) is a severe and frequent drug-related event. In order to enable efficient drug safety alert generation in the French National Healthcare System database (SNDS), we assessed and calibrated empirically case-based designs to identify drug associated with UGIB risk. METHODS:All cases of UGIB were extracted from SNDS (2009-2014) using two definitions. Positive and negative drug controls were used to compare 196 self-controlled case series (SCCS), case-control (CC) and case-population (CP) design variants. Each variant was evaluated in a 1/10th population sample using area under the receiver operating curve (AUC) and mean square error (MSE). Parameters that had major impacts on results were identified through logistic regression. Optimal designs were replicated in the unsampled population. RESULTS:Using a specific UGIB definition, AUCs ranged from 0.64 to 0.80, 0.44 to 0.61 and 0.50 to 0.67, for SCCS, CC and CP, respectively. MSE ranged from 0.07 to 0.39, 0.83 to 1.33 and 1.96 to 4.6, respectively. Univariate regressions showed that high AUCs were achieved with SCCS with multiple drug adjustment and a 30-day risk window starting at exposure. The top-performing SCCS variant in the unsampled population yielded an AUC = 0.84 and MSE = 0.14, with 10/36 negative controls presenting significant estimates. CONCLUSIONS:SCCS adjusting for multiple drugs and using a 30-day risk window has the potential to generate UGIB-related alerts in the SNDS and hypotheses on its potential population impact. Negative control implementation highlighted that low systematic error was generated but that protopathic bias and confounding by indication remained unaddressed issues.
    背景与目标: 目的:上消化道出血(UGIB)是一种严重且频繁的药物相关事件。为了在法国国家医疗保健系统数据库(SNDS)中实现高效的药物安全警报生成,我们评估并校准了基于经验的基于案例的设计,以识别与UGIB风险相关的药物。
    方法:所有的UGIB病例均使用两个定义从SNDS(2009-2014)中提取。使用阳性和阴性药物对照来比较196个自控病例系列(SCCS),病例对照(CC)和病例人群(CP)设计变体。使用接收器工作曲线(AUC)和均方误差(MSE)下的面积,在人口样本的1/10中评估每个变体。通过逻辑回归确定对结果有重大影响的参数。最佳设计在未抽样人群中重复进行。
    结果:使用特定的UGIB定义,SCCS,CC和CP的AUC分别为0.64至0.80、0.44至0.61和0.50至0.67。 MSE的范围分别为0.07至0.39、0.83至1.33和1.96至4.6。单因素回归表明,SCCS的高AUCs可以通过多种药物调整和从暴露开始的30天风险窗口来实现。未抽样人群中表现最好的SCCS变体的AUC = 0.84,MSE = 0.14,其中10/36个阴性对照的估计值显着。
    结论:针对多种药物进行调整并使用30天风险窗的SCCS可能会在SNDS中产生与UGIB相关的警报,并假设其可能对人群产生影响。负控制措施的实施突显出产生了较低的系统误差,但原发病率偏倚和因指示而造成的混淆仍未解决。
  • 【创伤后增生性玻璃体视网膜病变。流行病学特征,发病,危险因素和视觉结果。】 复制标题 收藏 收藏
    DOI:10.1016/s0161-6420(97)30167-5 复制DOI
    作者列表:Cardillo JA,Stout JT,LaBree L,Azen SP,Omphroy L,Cui JZ,Kimura H,Hinton DR,Ryan SJ
    BACKGROUND & AIMS: PURPOSE:The purpose of the study was to characterize the clinical development of proliferative vitreoretinopathy (PVR) after trauma in the human eye.

    METHODS:A chart review was performed on the records of 1564 patients with ocular trauma seen at a large metropolitan hospital. The frequency, type of ocular trauma, time to onset, potential risk factors, and visual outcome for PVR were evaluated.

    RESULTS:Proliferative vitreoretinopathy occurred in 71 (4%) of 1654 injured eyes. Of these 71 injured eyes, 30 (42%) resulted from rupture, 15 (21%) from penetration, 13 (18%) from perforation, and 7 (10%) from confusion. Six (9%) were associated with an intraocular foreign body (IOFB). The frequency of PVR following perforation, rupture, penetration, IOFB, and contusion was 43%, 21%, 15%, 11%, and 1%, respectively. Overall, those eyes that developed PVR had a poorer visual outcome, with PVR being the primary reason for visual loss. The time from injury to onset of PVR was shortest after perforation (median, 1.3 months), followed by rupture (2.1 months), IOFB (3.1 months), penetration (3.2 months), and contusion (5.7 months). Vitreous hemorrhage was the strongest independent predictive factor for the development of PVR. A long, posteriorly located wound and persistent intraocular inflammation were also important risk factors for PVR.

    CONCLUSIONS:These results suggest that PVR is a common complication following a variety of ocular injuries, and that it is associated with a poor visual outcome. Its frequency, onset, and outcome are strongly dependent on the nature of the trauma. Specific high-risk groups are identified as candidates for more aggressive therapy.

