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卫生系统知证政策指导：指导制定的基本原理和挑战

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中国循证医学杂志 2014年第7期14卷 777-782页

作者： Xavier Bosch-Capblanch John N. Lavis Simon Lewin Rifat Atun John-Arne Rottingen Daniel Droesche Lise Beck Edgardo Abalos Fadi El-Jardali Lucy Gilson Sandy Oliver Kaspar Wyss Peter Tugwell Regina Kulier Tikki Pang Andy Haines 王琪(译) 吴琼芳(译) 陈耀龙(审校) 杨克虎(审校) Swiss Tropical and Public Health Institute BaselSwitzerland University of Basel BaselSwitzerland McMaster Health Forum Centre for Health Economics and Policy AnalysisDepartment of Clinical Epidemiology and Biostatisticsand Department of Political ScienceMcMaster UniversityHamiltonOntarioCanada Norwegian Knowledge Centre for the Health Services OsloNorwayand Health Systems Research UnitMedical Research Council of South AfricaCape TownSouth Africa Global Fund to Fight AIDS Tuberculosis and MalariaGenevaSwitzerland Harvard Kennedy School CambridgeMassachusettsUnited States of America Centro Rosarino de Estudios Perinatales RosarioArgentina Department of Health Policy and Management American University of BeirutBeirutLebanonand McMaster Health ForumMcMaster UniversityHamiltonOntarioCanada School of Public Health University of Cape Town and Department of Global Health and DevelopmentLondon School of Hygiene and Tropical MedicineUnited Kingdom EPPI-Centre Social Science Research UnitInstitute of EducationLondonUnited Kingdom Centre for Global Health Institute of Population HealthUniversity of OttawaOttawaOntarioCanada Innovation InformationEvidence and ResearchWorld Health OrganizationGenevaSwitzerland Departments of Social and Environmental Health Research and of Nutrition and Public Health Research London School of Hygiene&Tropical MedicineLondonUnited Kingdom 兰州大学循证医学中心/中国GRADE中心兰州大学基础医学院兰州730000 甘肃省循证医学与临床转化重点实验室兰州730000

本文是《PLoS Medicine》关于卫生系统知证政策指导三篇系列文章的第一篇,阐述了应如何将证据转化为指导,以形成卫生系统政策,并促进临床和公共卫生干预的实施。其要点如下:①薄弱的卫生系统阻碍了有效干预的实施,加强此系统的政策需要... 详细信息

本文是《PLoS Medicine》关于卫生系统知证政策指导三篇系列文章的第一篇,阐述了应如何将证据转化为指导,以形成卫生系统政策,并促进临床和公共卫生干预的实施。其要点如下:①薄弱的卫生系统阻碍了有效干预的实施,加强此系统的政策需要基于当前可得的最佳证据;②卫生系统证据最好以政策制定过程参考的指导的形式呈现,但目前卫生系统指导制定质量较差;③将问题、干预及实施相关的研究转化为影响卫生系统组织方式的决策和政策是卫生系统指导制定面临的一个挑战;④制定及时且适用于广大卫生系统利益相关者的指导,并确定评价卫生系统指导质量的方法是另一个挑战;⑤改编现有方法(如用于临床指南的那些方法)制定有意义的建议来应对卫生系统、政策系统及背景的复杂性,尚需进一步研究。

关键词：卫生系统政策指导卫生干预最佳证据临床指南利益相关者 PLoS 制定过程

Amniotic membrane welded to contact lens by 1470-nm diode laser:a novel method for sutureless amniotic membrane transplantation

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International Journal of Ophthalmology(English edition) 2014年第6期7卷 996-1000页

作者： rifat Rasier Murat Gulsoy Department of Ophthalmology Istanbul Bilim University School of Medicine Instute of Biomedical Engineering Bogazici University

AIM: To avoid the side effects of the suture usage by welding amniotic membrane(AM) to contact lens(CL)with laser.METHODS: AM was taken from pregnant women and cleaned from blood clots with sterile phosphate-buffered physiological saline solution which included antibiotics.Stromal side of the AM was spread inside of the CL and it was welded to CL by 1470 nm diode laser. And 600 μm diameter fiber tip of the laser was contacted with the epithelial side of the AM from 4 separate points. After welding excess amniotic membrane around the CL was cut with a scalpel.RESULTS: Stromal side of the AM was spread inside of the CL and then with laser fiber, different power levels and exposure times were applied on the epithelium of AM and 340 m W for seven seconds was found optimal.CL and AM attached with the spot welding effect in 4points by touching fiber tip. CL-AM welded complex did not separated from each other while holding AM that extend beyond the CL with the help of two forceps.CONCLUSION: As a conclusion, it was aimed in this study to achieve the success of the conventional amniotic membrane transplantation(AMT) with the easiness of applying a CL and to avoid risks and side effects of corneal or conjunctival suturing. The results showed that the application of the CL-AM complex will be as easy as the application of a CL and lasts shortly.

