• 【饮酒信仰在解释美国大学生饮酒习惯中的种族差异中的作用。】 复制标题 收藏 收藏
    DOI:10.3109/10826084.2013.821659 复制DOI
    作者列表:Antin TMJ,Lipperman-Kreda S,Paschall MJ,Marzell M,Battle R
    BACKGROUND & AIMS: :This study, funded by the National Institute on Alcohol Abuse and Alcoholism, examines psychosocial mediators to explain discrepancies in past-30-day drinking between African American and White college student drinkers in the United States. Between 2008 and 2010, 5,845 college drinkers completed an online survey about their alcohol use. Using latent variable structural equations modeling, we investigated the relationships between ethnicity, drinking beliefs, and students' past 30-day alcohol use. Drinking beliefs-i.e., positive expectancies, perceived norms, and disapproval of alcohol use-fully mediated the relationship between ethnicity and drinking behaviors. Study limitations and directions for future research are discussed.
    背景与目标: :这项研究由美国国家酒精滥用和酒精中毒研究所资助,研究了社会心理调解员,以解释美国非洲裔美国人和白人大学生饮酒者过去30天饮酒之间的差异。在2008年至2010年之间,有5,845名大学饮酒者完成了有关其饮酒情况的在线调查。使用潜在的变量结构方程模型,我们调查了种族,饮酒信仰和学生过去30天的饮酒量之间的关系。饮酒信仰,即积极的期望,可感知的规范以及对饮酒的不满,充分介导了种族与饮酒行为之间的关系。讨论了研究的局限性和未来研究的方向。
  • 【参加过性犯罪者治疗小组的智障男性:随访。】 复制标题 收藏 收藏
    DOI:10.1111/jar.12038 复制DOI
    作者列表:Heaton KM,Murphy GH
    BACKGROUND & AIMS: BACKGROUND:There have been a number of studies of treatment for men with intellectual disabilities and sexually abusive behaviour but few follow-up studies. Our aim was to follow up men with intellectual disabilities who had attended group cognitive behavioural treatment (CBT) for sexually abusive behaviour. METHOD:Thirty-four men (from seven treatment sites) were followed up. All had attended SOTSEC-ID groups. The mean length of follow-up, since the end of the treatment group, was 44 months (SD 28.7, range 15-106 months). RESULTS:The statistically significant improvements in sexual knowledge, empathy and cognitive distortions that occurred during treatment were maintained at follow-up. In all, 11 of the 34 (32%) men showed further sexually abusive behaviour, but only two of these men received convictions. Analyses of the variables associated with further sexually abusive behaviour indicated that a diagnosis of autism was associated with a higher likelihood of further sexually abusive behaviour. CONCLUSIONS:This study provides some evidence of the longer-term effectiveness of group CBT for men with intellectual disabilities and sexually abusive behaviour.
    背景与目标: 背景:已有许多针对智障和性虐待行为的男性的治疗研究,但随访研究很少。我们的目的是跟进曾参加过针对性虐待行为的集体认知行为治疗(CBT)的智障男性。
    方法:对34名男性(来自7个治疗部位)进行了随访。所有人都参加了SOTSEC-ID组。自治疗组结束以来,平均随访时间为44个月(SD 28.7,范围15-106个月)。
    结果:随访期间,在治疗过程中发生的性知识,同理心和认知扭曲方面的统计学显着改善得以维持。在这34名男性中,有11名(32%)表现出进一步的性虐待行为,但其中只有2名被定罪。对与进一步的性虐待行为有关的变量的分析表明,自闭症的诊断与进一步的性虐待行为的可能性更高有关。
    结论:这项研究提供了一些证据,表明集体CBT对于智力残疾和性虐待行为的长期有效性。
  • 【癫痫治疗中的种族/种族差异:我们知道什么?我们需要知道些什么?】 复制标题 收藏 收藏
    DOI:10.1016/j.yebeh.2006.05.011 复制DOI
    作者列表:Szaflarski M,Szaflarski JP,Privitera MD,Ficker DM,Horner RD
    BACKGROUND & AIMS: :We examine current understanding of the minority disadvantage in the clinical management of epilepsy. We performed an online literature search using several keywords (race, ethnicity, epilepsy, treatment, and quality of life) and identified additional literature through cross-referencing/manual search. The search produced 58 items published between 1977 and 2005. Of 49 original research studies, 38 were quantitative, 7 were qualitative, and 4 used mixed methods. Three or more articles were published in Epilepsia, Epilepsy &Behavior, Epilepsy Research, Neurology, and Seizure. Research concerning racial/ethnic differences in epilepsy treatment is scarce and limited by methodology, but suggests underutilization of state-of-the-art therapies by minorities. Racial/ethnic minorities also appear to have limited knowledge about epilepsy and its treatment, experience barriers to care, lack social support, and seek alternative therapies for epilepsy. We propose a framework to identify the array of disparities, points of intervention, and interventions.
