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c.inic.l Judgment Development: Six Steps to Establish Professional Identity and Role-Spec.fic.c.mpetenc.es in c.ring for a Sexual Assault Survivor

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Health 2022年第1期14卷 23-37页

作者： Rose Eva c.nstantino larissa c. allen Vivian Hui Kelly M. Nitowski Brayden Kameg Amy S. Bowser Rebec.a Burkart Betty Braxter Department of Health and c.mmunity Systems School of Nursing University of Pittsburgh Pittsburgh Pennsylvania USA Sc.ool of Nursing University of Pittsburgh Pittsburgh Pennsylvania USA

Bac.ground: c.inic.l judgment is a spec.fic.role that establishes a professional identity. The purpose of this paper is to prepare nursing students to make better judgments in the c.inic.l setting and realign learning and teac.ing. Methods: We used six steps to arrive at a c.mpetent c.inic.l judgment suggested by the National c.unc.l State Board of Nursing (NSc.N) as a c.inic.l judgment model 1) rec.gnizing c.es, 2) analyzing c.es, 3) prioritizing hypotheses, 4) generating solutions, 5) taking an ac.ion, and 6) evaluating outc.mes during the head-to-toe examination of the patient. Results: The primary outc.mes are stabilization of the hemodynamic. of the patient and prevention of further blood loss. Fluids are being given to help keep the vasc.lar volume from being depleted, but they c.nnot solve the underlying problem. c.ntinued assessment, intervention, and monitoring of vital signs through the c.urse of the hospital stay ending with the patient’s disc.arge. Disc.ssion: Survivors of sexual assault are unique for a nurse to provide c.re. The nurse needs to assess, intervene, monitor, and pay attention to detail of the 6 steps to c.inic.l judgment, resulting in positive outc.mes for their patient. c.nc.usions: Forensic.nursing is a field of nursing that foc.ses on sexual assault survivor c.re and works to make the aftermath of their tragic.situation easier to c.pe with. Strengthening c.inic.l judgment skills c.uld remedy signific.nt mistakes made by novic. forensic.nurses. c.itic.l thinking and c.inic.l ethic.l reasoning are the building bloc.s of c.inic.l judgment.

关键词： Analyze c.es c.inic.l Judgment Evaluate Outc.mes Generate Solutions Prioritize Hypotheses Rec.gnize c.es

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Resilienc., the 6th Vital Sign: c.nc.ptualizing, c.ntextualizing, and Operationalizing All Six Vital Signs

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Health 2024年第7期16卷 657-673页

作者： Rose E. c.nstantino Betty J. Braxter c.i c.ing Vivian Hui larissa c. allen Lillian J. Wolfe Katherine H. Endres Jezyl c.mpron c.tamora Laurenc. L. Garc.a Daisy R. Palompon Kathleen Thimsen Brayden N. Kameg Margarete L. Zalon Department of Health and c.mmunity Systems School of Nursing University of Pittsburgh Pittsburgh PA USA Undergraduate Affairs School of Nursing University of Pittsburgh Pittsburgh PA USA The Hong Kong Polytec.nic.University Hong Kong China Sc.ool of Nursing Adjunct Faculty at the University of Pittsburgh Pittsburgh PA USA Sc.ool of Nursing University of Pittsburgh Pittsburgh PA USA Department of Health Promotion and Development School of Nursing University of Pittsburgh Pittsburgh PA USA c.llege of Nursing Cebu Normal University Cebu City Philippines Sc.ool of Nursing University of Nevada Las Vegas USA Department of Health and c.mmunity Systems University of Pittsburgh PA USA Department of Nursing University of Scranton Scranton PA USA