关键词： amniotic membrane contact lens laser welding

TBBPA rather than its main derivatives enhanced growth of endometrial cancer via p53 ubiquitination

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Journal of Environmental Sciences 2024年第3期137卷 82-95页

作者： Hongyan Yu Jingxu Zhang Jing Liu Ruonan Pan Yu Wang Xiaoting Jin rifat Zubair Ahmed Yuxin Zheng Department of Occupational Health and Environmental Health School of Public HealthQingdao UniversityQingdao 266071China State Key Laboratory of Environmental Chemistry and Ecotoxicology Research Center for Eco-Environmental SciencesChinese Academy of SciencesBeijing 100085China Department of Genetics University of KarachiKarachi 75270Pakistan

Tetrabromobisphenol A(TBBPA)and its derivatives widely exist in various environments and biota.Although the available data indicate that TBBPA exposure is highly associated with the increased incidence of endometrial cancer(EC),the effects of TBBPA and its main derivatives on EC proliferation and the involved crucial mechanism remain unclear.The present study aimed to investigate the effects of TBBPA and its derivatives under environmental concentrations on the proliferation of EC,and the crucial mechanism on the progression of EC caused by bromine fame retardants exposure.In this research,TBBPA and two of the most common TBBPA derivatives including TBBPA bis(2-hydroxyethyl ether)(TBBPABHEE)and TBBPA bis(dibromopropyl ether)(TBBPA-BDBPE)were screened for their capacities in induced EC proliferation and explored the related mechanism by in vitro cell culture model and in vivo mice model.Under environmental concentrations,TBBPA promoted the proliferation of EC,the main derivatives of TBBPA(TBBPA-BHEE and TBBPA-BDBPE)did not present the similar facilitation effects.The ubiquitination degradation of p53 was crucial in TBBPA induced EC proliferation,which resulted in the increase of downstream cell cycle and decrease of apoptosis.The further molecular docking result suggested the high affinity between TBBPA and ubiquitinated proteasome.This finding revealed the effects of TBBPA and its derivatives on EC proliferation,thus providing novel insights into the underlying mechanisms of TBBPA-caused EC.

关键词： Tetrabromobisphenol A(TBBPA) Endometrial cancer(EC) Derivatives Ubiquitin proteases p53

New autologous material for the frontalis suspension technique:superficial temporal fascia

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International Journal of Ophthalmology(English edition) 2016年第2期9卷 315-317页

作者： Elif Sari Hulda rifat Ozakpinar Ali Teoman Tellioglu Department of Plastic Reconstructive and Aesthetic Surgery Kirikkale University Faculty of Medicine Clinic of Plastic Reconstructive and Aesthetic SurgeryDiskapi Yildirim Beyazit Education and Research Hospital Department of Plastic Reconstructive and Aesthetic Surgery Yildirim Beyazit University Faculty of Medicine

The frontalis suspension technique, which is a well-known surgical procedure, has been used for congenital ptosis for many years [1]. Several autologous and foreign grafts or materials have been preferred for this suspension, such as collagen, tensor fascia lata, palmaris longus tendon, deep temporal fascia, catgut, prolene, silicone, stainless steel, and supramid suture . Each of these have their own advantages and disadvantages; however, the superficial temporal fascia has not been used for the frontalis suspension method before.

关键词： Figure New autologous material for the frontalis suspension technique

Effective antimicrobial therapies of urinary tract infections among children in low-and middle-income countries:A systematic review

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Pediatric Investigation 2023年第2期7卷 102-110页

作者： rifat Ara Sarker Mohammad Nasrullah Zarrin Tasnim Sadia Afrin Mohammad Delwer Hossain Hawlader KM Saif-Ur-Rahman Infectious Disease Division icddrbDhakaBangladesh Maternal and Child Health Division icddrbDhakaBangladesh Public Health Professional Development Society(PPDS) DhakaBangladesh Health System and Population Studies Division icddrbDhakaBangladesh Department of Public Health North South UniversityDhakaBangladesh Evidence Synthesis Ireland and Cochrane Ireland University of GalwayGalwayIreland College of Medicine Nursing and Health SciencesUniversity of GalwayGalwayIreland