    背景与目标: :我们研究了目前对癫痫临床治疗中少数群体不利因素的理解。我们使用几个关键字(种族,种族,癫痫症,治疗和生活质量)进行了在线文献搜索,并通过交叉引用/手动搜索确定了其他文献。该检索产生了1977年至2005年之间出版的58项。在49项原始研究中,定量研究38项,定性研究7项,混合使用方法4项。在癫痫,癫痫行为,癫痫研究,神经病学和癫痫发作中发表了三篇或以上文章。关于癫痫治疗中种族/族裔差异的研究很少,并且受到方法论的限制,但表明少数群体对最新疗法的利用不足。种族/族裔少数群体对癫痫及其治疗的知识似乎也很有限,遇到护理障碍,缺乏社会支持并寻求癫痫的替代疗法。我们提出了一个框架,以识别差距,干预点和干预措施。
  • 【在开发PROMIS儿科项目库中使用焦点小组。】 复制标题 收藏 收藏
    DOI:10.1007/s11136-008-9338-1 复制DOI
    作者列表:Walsh TR,Irwin DE,Meier A,Varni JW,DeWalt DA
    BACKGROUND & AIMS: PURPOSE:To understand differences in perceptions of patient-reported outcome domains between children with asthma and children from the general population. We used this information in the development of patient-reported outcome items for the Patient-Reported Outcomes Measurement Information System Pediatrics project. METHODS:We conducted focus groups composed of ethnically, racially, and geographically diverse youth (8-12, 13-17 years) from the general population and youth with asthma. We performed content analysis to identify important themes. RESULTS:We identified five unique and different challenges that may confront youth with asthma as compared to general population youth: (1) They experience more difficulties when participating in physical activities; (2) They may experience anxiety about having an asthma attack at anytime and anywhere; (3) They may experience sleep disturbances and fatigue secondary to their asthma symptoms; (4) Their health condition has a greater effect on their emotional well-being and interpersonal relationships; and (5) Youth with asthma report that asthma often leaves them with insufficient energy to complete their school activities, especially physical activities. CONCLUSIONS:The results confirm unique experiences for children with asthma across a broad range of health domains and enhance the breadth of all domains when creating an item bank.
    背景与目标: 目的:了解哮喘儿童和普通人群儿童对患者报告的结局认识的差异。我们在为患者报告的结果测量信息系统儿科项目开发患者报告的结果项目时使用了此信息。
    方法:我们进行了焦点小组讨论,这些小组由种族,种族和地理上不同的青年(8-12岁,13-17岁)组成,这些青年来自普通人群和哮喘青年。我们进行了内容分析,以识别重要的主题。
    结果:与普通人群的青年相比,我们确定了青年哮喘可能面临的五个独特且不同的挑战:(1)他们在参加体育活动时遇到更多的困难; (2)他们可能随时随地都对哮喘发作感到焦虑; (3)他们可能会因哮喘症状而继发睡眠障碍和疲劳; (4)他们的健康状况对他​​们的情绪健康和人际关系有更大的影响; (5)患有哮喘的青年报告说,哮喘常常使他们精力不足,无法完成其学校活动,尤其是体育活动。
    结论:这些结果证实了哮喘儿童在广泛的健康领域中的独特经历,并在创建项目库时提高了所有领域的广度。
  • 【比利时70至90岁年龄段的散发性Creutzfeldt-Jakob病发病率增加。】 复制标题 收藏 收藏
    DOI:10.1007/s10654-006-9012-2 复制DOI
    作者列表:Van Everbroeck B,Michotte A,Sciot R,Godfraind C,Deprez M,Quoilin S,Martin JJ,Cras P
    BACKGROUND & AIMS: :From 1998 a prospective surveillance study of Creutzfeldt-Jakob disease (CJD) has been initiated in Belgium. In addition to epidemiological data, information on cerebrospinal fluid biomarkers, prion protein gene and brain neuropathology was collected. From 1-1-1998 to 31-12-2004, 188 patients were referred to the surveillance system. In 85 patients a 'definite' diagnosis of sporadic CJD (sCJD) could be made, whereas 26 patients remained 'probable'. We further identified two unrelated patients with an E200K mutation, and two patients with a seven octapeptide repeat insertion in one family. In one patient a familial history was noted but genetic analysis was not performed. In 72 patients different final diagnoses were made, Alzheimer's disease being the most frequent (N = 20). The demographic parameters of the Belgian population were similar to those observed in the rest of Europe. We did notice a significantly increased age-specific incidence (> 6/10(6)/year) of sCJD patients between 70 and 90 years old in the period 2002-2004 compared to 1998-2001 and retrospectively obtained data (1990-1997, p < 0.01). We undertook a detailed clinical and biochemical analysis to investigate this increase but could not identify any reason other than an increased vigilance for the diagnosis. In conclusion, our study identified that in the past sCJD may have been underestimated in patients over age 70 although these patients are both clinically and neurobiochemically similar to the general sCJD phenotype.