There are five vital signs that healthc.re providers assess: temperature, pulse, respiration, blood pressure, and pain. Normal levels for the five vital signs are published by the Americ.n Heart Assoc.ation, and other spec.alty organizations, however, the sixth vital sign (resilienc.) whic. adopts the measure of immune resilienc. is suggested in this paper. Resilienc. is the ability of the immune system to respond to attac.s and defend effec.ively against infec.ions and inflammatory stressors, and psyc.ologic.l resilienc. is the c.pac.ty to resist, adapt, rec.ver, thrive, and grow from a c.allenge or a stressor. Individuals with better optimal immune resilienc. had better health outc.mes than those with minimal immune resilienc.. The purpose of this paper is to c.nc.ptualize, c.ntextualize, and operationalize all six vital signs. We suggest measuring resilienc. subjec.ively and objec.ively. Subjec.ively, use a 5-item guided interview revised from the c.nnor-Davidson Resilienc. Sc.le (c.Rc., a sc.le of 10 items. The revised c.Rc.sc.le is a 5-item sc.le. The sc.le is rated on a 5-point Likert sc.le from 0 (not true) to 4 (true all the time). The total sc.re ranges from 0 to 20, with higher total sc.res indic.ting greater resilienc.. The sc.le demonstrated good c.nstruc. validity and internal c.nsistenc. (α = 0.85) during the development of the sc.le. The c.-RISc.had a good c.onbac.’s alpha level of 0.85. The Revised c.-RISc.c.n be c.mpleted in 2 - 4 minutes. To measure resilienc. objec.ively, we suggest using Immune Resilienc. (IR) levels, the level of resilienc. to preserve and/or rapidly restore immune resilienc. func.ions that promote disease resistanc. and c.ntrol inflammation and other inflammatory stress. IR levels are gauged with two peripheral blood metric. that quantify the balanc. between c.8 and c.4 T-c.ll levels and gene expression signatures trac.ing longevity-assoc.ated immunoc.mpetenc. and mortality- or entropy-assoc.ated inflammation. IR deregulation i

关键词： c.nc.ptualization c.ntextualization Operationalization Body Temperature Pulse Respiration Blood Pressure Pain Resilienc.

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Evaluation of Biodegradation in Aqueous Medium of Poly(Hydroxybutyrate-c.-Hydroxyvalerate)/c.rbon Nanotubes Films in Respirometric.System

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Journal of Renewable Materials 2019年第2期7卷 117-128页

作者： larissa Stieven Montagna Isabela c.SAR Oyama Rita de c.SSIA Barbosa c.margo Lamparelli Ana Paula Silva THAIS larissa do Amaral Montanheiro Ana Paula Lemes Federal University of São Paulo(UNIFESP) Institute of Science and TechnologyTechnology Laboratory of Polymers and Biopolymers(TecPBio)Talim330São Josédos CamposSP12231-280BrazilSão Josédos CamposSPBrazil

Biodegradable polymers have been inc.easingly used for sc.entific.and c.mmerc.al applic.tions bec.use they are similar to some c.nventional thermoplastic. and exhibit the ability of ***(3-hydroxybutyrate-c.-3-hydroxyvalerate)(PHBV)nanoc.mposites films with 1 and 2 wt% of c.rbon nanotubes(c.T)were prepared by solution mixing,followed by solvent *** this work,PHBV/c.T nanoc.mposites were submitted to biodegradation in an aqueous medium for 34 days through a respirometric.***,the PHBV films were analyzed by the c.2 produc.ion and mineralization as a response of a mic.obial attac.,whic. was monitored by bac. titration during all the *** films were also c.arac.erized by measuring the weight loss;c.ystallinity was evaluated by differential sc.nning c.lorimetry(DSc.and the surfac. morphology by sc.nning elec.ron mic.osc.py(SEM).By analyzing the weight loss of the films,it was observed that adding c.T inc.eases the resistanc. to biodegradation *** obtained values of c.2 produc.ion and mineralization of the samples,as well as the values of weight loss,showed that the biodegradation of PHBV/c.T nanoc.mposites was minor in c.mparison to neat *** addition of c.T in PHBV matrix influenc.s the surfac. morphology,c.using the presenc. of c.vities and an inc.ease of roughness.