Importance:Urinary tract infection(UTI)is one of the most common infections encountered in infancy and childhood.Despite the emerging problem of antibiotic resistance in recent years,the use of antibiotics for better management of UTIs is inevitable.Objective:This study aims to explore the efficacy and adverse effects of the available antimicrobial agents that are used in pediatric UTIs in low-and middle-income countries(LMICs).Methods:Five electronic databases were searched to identify relevant articles.Two reviewers independently performed screening,data extraction,and quality assessment of the available literature.Randomized controlled trials providing antimicrobial interventions in both male and female participants within the age range of 3 months to 17 years in LMICs were included.Results:Six randomized controlled trials from 13 LMICs were included in this review(four trials explored the efficacy).Due to high heterogeneity across the studies,a meta-analysis was not performed.Other than attrition and reporting bias,the risk of bias was moderate to high due to poor study designs.The differences in the efficacy and adverse events of different antimicrobials were not found to be statistically significant.Interpretation:This review indicates the necessity for additional clinical trials on children from LMICs with more significant sample numbers,adequate intervention periods,and study design.

关键词： Antimicrobial agents Children Efficacy LMICs Urinary tract infection

Impact of Flow Rate in Integration with Solar Radiation on Color and COD Removal in Dye Contaminated Textile Industry Wastewater:Optimization Study

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Energy Engineering 2022年第1期119卷 419-427页

作者： Pradeep K.Majhi rifat Azam Richa Kothari Naveen Kumar Arora V.V.Tyagi Department of Environmental Sciences Babasaheb Bhimrao Ambedkar UniversityLucknow226025U.P.India Department of Environmental Sciences Central University of JammuRahya-SuchaniBaglaSamba181143J&KIndia School of Energy Management Shri Mata Vaishno Devi UniversityKatra182320J&KIndia

Dyes are an integral part of the dying industry and have significantly resulted in environmental pollution by altering the standardwater quality after their discharge into the water bodies.The culprits behind the altered water quality are the pretreatment chemicals used during dying manufacturing processes.Various advanced treatmentmethods using conventional and advanced treatment options including solar energy have been put forth by researchers for the treatment of the dying effluents but,these methods have not proved significantly considerable.Therefore,the present study intends to check the efficiency of solar parabolic trough collector for treating the dying effluents in terms of color and COD.However,other wastewater parameters(BOD,nitrate and phosphate)have also been considered for this experimental analysis.Four standard flow rates(0.5,1.3,1.95 and 2.6 L/M)were maintained during the experiment for six hours at solar intensity(849.3±21.2W/m^(2))and the optimized flow rate(1.95 L/M)was detected and considered for further study during the present experiment.The color concentration showed a significant reduction(≥76.4%)by treatment with the designed solar reactor.Similar significant results were also noticed in terms of COD(79%).In this context,the current experimental study provides ideas on the decolorization and COD reduction efficiency with optimal flow rate in terms of cost-effectiveness with designed experimental reactor which could be further used and implemented for advanced scientific purposes.

关键词： Dye industry effluents decolorization renewable energy-based treatment lab-scale experiment

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柔性接头地铁隧道穿越地裂缝的地震响应

交通运输工程学报 2015年第4期15卷 34-42页

作者：刘妮娜刘军涛黄强兵韩冬冬 BULUT rifat 长安大学地质工程与测绘学院陕西西安710054 长安大学西部矿产资源与地质工程教育部重点实验室陕西西安710054 陕西华山路桥工程有限公司陕西西安710016 俄克拉荷马州立大学土木与环境工程学院俄克拉荷马斯蒂尔沃特74078

采用振动台模型试验,模拟地震荷载和地裂缝场地沉降,分析了穿越地裂缝区域且设置柔性接头的分段地铁隧道的动力响应,研究了地裂缝场地沉降、裂缝发育特征、地铁隧道加速度响应特征、土压力与隧道各区段不同部位的应变规律。分析结果表明... 详细信息

采用振动台模型试验,模拟地震荷载和地裂缝场地沉降,分析了穿越地裂缝区域且设置柔性接头的分段地铁隧道的动力响应,研究了地裂缝场地沉降、裂缝发育特征、地铁隧道加速度响应特征、土压力与隧道各区段不同部位的应变规律。分析结果表明:由地裂缝场地沉降与地震荷载耦合作用所产生的差异沉降和裂缝多集中于柔性接头部位;各区段地铁隧道间的运动具有一定独立性,上盘靠近地裂缝的地铁隧道的加速度峰值是下盘隧道的3.2倍;距离地裂缝越近土压力越大,且在耦合荷载作用下,上盘土压力是下盘土压力的6.7倍;地铁隧道各区段左右拱腰应变较大,底板处应变次之,拱顶部位应变较小;柔性接头设置后各区段应变增率减小,在距离地裂缝较近部位未出现明显的应变增加现象。可见,在地震荷载与地裂缝场地沉降耦合作用下,柔性接头能够减小地铁隧道地裂缝位置处的集中应力与地裂缝场地的变形。