    背景与目标: :从1998年开始,比利时开始进行克雅氏病(CJD)的前瞻性监测研究。除流行病学数据外,还收集了有关脑脊液生物标志物,病毒蛋白基因和脑神经病理学的信息。从1998年1月1日到2004年12月31日,有188名患者被转诊到监视系统。在85例患者中,可以对散发性CJD(sCJD)做出“确定”诊断,而26例患者仍然“可能”。我们进一步确定了一个家族中两名具有E200K突变的无关患者和两名具有7个八肽重复插入的患者。一名患者有家族史,但未进行遗传分析。在72位患者中,做出了不同的最终诊断,其中最常见的是阿尔茨海默氏病(N = 20)。比利时人口的人口统计学参数与欧洲其他地区相似。我们确实注意到,与1998-2001年相比,2002-2004年间70-90岁的sCJD患者的年龄特异性发病率显着增加(> 6/10(6)/年),并且回顾性地获得了数据(1990-1997年, p <0.01)。我们进行了详细的临床和生化分析,以调查这种增加,但除了提高对诊断的警惕性外,无法确定任何其他原因。总之,我们的研究发现,过去的sCJD在70岁以上的患者中可能被低估了,尽管这些患者在临床和神经生化方面均与一般sCJD表型相似。
  • 【SES和种族民族在年轻人应对资源的压力缓冲效果中的差异。】 复制标题 收藏 收藏
    DOI:10.1080/13557858.2013.828827 复制DOI
    作者列表:Gayman MD,Cislo AM,Goidel AR,Ueno K
    BACKGROUND & AIMS: OBJECTIVES:This study assesses socioeconomic status (SES) and race-ethnic differences in the extent to which coping resources (social support and self-esteem) buffer the negative impact of chronic stress on depressive symptoms. DESIGN:We analyze data from a large community-based sample of young adults (ages 18-23) living in Miami-Dade County, Florida, USA (N = 1411). RESULTS:Study findings indicate that the stress-buffering effects of social support or self-esteem do not vary by SES. However, independent of SES and other study controls, non-Hispanic whites experience greater stress-buffering effects from social support than African-Americans and African-Americans experience greater stress-buffering effects from self-esteem than Cubans and Nicaraguans. CONCLUSION:In light of these results, we conclude that a greater understanding of racial and ethnic differences in mental health requires close attention to cultural transmissions of coping strategies within groups, which may be partly responsible for these differences in buffering effects.
    背景与目标: 目的:本研究评估社会经济地位(SES)和种族种族差异,应对资源(社会支持和自尊)缓解慢性压力对抑郁症状的负面影响的程度。
    设计:我们分析来自居住在美国佛罗里达州迈阿密戴德县(N = 1411)的大量年轻人(18至23岁)的社区样本数据。
    结果:研究结果表明,社会支持或自尊的压力缓冲作用不会因SES而变化。但是,独立于SES和其他研究对照,非西班牙裔白人比非裔美国人受到社会支持的压力缓冲作用更大,非裔美国人比古巴人和尼加拉瓜人受到自尊的压力缓冲作用更大。
    结论:根据这些结果,我们得出结论,对心理健康中种族和种族差异的更多了解需要密切注意群体内部应对策略的文化传播,这可能部分是造成缓冲效果差异的部分原因。
  • 【参加WIC的美国儿童在饮食摄入方面的种族/种族差异。】 复制标题 收藏 收藏
    DOI:10.3390/nu11112607 复制DOI
    作者列表:Zimmer MC,Rubio V,Kintziger KW,Barroso C
    BACKGROUND & AIMS: :Recent studies have assessed diet quality of low-income U.S. children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but differences by race/ethnicity remain unknown. We assessed racial/ethnic disparities in nutrient intake from dietary sources (not supplements) among children participating in WIC, with a focus on priority nutrients and food groups for future WIC food package revisions, as described in a recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM). We used data from the 2011-2014 National Health and Nutrition Examination Surveys (NHANES) and multivariable linear regression analysis to evaluate relationships between race/ethnicity and nutrient/food group intake of children participating in WIC. All data were analyzed using SAS 9.4 survey procedures, accounting for the complex survey design of the NHANES. Compared to non-Hispanic White children, Hispanic children had diets with better nutrient distribution and lower dietary energy density, while non-Hispanic Black children had diets with poorer nutrient intake. Hispanic children had higher potassium and fiber intake, and consumed more legumes, while non-Hispanic Black children had lower calcium and vitamin D intake, higher sodium intake, and lower total dairy intake, compared to non-Hispanic White children. These findings can inform WIC nutrition education messages and future food package revisions.