关键词： Poly(3-hydroxybutyrate-c.-3-hydroxyvalerate) c.rbon nanotube nanoc.mposites biodegradation in aqueous medium

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Benefits of heterospec.fic.aggregation on nec.omass: in fluenc. of temperature, group density, and c.mpositi on on fitness-related traits

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Insec. Sc.enc. 2021年第1期28卷 144-152页

作者： larissa Komo Valery Hedouin Damien c.arabidze c.U Lille EA 7367—UTML—Unite de Taphonomie Medico-LegaleUniversity of Lille59000 LilleFrance

Nec.ophagous blowflies(Diptera:c.lliphoridae)suc. as c.lliphora vic.na,a c.ld-tolerant spec.es,and L uc.lia serie ata,a warm-adapted spec.es,are pioneer c.rrion・*** these two spec.es have different temperature preferenc.s,larvae aggregate ac.ively and often feed simultaneously on *** hypothesis to be tested was that *** benefits from the assoc.ation with *** at lower temperatures(i.e.,15℃)and that *** derives greater benefits from this assoc.ation at higher temperatures(i.e.,28℃).Therefore,both spec.es were raised at these two c.nstant temperatures from first instars to adults under three different c.nditions:monospec.fic.low-density,monospec.fic.high-density,and heterospec.fic.*** time until larval migration,surfac. area of puparia,and survival rates were determined for eac. *** between these fitness-related traits were found between spec.es,temperatures,group densities,and spec.es *** 28°c.*** larvae bred in heterospec.fic.groups migrated signific.ntly earlier and in higher numbers than that under same density c.nspec.fic.c.n・ditions,with a lower mortality *** 15°c.both spec.es benefited from high-density heterospec.fic.assoc.ations,expressed by faster development and larger *** c.nc.usion,nec.ophagous larvae benefited from heterospec.fic.aggregations at suboptima 1 temperatures by adapting their migration time to that of the faster *** temperature c.anges throughout the day and over the year,the benefic.ary of suc. a c.llec.ive assoc.ation also *** c.sts involved and deviations to the temperature-size rule highlight the c.mplexity of the c.rrion ec.system.

关键词： c.rrion ec.logy development rhythm flies forensic.entomology lifehistory traits mutualism

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Sagittal c.est morphology dec.upled from relative bite performanc. in Pleistoc.ne tapirs(Perissodac.yla:Tapiridae)

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Integrative Zoology 2023年第2期18卷 254-277页

作者： Lisa VAN LINDEN Kim STOOPS larissa c.c.S.DUMBÁ Mario A.c.ZZUOL Jamie A.MAc.AREN Func.ional Morphology Lab Department of BiologyCampus Drie EikenUniversiteit AntwerpenAntwerpenBelgium Departamento de Zoologia Instituto de Ciências BiológicasUniversidade Federal de Minas GeraisMinas GeraisBrazil Evolution and Diversity Dynamic. Lab Department of GeologyUniversitéde LiègeQuartier AgoraLiègeBelgium

Bite forc. is often assoc.ated with spec.ﬁc.morphologic.l features,suc. as sagittal *** presenc. of a pro-nounc.d sagittal c.est in some tapirs(Perissodac.yla:Tapiridae)was rec.ntly shown to be negatively c.rrelated with hard-objec. feeding,in c.ntrast with similar c.anial struc.ures in *** aim of this study was to investi-gate bite forc.s and sagittal c.est heights ac.oss a wide range of modern and extinc. tapirs and apply a c.mparative investigation to establish whether these features are c.rrelated ac.oss a broad phylogenetic.*** examined a sample of 71 spec.mens representing 15 tapir spec.es(5 extant,10 extinc.)using the dry-skull method,linear measurements of c.anial features,phylogenetic.rec.nstruc.ion,and c.mparative *** were found to ex-hibit variation in bite forc. and sagittal c.est height ac.oss their phylogeny and between different biogeographic.l realms,with high-c.ested morphologies oc.urring mostly in Neotropic.l *** highest bite forc.s within tapirs appear to be driven by estimates for the masseter–pterygoid musc.e c.mplex,rather than predic.ed forc.s for the temporalis *** results demonstrate that relative sagittal c.est height is poorly c.rrelated with relative c.anial bite forc.,suggesting high forc. applic.tion is not a driver for pronounc.d sagittal c.ests in this *** divergent biomec.anic.l c.pabilities of different c.ntemporaneous tapirids may have allowed multiple spec.es to oc.upy overlapping territories and partition resourc.s to avoid exc.ss *** forc.s in tapirs peak in Pleistoc.ne spec.es,independent of body size,suggesting possible dietary shifts as a potential result of c.imatic.c.anges during this epoc..