    背景与目标: 目的:该研究的目的是表征人眼创伤后增生性玻璃体视网膜病变(PVR)的临床发展。

    方法:图表在一家大城市医院对1564例眼外伤患者的记录进行了回顾。评估了PVR的发生频率,眼外伤类型,发作时间,潜在危险因素和视觉结果。

    结果:1654例中有71例(4%)发生了增殖性玻璃体视网膜病变受伤的眼睛。在这71眼受伤的眼中,有30眼(42%)由破裂引起,有15眼(21%)由穿透引起,有13眼(18%)由穿孔引起,有7眼(10%)由混乱引起。六个(9%)与眼内异物(IOFB)相关。穿孔,破裂,穿透,IOFB和挫伤后PVR的发生率分别为43%,21%,15%,11%和1%。总体而言,那些发展为PVR的眼睛的视觉效果较差,其中PVR是造成视力丧失的主要原因。穿孔后从受伤到PVR发作的时间最短(中位1.3个月),其次是破裂(2.1个月),IOFB(3.1个月),穿透(3.2个月)和挫伤(5.7个月)。玻璃体出血是PVR发展的最强独立预测因素。长期,位于后方的伤口和持续的眼内炎症也是造成PVR的重要危险因素。

    结论:这些结果表明,PVR是多种眼外伤后的常见并发症,并且与视觉效果差有关。其频率,发作和结果在很大程度上取决于创伤的性质。特定的高危人群被确定为更积极治疗的候选者。

  • 【渗滤液中难降解有机物的高级氧化-潜在方法和剩余底物的生物降解性评估。】 复制标题 收藏 收藏
    DOI:10.1080/09593330801985057 复制DOI
    作者列表:Hagman M,Heander E,Jansen JL
    BACKGROUND & AIMS: :An assessment of potential methods suitable for degradation and/or reduction of refractory organics was performed on landfill leachate from SYSAV AB, Malmö, Sweden. Pretreatment of the leachate was performed in a sequence batch reactor designed for nitrification in activated sludge. Oxidation of the leachate was then O3, O3/pH adjustment (pH 9 and 10), H2O2, O3/H2O2 and performic acid in lab-scale reactors. The degradation of organic material was followed with chemical oxygen demand (COD) measurements for all experiments except for the performic acid treatment for which total organic carbon (TOC) measurements were used. The potential degradation of refractory organics into biodegradable organic material was analysed by subsequent oxygen uptake rate (OUR) measurements in laboratory batch reactors. Ozonation of biologically pre-treated leachate increased reduction of the organic material. The most biodegradable organic material was produced after oxidation with only ozone and ozonation at pH 9. Performic acid did not reduce the content of organic material in the leachate. However, a combination of biological pretreatment, chemical oxidation with O3/H2O2 and a subsequent biological process resulted in the most efficient oxidation method for the tested leachate.
    背景与目标: :对来自瑞典马尔默的SYSAV AB的垃圾渗滤液进行了适用于降解和/或还原难降解有机物的潜在方法的评估。在设计用于活性污泥硝化的顺序分批反应器中进行渗滤液的预处理。然后在实验室规模的反应器中对渗滤液的氧化是O3,O3 / pH调节(pH 9和10),H2O2,O3 / H2O2和过甲酸。除过甲酸处理使用总有机碳(TOC)测量值外,所有实验均在化学物质需氧量(COD)测量之后跟踪有机材料的降解情况。通过随后在实验室间歇式反应器中的氧气吸收率(OUR)测量,分析了难降解有机物降解为可生物降解有机材料的潜在可能性。生物预处理渗滤液的臭氧化增加了有机物质的减少。在仅用臭氧氧化并在pH 9下进行臭氧氧化后,才能生产出可生物降解性最高的有机材料。过甲酸不会降低渗滤液中有机材料的含量。然而,将生物预处理,用O3 / H2O2进行化学氧化以及随后的生物过程相结合,可以为测试的渗滤液提供最有效的氧化方法。
  • 【用于重症监护病房中处理方法和计算机化指南的在线比较和验证的体系结构。】 复制标题 收藏 收藏
    DOI:10.1016/j.cmpb.2008.07.012 复制DOI
    作者列表:Allart L,Vilhelm C,Mehdaoui H,Hubert H,Sarrazin B,Zitouni D,Lemdani M,Ravaux P
    BACKGROUND & AIMS: :Clinical decision support systems are a combination of software techniques to help the clinicians in their medical decision making process via functionalities ranging from basic signal analysis to therapeutic planning and computerized guidelines. The algorithms providing all these functionalities must be very carefully validated on real patient data and must be confronted to everyday clinical practice. One of the main problems when developing these techniques is the difficulty to obtain high-quality complete patient records, comprising data coming both from the biomedical equipment (high-frequency signals), and from numerous other sources (therapeutics, imagery, clinical actions, etc.). In this paper, we present an infrastructure for developing and testing such software algorithms. It is based on a bedside workstation where testing different algorithms simultaneously on real-time data is possible in the ward. It is completed by a collaborative portal enabling different teams to test their software algorithms on the same patient records, making comparisons and cross-validations more easily.
    背景与目标: :临床决策支持系统是软件技术的组合,可通过从基本信号分析到治疗计划和计算机化指南等功能帮助临床医生进行医疗决策。提供所有这些功能的算法必须在真实的​​患者数据上非常仔细地验证,并且必须面对日常临床实践。开发这些技术时的主要问题之一是难以获得高质量的完整患者记录,包括来自生物医学设备(高频信号)以及来自许多其他来源(治疗,图像,临床行动等)的数据)。在本文中,我们提供了用于开发和测试此类软件算法的基础架构。它基于床头工作站,可以在病房中同时对实时数据测试不同的算法。它是由一个协作门户网站完成的,该门户网站使不同的团队可以在相同的患者记录上测试他们的软件算法,从而使比较和交叉验证更加容易。

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