    背景与目标: :最近的研究评估了参加妇女,婴儿和儿童特别营养补充计划(WIC)的美国低收入儿童的饮食质量,但种族/族裔之间的差异仍然未知。正如美国国家科学院最近的报告所述,我们评估了参加WIC的儿童从饮食来源(而非补充剂)中摄入的营养素的种族/种族差异,重点关注了未来WIC食品包装修订中的优先营养素和食物组。 ,工程与医学(NASEM)。我们使用了2011-2014年全国健康和营养检查调查(NHANES)的数据以及多变量线性回归分析来评估参加WIC的儿童的种族/族裔与营养/食物组摄入量之间的关系。所有数据均使用SAS 9.4调查程序进行了分析,这说明了NHANES的复杂调查设计。与非西班牙裔白人儿童相比,西班牙裔儿童的饮食具有更好的营养分布和较低的饮食能量密度,而非西班牙裔黑人儿童的饮食具有较低的营养摄入量。与非西班牙裔白人儿童相比,西班牙裔儿童的钾和纤维摄入量较高,并且食用豆类较多,而非西班牙裔黑人儿童的钙和维生素D摄入量较低,钠摄入量较高,乳制品总摄入量较低。这些发现可以为WIC营养教育信息和将来的食品包装修订提供参考。
  • 【在英国国家饮食与营养调查中,所食用食物组的份量与肥胖测量之间的关联。】 复制标题 收藏 收藏
    DOI:10.1017/S0007114508060777 复制DOI
    作者列表:Kelly MT,Rennie KL,Wallace JM,Robson PJ,Welch RW,Hannon-Fletcher MP,Livingstone MB
    BACKGROUND & AIMS: :The objective of the present study was to examine the associations between the portion sizes of food groups consumed with measures of adiposity using data from the National Diet and Nutrition Survey of British adults. Seven-day weighed dietary records, physical activity diaries and anthropometric measurements were used. Foods eaten were assigned to thirty different food groups and analyses were undertaken separately for men and women. The median daily portion size of each food group consumed was calculated. The potential mis-reporting [corrected] of dietary energy intake (EI) was identified using the following equation: EI--estimated energy requirements/EER [corrected] x 100 = percentage of under-reporting (UR) of energy needs. Multinomial logistic regression (adjusted for age, social class, physical activity level and UR) was used to determine the portion sizes of food groups most strongly associated with obesity status. Few positive associations between the portion sizes of food groups consumed and obesity status were found. However, UR was prevalent, with a median UR of predicted energy needs of 34 and 33 % in men and women, respectively. After the adjustment was made for UR, more associations between the food groups and obesity status became apparent in both sexes. The present study suggests that the true effect of increased portion size of foods on obesity status may be masked by high levels of UR. Alternatively, these data may indicate that an increased risk of obesity is not associated with specific foods/food groups but rather with an overall increase in the range of foods and food groups being consumed.
    背景与目标: :本研究的目的是使用英国成年人的国家饮食和营养调查所提供的数据,通过肥胖测量来检验食用的食物组的份量之间的关联。使用7天称重的饮食记录,体力活动日记和人体测量值。食用的食物被分配到30个不同的食物组中,并且分别对男性和女性进行了分析。计算每个食用食物组的中位数每日份量。饮食能量摄入(EI)的潜在错误报告[校正]使用以下公式确定:EI-估计能量需求/ EER [校正] x 100 =能量需求报告不足(UR)的百分比。使用多项式逻辑回归(根据年龄,社会阶层,体育活动水平和UR进行调整)来确定与肥胖状况最相关的食物组的份量。在食用的食物类别的份量与肥胖状况之间几乎没有正相关。但是,UR普遍存在,男性和女性的预期能量需求中值UR分别为34%和33%。在对UR进行调整后,两性之间的食物组与肥胖状况之间的联系更加明显。本研究表明,高比例的尿素可能掩盖了食物份量增加对肥胖状况的真正影响。或者,这些数据可能表明肥胖的风险增加与特定食品/食物类别无关,而与所食用的食品和食物类别范围的总体增加有关。
  • 【弱势群体对电子健康工具的坚持:系统文献综述和荟萃分析。】 复制标题 收藏 收藏
    DOI:10.2196/11613 复制DOI
    作者列表:Arsenijevic J,Tummers L,Bosma N
    BACKGROUND & AIMS: BACKGROUND:Electronic health (eHealth) tools are increasingly being applied in health care. They are expected to improve access to health care, quality of health care, and health outcomes. Although the advantages of using these tools in health care are well described, it is unknown to what extent eHealth tools are effective when used by vulnerable population groups, such as the elderly, people with low socioeconomic status, single parents, minorities, or immigrants. OBJECTIVE:This study aimed to examine whether the design and implementation characteristics of eHealth tools contribute to better use of these tools among vulnerable groups. METHODS:In this systematic review, we assessed the design and implementation characteristics of eHealth tools that are used by vulnerable groups. In the meta-analysis, we used the adherence rate as an effect size measure. The adherence rate is defined as the number of people who are repetitive users (ie, use the eHealth tool more than once). We also performed a meta-regression analysis to examine how different design and implementation characteristics influenced the adherence rate. RESULTS:Currently, eHealth tools are continuously used by vulnerable groups but to a small extent. eHealth tools that use multimodal content (such as videos) and have the possibility for direct communication with providers show improved adherence among vulnerable groups. CONCLUSIONS:eHealth tools that use multimodal content and provide the possibility for direct communication with providers have a higher adherence among vulnerable groups. However, most of the eHealth tools are not embedded within the health care system. They are usually focused on specific problems, such as diabetes or obesity. Hence, they do not provide comprehensive services for patients. This limits the use of eHealth tools as a replacement for existing health care services.