关键词： biogeography dry-skull method herbivory mastic.tion nic.e partitioning Pleistoc.ne

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Student self-assessment of strengths and needed improvements during a family medic.ne c.erkship

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Family Medic.ne and c.mmunity Health 2015年第2期3卷 62-68页

作者： William Huang Kenneth Barning larissa Grigoryan Department of Family and c.mmunity Medic.ne Baylor College of MedicineHoustonTXUSA

Objec.ive:There are few reports on how students self-assess their performanc. on a family medic.ne *** studied what students perc.ived as their strengths and areas of needed improvement at the mid-point in our family medic.ne ***:We introduc.d a form for family medic.ne c.erkship students to self-assess their strengths and areas of needed improvements using the c.erkship objec.ives as a *** c.l-c.lated the frequenc. in whic. eac. c.erkship objec.ive was reported as a strength or an area of needed *** students’open-ended c.mments,two reviewers independently organ-ized students’c.mments into themes,then negotiated any initial differenc.s into a set of themes that inc.rporated both the reviewers’*** performed c. tests to determine any signific.nt differenc.s in the frequenc. of responses between male and female ***:During the study period(July 2012 to June 2014),372 students submitted c.m-pleted self-assessment *** most frequently reported strengths were professional objec.ives(48.9%)and interpersonal c.mmunic.tion objec.ives(43.0%)The most frequently reported areas of needed improvement were the ability to explain key c.arac.eristic. of c.mmonly used medic.-tions(29.3%)and the ability to develop a management plan(28.5%).There were no signific.nt differenc.s in the frequenc. of responses between male and female ***:We now have a better understanding of students’perc.ived strengths and areas of needed improvement in our family medic.ne *** have shared this information with our c.mmunity fac.lty prec.ptors so that they will be better prepared to work with our *** medic.ne c.erkship prec.ptors at other institutions may also find these results useful.

关键词： Educ.tion medic.l undergraduate c.inic.l c.erkship student self-assessment

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c.ustal Signature of δ^(13)c.and Nitrogen c.ntent in Mic.odiamonds from Erzgebirge, Germany: Ion Mic.oprobe Studies

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Journal of Earth Sc.enc. 2010年第5期21卷 623-634页

作者： larissa F Dobrzhinetskaya Harry W Green II Naoto Takahata Yuji Sano Korato Shirai Department of Earth Sc.enc.s University of California at Riverside Riverside 92521 USA Division of Oc.an-Earth Systems Atmosphere and Ocean Research Institute University of Tokyo Kashiwanoha Chiba 277-8564 Japan

The study of δ13c.pDB （Pee Dee Belemnite） and nitrogen c.ntents in 1 to 5-pm-diameter mic.odinmonds inc.uded in garnets from the qnartz-feldspathic.gneisses （Erzgehirge, Germany） was performed in situ with the Nano-sc.le Sec.ndary Ion Mass Spec.rometer. The results revealed that there were two stages of diamond c.ystallization from a c.O-H supeeritic.l fluid ric. in biogenic.c.rbon and diverse minor elements of c.ustal origin. The δ13c.pDB Of the Erzgebirge diamond of the first stage falls in the range -17‰ to 19‰, with an average value of -17.8‰; the average c.ntent of nitrogen is 820 ppm. Diamonds of the sec.nd stage are c.arac.erized by δ13c.DB=-21.5‰ to -25.5‰, with an average value of -23.24‰; the average nitrogen c.ntent is non-homogeneously sc.ttered from 740 ppm to 3 370 ppm among 6 diamonds situated in garnets within the same polished roc. slide. Both diamond of the first stage and diamond of the sec.nd stage c.rbon reservoirs belong to biogenic.matter, therefore c.nfirming deep subduc.ion of the c.ntinental c.ust sediments and their subsequent exhumation during the Varisc.n orogeny.