关键词：地铁隧道地震荷载活动地裂缝耦合荷载地震响应

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地铁隧道邻近地裂缝带的地震响应

交通运输工程学报 2018年第4期18卷 72-81页

作者：刘妮娜朱勇锋李俊冯骁阳马玉杰 BULUT rifat 长安大学地质工程与测绘学院陕西西安710054 长安大学西部矿产资源与地质工程教育部重点实验室陕西西安710054 西安中交公路岩土工程有限公司陕西西安710075 俄克拉荷马州立大学土木与环境工程学院俄克拉荷马斯蒂尔沃特74078

采用数值模拟方法,在不同震级人工地震波作用下,研究了具有近距离平行地裂缝的地铁隧道的加速度、位移和内力特征,计算了地裂缝的影响区域、围岩动土压力变化规律和隧道与围岩接触动土压力变化规律。研究结果表明:在地表距隧道水平距离... 详细信息

采用数值模拟方法,在不同震级人工地震波作用下,研究了具有近距离平行地裂缝的地铁隧道的加速度、位移和内力特征,计算了地裂缝的影响区域、围岩动土压力变化规律和隧道与围岩接触动土压力变化规律。研究结果表明:在地表距隧道水平距离约25~50m范围内加速度响应存在一个附加放大区域;当输入地震动强度较小时(50年超越概率为63%),地铁隧道拱顶和拱底处相对水平位移都较小(约为0.39mm),但随着输入地震动强度的增大(50年超越概率为2%),拱顶和拱底的相对水平位移均逐渐增大,最终增大至1.53mm;在地震动作用下,隧道结构的左、右拱肩和拱脚处的轴力都较大,其中右拱脚处的轴力最大,为1 926kN;隧道结构的左、右拱腰处的弯矩和剪力都较大,其中最大弯矩与最大剪力在右拱腰处,分别为78.54kN·m与1 830kN;随着地震动强度的增大,隧道结构的内力逐渐增强;地裂缝附近的动土压力较大,并向两侧逐渐减小;在中震作用下隧道拱顶处,地裂缝上盘影响宽度为25m,下盘影响宽度为20m,在拱底处,地裂缝上盘影响宽度为26m,下盘影响宽度为22m;在大震作用下,地裂缝上、下盘影响宽度较中震时增大约35%;地裂缝附近的隧道拱顶和拱底的动土压力变化规律与无地裂缝时基本一致,但隧道结构附近的动土压力较大,其最大值为138kPa;在地震动作用下,隧道结构拱腰处的接触动土压力增量较大,右拱腰处即靠近地裂缝一侧最大,增量为45.27%,拱顶次之,增量为13.41%,拱底最小,增量为6.86%。

关键词：地铁隧道地震荷载活动地裂缝地震响应数值模拟动土压力

Knowledge, Attitude and Practices about Colostrum Feeding among Pregnant Women in Military Hospital Rawalpindi of Pakistan

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Open Journal of Nursing 2016年第4期6卷 309-313页

作者： rifat Aisha Fakhar Batool Saema Sultana College of Nursing AFPGMI RWP College of Nursing PIMS Islamabad Pakistan

Background: It is well known that colostrum is important for promoting health, growth and development of the newborn, and it also helps to prevent against the infections. Breast feeding is a common practice in Pakistan but the importance of colostrums feeding is still poorly understood due to cultural variations. Objectives: The objectives are to assess the knowledge about the importance of colostrums feeding and to promote the practice of colostrums feeding in pregnant women. Methods: Data collection was done through semi-structured questionnaire regarding colostrum feeding among pregnant women. Gynaecology and Obstetrics Outpatient Department (OPD) and Antenatal Ward of Military Hospital Rawalpindi were selected for study purpose. Results: This study showed that 65% of women heard about colostrums from various sources like media, family and friends, and 35% heard from the health professional during antenatal visits. Only 6% of women knew that it is nutritious milk for the new born. Only women (9%) were aware about its protective effects and had knowledge that it helps to improve the growth of the babies and fight against infections. 35% of women perceived that there is something harmful which is not good for the newborn while 25% of women asked that this is the milk to be fed to baby and 15% of women asked this the milk to be discarded before feeding. There were still many women (39%) who lacked knowledge about colostrum, only 14% of the women in this study knew that the appropriate time for feeding colostrum is immediately after birth (1/2-1hour), whereas 86% of women starts feeding after 6 - 24 hrs. Majority of them who came from the rural areas were uneducated. Conclusion: Many women were aware about the importance of colostrum but the data still indicate that further efforts are required to improve the Knowledge, Attitude and Practice of colostrums feeding.

关键词： Knowledge Attitude Practices and Colostrum