    背景与目标: 背景技术:电子保健(eHealth)工具正越来越多地应用于医疗保健中。他们有望改善获得医疗保健的机会,医疗保健的质量和健康结果。尽管已很好地描述了在卫生保健中使用这些工具的优势,但尚不知道eHealth工具在被弱势人群(例如老年人,社会经济地位低下的人,单亲父母,少数民族或移民)使用时在多大程度上有效。
    目的:本研究旨在检查电子卫生保健工具的设计和实施特征是否有助于弱势群体更好地使用这些工具。
    方法:在这项系统的审查中,我们评估了弱势群体使用的eHealth工具的设计和实施特征。在荟萃分析中,我们将依从率作为效应量度。遵守率定义为重复用户(即多次使用eHealth工具)的人数。我们还进行了元回归分析,以检查不同的设计和实现特征如何影响依从率。
    结果:当前,易受伤害群体仍在使用eHealth工具,但程度很小。使用多模式内容(例如视频)并可以与提供者直接通信的eHealth工具显示,弱势群体之间的依从性得到了提高。
    结论:使用多模式内容并提供与提供者直接通信的可能性的eHealth工具在弱势群体中具有更高的依从性。但是,大多数eHealth工具并未嵌入医疗保健系统中。他们通常专注于特定问题,例如糖尿病或肥胖。因此,他们没有为患者提供全面的服务。这限制了使用eHealth工具替代现有的医疗服务。
  • 【生物素基和磷酸酪氨酰基亚磷酰胺衍生物可用于在合成寡核苷酸上掺入多个报告基团。】 复制标题 收藏 收藏
    DOI:10.1093/nar/18.15.4345 复制DOI
    作者列表:Misiura K,Durrant I,Evans MR,Gait MJ
    BACKGROUND & AIMS: :Non-nucleosidic phosphoramidite linker units suitable for use on commercial DNA synthesis machines have been designed for the direct incorporation of biotin and a new reporter group, phosphotyrosine, at multiple sites on synthetic oligonucleotides. The units are based on a 3-carbon glyceryl backbone where the reporter group is attached to the 2-O-position through a 3-aminopropyl spacer. 17-mer oligonucleotides were synthesized carrying at the 5'-end 1, 2, 4 or 8 biotinyl units or 1, 2, 4 or 8 phosphotyrosinyl units respectively and used for the detection of DNA on nitrocellulose filters by hybridization. Subsequent incubation of the filters with a monoclonal antibody to the reporter group followed by secondary detection using enhanced chemiluminescence (ECL) resulted in amplification of signal strengths as the number of reporter groups was increased. The results were quantitated by use of a charge couple device (CCD) camera. Spacing of biotin moieties by thymidyl residues resulted in further improvements in signal strengths, whereas similar spacing of phosphotyrosinyl units did not.
    背景与目标: :已设计出适用于商业DNA合成机的非核苷亚磷酰胺连接体单元,用于在合成寡核苷酸的多个位点直接掺入生物素和新的报告基团磷酸酪氨酸。这些单元基于3-碳甘油基主链,其中报告基团通过3-氨丙基间隔基连接到2-O-位。合成分别具有5'端1、2、4或8个生物素基单元或1、2、4或8个磷酸酪氨酸基单元的17聚体寡核苷酸,并用于通过杂交在硝酸纤维素滤膜上检测DNA。随后将滤膜与针对报告基因组的单克隆抗体一起孵育,然后使用增强的化学发光(ECL)进行二次检测,导致信号强度随报告基因组数量的增加而放大。通过使用电荷耦合器件(CCD)相机对结果进行定量。胸苷残基对生物素部分的间隔导致信号强度的进一步提高,而磷酸酪氨酰基单元的相似间隔却没有。
  • 【Rosai-Dorfman病32例患者的疾病特征,放射学特征,合并症和种族差异。】 复制标题 收藏 收藏
    DOI:10.1097/RCT.0000000000000983 复制DOI
    作者列表:Elshikh M,Schellingerhout D,Rayan J,Taher A,Elsayes AK,Mujtaba B,Garg N
    BACKGROUND & AIMS: OBJECTIVE:Rosai-Dorfman disease (RDD) is a rare and idiopathic nonneoplastic disease of histiocytes that is characterized by lymphadenopathy and extranodal disease. In this study, we documented anatomical preferences, imaging findings, comorbid diseases, and ethnic differences in 32 RDD patients. METHODS:We conducted a retrospective review of pathologically confirmed cases seen at our institution from 1998 to 2016. These cases were analyzed for (a) anatomical locations, (b) radiologic appearance, (c) comorbid diseases, and (d) differences between ethnic groups. RESULTS:We found 32 patients with RDD, 18 were women and 14 were men. There were 51 lesions in all patients, 23.5% of which were nodal, involving 11 lymph node regions, and 76.5% were extranodal. Cervical lymph nodes and maxillofacial area were the most common affected nodal and extranodal locations, respectively. Only 4 (12.5%) of 32 patients had pure nodal involvement, whereas 20 (62.5%) of 32 had pure extranodal disease and 8 (25%) of 32 had mixed nodal and extranodal disease.Anatomically, RDD affected multiple organs in our cohort, including the lymphatic system, maxillofacial area (glandular and nonglandular tissues), superficial soft tissue, central nervous system, breast, peritoneum, gastrointestinal tract, and lungs.Radiologically, RDD presentation was variable from an organ to another. However, most lesions were hypermetabolic on 18F-fluorodeoxyglucose positron-emission tomography/computed tomography and isointense on T1-weighted magnetic resonance imaging. Computed tomographic findings were extremely variable between organs.Comorbid diseases were found in 11 patients. Those patients had 17 comorbid diseases; the most common were autoimmune diseases, viral diseases, and cancer.The organ distribution of RDD was slightly different between ethnic groups. The most frequent disease location for African Americans was lymph nodes; for whites, central nervous system and nonglandular maxillofacial (27.3% each); for Asians, lymph nodes, subcutaneous tissue, and nonglandular maxillofacial (25% each); and for Hispanics, lymph nodes and glandular maxillofacial (33.3% each). CONCLUSIONS:Rosai-Dorfman disease represents a wide-spectrum disease not limited to lymph nodes. Radiologically, RDD has diverse imaging findings. However, most lesions were hypermetabolic on 18F-fluorodeoxyglucose positron-emission tomography/computed tomography and isointense on T1-weighted imaging. Patients with RDD have a high rate of comorbid diseases including autoimmune disease, viral infections, and cancer.