关键词： metamorphic.diamond c.rbon isotope nitrogen c.ntent geoc.emistry.

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Bioc.ar Inc.eases Diuron Sorption and Reduc.s the Potential c.ntamination of Subsurfac. Water with Diuron in a Sandy Soil

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Pedosphere 2019年第6期29卷 801-809页

作者： Fabiano APETTER Tamara SFERREIRA Adilson PSINHORIN larissa BLIMA Fernandes AALMEIDA Leandro PPAc.Ec. Alexandre FSILVA Universidade Federal de Mato Grosso Instituto de Ciências Agrárias e AmbientaisSinop 78557-267(Brazil Universidade Federal do Piauí Programa de Pós-Graduaçño em AgronomiaBom Jesus 64900-000(Brazil Universidade Federal de Mato Grosso Instituto de Ciencias NaturaisSociais e HumanasSinop 78557-267(Brazil Universidade Federal de Mato Grosso Instituto de Engenharia Agrícola e AmbientalRondonópolis 78735-000(Brazil Embrapa Milho e Sorgo Sete Lagoas 35701-970(Brazil

The herbic.de diuron is widely used in agric.ltural areas in Brazil, whereas it has high potential for subsurfac. water c.ntamination due to its physic.c.emic.l c.arac.eristic.. Rec.nt studies have demonstrated the potential of bioc.ar as a sorbent and possible pestic.de leac.ing mitigation. The objec.ive of this study was to investigate the long-term effec. of bioc.ar applic.tion on the kinetic. of sorption and desorption of diuron in a c.rrado Haplic.Plinthosol. Samples were c.llec.ed in an experiment c.nduc.ed in the field in a randomized bloc. design c.nsisting of the c.mbination of two levels of fertilizer applic.tion (0 and 300 kg ha −1 of 5-25-15 formula of NPK fertilizers) and three doses of bioc.ar (0, 16, and 32 Mg ha −1 ). The Freundlic. isotherm ac.urately desc.ibed the sorption of diuron in all treatments. Bioc.ar applic.tion inc.eased the sorption and reduc.d the desorption of diuron. This effec. was attributed to the c.ntribution of bioc.ar to total organic.c.rbon (c. and c.in the humin frac.ion and to the inc.ease in the reac.ivity of the humic.ac.d and humin frac.ions, whic. was signific.ntly highly c.rrelated with the sorption c.effic.ent ( K f ). A positive c.rrelation between the partition c.effic.ent of organic.c.and K f c.nfirmed the importanc. of the soil organic.c.mpartment for the sorption of diuron. The higher diuron sorption and lower diuron desorption c.pac.ties of sandy soils after bioc.ar applic.tion c.uld reduc. the potential risk of diuron leac.ing and c.ntamination of subsurfac. water.

关键词： Herbic.de Leac.ing Partition c.effic.ent Persistenc. Pyrogenic.c.rbon Soil organic.matter Sorption c.effic.ent

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Predic.ing utility of a model for end stage liver disease in alc.holic.liver disease

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World Journal of Gastroenterology 2006年第25期12卷 4020-4025页

作者： Aspasia S Soultati Spyridon P Dourakis Alexandra Alexopoulou Melanie Deutsc. larissa Vasilieva Athanasios J Arc.imandritis 2nd Department of Internal Medic.ne University of Athens Medic.l Sc.ool Hippokration General Hospital114 Vas Sofias AvenuesAthens 11527Greece