    背景与目标: 目的:罗赛-多夫曼病(Rosai-Dorfman disease,RDD)是一种罕见的特发性组织细胞非肿瘤性疾病,其特征是淋巴结病和结节外疾病。在这项研究中,我们记录了32例RDD患者的解剖学偏好,影像学发现,合并症​​和种族差异。
    方法:我们对1998年至2016年在我院经病理证实的病例进行了回顾性研究。对这些病例进行了以下分析:(a)解剖位置,(b)放射学表现,(c)合并症,以及(d)种族之间的差异组。
    结果:我们发现32例RDD患者,其中18例为女性,14例为男性。所有患者中有51个病灶,其中23.5%为淋巴结,累及11个淋巴结区域,而76.5%为结外。宫颈淋巴结和颌面部面积分别是最常见的受累淋巴结和淋巴结外位置。在32例患者中,只有4例(12.5%)有纯淋巴结受累,而32例中有20例(62.5%)有纯结外病,而32例中有8例(25%)有混合性淋巴结和结外病。包括淋巴系统,颌面部区域(腺和非腺组织),浅表软组织,中枢神经系统,乳房,腹膜,胃肠道和肺。然而,大多数病变在18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描上表现为代谢过多,而在T1加权磁共振成像上表现为等强度。计算机断层扫描结果在器官之间差异很大.11例患者发现了合并症。这些患者有17种合并症;最常见的是自身免疫性疾病,病毒性疾病和癌症。RDD的器官分布在不同种族之间略有不同。非裔美国人最常见的疾病部位是淋巴结。适用于白人,中枢神经系统和非腺颌面部(各27.3%);适用于亚洲人,淋巴结,皮下组织和非腺上颌面(各占25%);对于西班牙裔,淋巴结和上颌颌面(各占33.3%)。
    结论:Rosai-Dorfman病是一种广谱疾病,不仅限于淋巴结。放射学上,RDD有多种影像学表现。但是,大多数病变在18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描上表现为代谢亢进,而在T1加权成像上表现为等强度。 RDD患者患有多种合并症,包括自身免疫性疾病,病毒感染和癌症。
  • 【由初级保健领导的调试:将过去的经验教训应用到英格兰临床调试小组的早期发展中。】 复制标题 收藏 收藏
    DOI:10.3399/bjgp13X671597 复制DOI
    作者列表:Checkland K,Coleman A,McDermott I,Segar J,Miller R,Petsoulas C,Wallace A,Harrison S,Peckham S
    BACKGROUND & AIMS: BACKGROUND:The current reorganisation of the English NHS is one of the most comprehensive ever seen. This study reports early evidence from the development of clinical commissioning groups (CCGs), a key element in the new structures. AIM:To explore the development of CCGs in the context of what is known from previous studies of GP involvement in commissioning. DESIGN AND SETTING:Case study analysis from sites chosen to provide maximum variety across a number of dimensions, from September 2011 to June 2012. METHOD:A case study analysis was conducted using eight detailed qualitative case studies supplemented by descriptive information from web surveys at two points in time. Data collection involved observation of a variety of meetings, and interviews with key participants. RESULTS:Previous research shows that clinical involvement in commissioning is most effective when GPs feel able to act autonomously. Complicated internal structures, alongside developing external accountability relationships mean that CCGs' freedom to act may be subject to considerable constraint. Effective GP engagement is also important in determining outcomes of clinical commissioning, and there are a number of outstanding issues for CCGs, including: who feels 'ownership' of the CCG; how internal communication is conceptualised and realised; and the role and remit of locality groups. Previous incarnations of GP-led commissioning have tended to focus on local and primary care services. CCGs are keen to act to improve quality in their constituent practices, using approaches that many developed under practice-based commissioning. Constrained managerial support and the need to maintain GP engagement may have an impact. CONCLUSION:CCGs are new organisations, faced with significant new responsibilities. This study provides early evidence of issues that CCGs and those responsible for CCG development may wish to address.
    背景与目标: 背景:目前对英语NHS的重组是有史以来最全面的重组之一。这项研究报告了来自临床调试小组(CCG)发展的早期证据,CCG是新结构中的关键要素。
    目的:在先前有关GP参与调试的研究中得知的背景下,探索CCG的发展。
    设计与设置:从2011年9月至2012年6月,对在各个维度上提供最大多样性的站点进行案例研究分析。
    方法:使用八个详细的定性案例研究进行案例分析,并在两个时间点从网络调查中获得描述性信息。数据收集涉及对各种会议的观察以及对主要参与者的采访。
    结果:先前的研究表明,当GP能够自主行动时,临床参与调试是最有效的。复杂的内部结构以及不断发展的外部问责关系意味着CCG的行动自由可能受到相当大的限制。有效的全科医生参与对于确定临床调试的结果也很重要,对于CCG而言,存在许多悬而未决的问题,包括:谁感觉到CCG的“所有权”;内部沟通如何被概念化和实现;以及地方团体的作用和职权范围。以前由GP领导的投身方式倾向于集中在本地和初级保健服务上。 CCG热衷于采取行动,使用许多基于实践的委托开发的方法来提高其组成实践的质量。有限的管理支持和维持GP参与的需求可能会产生影响。
    结论:CCG是新的组织,面临着重大的新职责。这项研究提供了CCG和CCG开发负责人可能希望解决的问题的早期证据。
  • 【黄瓜Thanatephorus cucumeris(Rhizoctonia solani)中新的体细胞相容性基团的生成机理。】 复制标题 收藏 收藏
    DOI:10.1264/jsme2.me12214 复制DOI
    作者列表:Qu P,Saldajeno MG,Hyakumachi M
    BACKGROUND & AIMS: :Single-basidiospore isolates (SBIs) were obtained from field isolates of Thanatephorus cucumeris (Rhizoctonia solani) AG-1 IC and AG-2-2 IV. Formation of distinctive tufts, a recognized feature of heterokaryon synthesis, was observed, and isolates derived from hyphal-tipped tuft hyphae were obtained following pairings between various strains. Three distinctive types of tufts were formed: the fibrous type of mating-compatible homokaryon-homokaryon (Hom-Hom) pairings, the sparse type between heterokaryon-homokaryon (Het-Hom) pairings originating from one parent, and the compact type between Het-Hom pairings originating from different parents. Amplified Fragment Length Polymorphism (AFLP) profile of fingerprints of these tuft isolates verified that they were all heterokaryotic. Because of heterokaryotic vigor, the growth and pathogenicity of the majority of tuft isolates increased compared with their contributing SBIs. New somatic compatibility groups (SCGs) that were different from parental field isolates occurred following heterokaryon formation within T. cucumeris. Tuft isolates produced by Hom-Hom and Het-Hom pairings among isolates of different parents yielded no somatic compatibility with the original parent isolates and a high frequency of new SCGs (62-100%). This was in contrast to those produced by Hom-Hom and Het-Hom pairings among isolates with a common parent that yielded only 12-37% new SCGs. The SCG diversity of R. solani in the field may be attributed to new fitter heterokaryons formed between a heterokaryon of one pair of parents and a homokaryon of another parent pair. This mechanism greatly contributes to genetic diversity in the field and accounts for the failure to recover the expected distribution of SCGs from a field population.