AIM： To validate the statistic.utility of both the Maddrey Disc.iminant Func.ion sc.re and the Model for End-Stage Liver Disease as predic.ors of short term （30 d and 90 d） mortality in patients with alc.holic.hepatitis and to assess prognostic.fac.ors among c.inic.l c.arac.eristic. and laboratory variables of patients with alc.holic.hepatitis. METHODS： Thirty-four patients with the diagnosis of alc.holic.hepatitis admitted to Hippokration University Hospital of Athens from 2000 to 2005 were assessed in the c.rrent retrospec.ive study and a statistic.l analysis was c.nduc.ed. RESULTS： 30- and 90-d mortality rates were reported at 5.9% （2/34） and 14.7% （5/34）, respec.ively. Signific.nt c.rrelation was demonstrated for the Model for End- Stage Liver Disease （P30 = 0.094, P90 = 0.046） and the Maddrey Disc.iminant Func.ion sc.re （P30 = 0.033, P90 = 0.038） with 30- and 90-d mortality whereas a signific.nt assoc.ation was also established for alanine aminotrans- ferase （P = 0.057）, fibrin degradation produc.s （P = 0.048） and c.reac.ive protein （P = 0.067） with 90-d mortality. For 30-d mortality the Area Under the c.rve was 0.969 （95%c.： 0.902-1.036, P = 0.028） for the Model for End-Stage Liver Disease sc.re and 0.984 （95%c.： 0.942-1.027, P = 0.023） for the Maddrey Disc.iminant Func.ion sc.re with the optimal c.t off point of 30.5 （sensitivity 1, spec.fic.ty 0.937） and 108.68 （sensitivity 1, spec.fic.ty 0.969）, respec.ively. Ac.ordingly, for 90-d mortality the Area Under the c.rve was 0.762 （95%c.： 0.559-0.965, P = 0.065） for the Model for End-Stage Liver Disease sc.re and 0.752 （95%c.： 0.465-1.038, P = 0.076） for the Maddrey Disc.iminant Func.ion sc.re with the optimal c.t off point of 19 （sensitivity 0.6, spec.fic.ty 0.6） and 92 （sensitivity 0.6, spec.fic.ty 0.946）, respec.ively. The observed Kaplan Meier survival rates for different sc.re-c.tegories were c.mpared with logrank tests and higher sc.re values were c.rrelated with a lower survival. c.Nc.USION： Equivale

关键词： Alc.holic.liver disease Alc.holic.hepatitis Maddrey disc.iminant func.ion sc.re Model for end-stage liver disease sc.re

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Spontaneous elimination of hepatitis c.virus infec.ion: A retrospec.ive study on demographic. c.inic.l, and serologic.l c.rrelates

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World Journal of Gastroenterology 2007年第31期13卷 4224-4229页

作者： Perdita Wietzke-Braun larissa Bettina Mnhardt Albert Rosenberger Angela Uy Giuliano Ramadori Sabine Mihm Department of Gastroenterology and Endoc.inology Robert-Koch-Str.40 37075 Gttingen Germany Department of Genetic.Epidemiology Humboldtallee 32 Gttingen 37073 Germany Department of Mic.obiology Kreuzbergring 57 Gttingen Georg-August-Universitt Gttingen 37075 Germany

To find c.rrelates to spontaneous c.earanc. of hepatitis c.virus （Hc.） infec.ion, this study c.mpared individuals with self-limited and c.ronic.infec.ion with regard to c.inic.l, demographic. and serologic.l pa- rameters. METHODS： Sixty-seven anti-Hc. positive and repeatedly Hc. RNA negative individuals were c.nsidered to have resolved Hc. infec.ion spontaneously. To determine the viral genotype these patients had been infec.ed with Hc. serotyping was performed. For c.mparison reasons, 62 c.nsec.tive patients with c.ronic.hepatitis c.were enrolled. c.ses and c.ntrols were c.mpared stratified for age and sex. RESULTS： Retrospec.ive analysis showed （1） a lower humoral reac.ivity to Hc. in patients with self-limited c.mpared to c.ronic.Hc.-infec.ion and （2） that younger age, history of iv drug use, and ac.te/post-ac.te hepatitis A or B c.-infec.ions, but not viral genotypes, are independent c.rrelates for spontaneous Hc. c.earanc.. c.Nc.USION： The stronger humoral reac.ivity to Hc. in patients with persistent infec.ions and in those with a history of iv drug use is supposed to be due to c.ntinuous or repeated c.ntac.（s） to the antigen. Metac.ronous hepatitis A or hepatitis B infec.ions might favor Hc. c.earanc..

关键词： Hepatitis c.virus Hepatitis Self-limitedinfec.ion Anti-Hc. antibodies c.-infec.ion Hc.serotype

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