    背景与目标: ::单枯草芽孢杆菌分离物(SBIs)从黄瓜枯草杆菌(Rhizoctonia solani)AG-1 IC和AG-2-2 IV的田间分离物中获得。观察到了独特的簇的形成,这是异核体合成的公认特征,并且在各种菌株之间配对后,获得了从菌丝尖端的簇菌丝衍生的分离物。形成了三种不同类型的簇簇:交配相容的同核-纯核(Hom-Hom)配对的纤维型,异核与纯核(Het-Hom)配对之间的稀疏型以及Het-与纯核之间的紧密型。来自不同父母的霍姆配对。这些簇分离物的指纹的扩增片段长度多态性(AFLP)图谱证实它们都是异核的。由于异核生物的活力,大多数簇簇分离物的生长和致病性与其贡献的SBI相比有所增加。与黄瓜田间分离株不同的新的体细胞相容性基团(SCG)是在黄瓜圆线虫内形成异核体后发生的。在不同亲本的分离株中,由Hom-Hom和Het-Hom配对产生的簇状分离株与原始亲本分离株没有体细胞相容性,而且新SCG的出现频率很高(62-100%)。这与由具有共同亲本的分离株中的Hom-Hom和Het-Hom配对产生的结果相反,后者仅产生12-37%的新SCG。在该领域中,茄红梭菌的SCG多样性可以归因于在一对亲本的异核和另一对亲本的同核之间形成的新钳工异核。该机制极大地促进了田间遗传多样性,并解释了无法从田间种群中恢复预期的SCG分布的情况。
  • 【在匈牙利的少数族裔人群(吉普赛成年人)中进行代谢综合征的筛查。】 复制标题 收藏 收藏
    DOI:10.4149/bll_2012_163 复制DOI
    作者列表:Hidvegi T,Hetyesi K,Biro L,Nadas J,Jermendy G
    BACKGROUND & AIMS: BACKGROUND:Metabolic syndrome occurs more often among people living in poorer social conditions. The health status of the largest minority ethnic group in Hungary lags in many aspects behind that of the general population. METHODS:To estimate the prevalence of metabolic syndrome a screening was initiated in the city of Győr among subjects aged 20-70 years who declared themselves as Gypsy. Subjects with known diabetes and cardiovascular disease were excluded. The diagnosis of metabolic syndrome was based on the ATP-III criteria. RESULTS:Among the 77 individuals screened (35 men, 42 women, age 46.9 ± 10.6 years, x ± SD) diabetes mellitus was found in 14 cases (18.2 %), and pre-diabetes (impaired fasting blood glucose (IFG) or impaired glucose tolerance (IGT) could be diagnosed in further 14 cases (18.2 %). Individual components of the metabolic syndrome occurred as follows: hypertension in 47 subjects (61.0 %), abnormal waist circumference in 40 individuals (51.9 %), abnormal HDL-cholesterol in 39 cases (50.6 %), abnormal triglycerides in 35 individuals (45.5 %) and abnormal fasting blood glucose in 15 subjects (19.5 %). Within the cohort metabolic syndrome could be diagnosed in 39 individuals (50.6 %) without a significant gender difference (males 20/35 = 57.1 %; women: 19/42 = 45.2 %, p>0.05). CONCLUSION:The occurrence of metabolic syndrome and that of glucose intolerance is high among adult Gypsy people in Hungary. In order to recognise cardio-metabolic risks and to prevent their cardiovascular consequences, continuous health promotion and adequate medical care should be provided for the Gypsy population in Hungary (Tab. 5, Ref. 32).
    背景与目标: 背景:代谢综合征在生活条件较差的人群中更常见。匈牙利最大的少数族裔的健康状况在许多方面落后于总人口的健康状况。
    方法:为了评估代谢综合征的患病率,在盖尔市开始了一项针对20-70岁自称为吉普赛人的受试者的筛查。排除患有已知糖尿病和心血管疾病的受试者。代谢综合征的诊断基于ATP-III标准。
    结果:在筛查的77例个体中(男性35例,女性42例,年龄46.9±10.6岁,x±SD),在14例(18.2%)糖尿病前期(空腹血糖受损(IFG)受损或受损)中被发现可以诊断出另外14例(18.2%)的葡萄糖耐量(IGT)。代谢综合征的各个组成部分如下:47位受试者的高血压(61.0%),40位受试者的腰围异常(51.9%),HDL-异常胆固醇39例(50.6%),甘油三酯异常(45.5%)和15名受试者的空腹血糖异常(19.5%),可以在39例无明显性别的人群中诊断出代谢综合征差异(男性20/35 = 57.1%;女性:19/42 = 45.2%,p> 0.05)。
    结论:匈牙利成年人吉普赛成年人中代谢综合征和葡萄糖耐量异常的发生率较高。为了认识到心脏代谢风险并预防其心血管后果,应为匈牙利的吉普赛人提供持续的健康促进和适当的医疗服务(表5,参考文献32)。
  • 【耳蜗背核中神经元组的共享刺激驱动和连通性。】 复制标题 收藏 收藏
    DOI:10.1016/0378-5955(91)90088-q 复制DOI
    作者列表:Kipke DR,Clopton BM,Anderson DJ
    BACKGROUND & AIMS: :Extracellular spike discharges were recorded from ensembles of up to five neurons simultaneously in the DCN of guinea pig using solid-state, thin-film, multichannel electrodes having up to five recording sites spanning up to 600 microns. Responses from 73 unit pairs were collected of which 54 had both units responding to pseudorandom wideband noise stimulation. Shared-stimulus driving was present in 78% (42/54) of the unit pairs and could be attributed to an overlap in their spectral sensitivities. Effective connectivity was indicated for 87% (47/54) of the unit pairs. Wideband noise proved more useful than tonebursts for investigating shared-stimulus driving and connectivity because it evoked widespread, but not overly synchronous, responses in the ensembles.
    背景与目标: :使用固态,薄膜,多通道电极(最多具有五个跨越600微米的记录位点),在豚鼠DCN中同时记录了多达五个神经元的集合的细胞外尖峰放电。收集了来自73个单元对的响应,其中54个单元对两个单元均响应了伪随机宽带噪声刺激。共享刺激驱动存在于78%(42/54)的单元对中,这可能归因于其光谱灵敏度的重叠。指出有效连接率达到87%(47/54)的设备对。在调查共享激励驱动和连接性方面,宽带噪声被证明比音频突发更有用,因为它引起了集合中的广泛但并非过度同步的响应。

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