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Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

Open Journal of Pediatrics 2024年第3期14卷 488-513页

作者： Belinda O’Hagan Julie White Ilana Hardesty rachel Amgott Candice Bangham Xinyang Liu Alyson Codner Amy Ursitti Alana Chandler Sarah Foster Marilyn Augustyn Jacey Greece Division of Developmental and Behavioral Pediatrics Department of Pediatrics Boston Medical Center Boston United States of America Boston University Chobanian & Avedisian School of Medicine Boston United States of America Department of Community Health Sciences Boston University School of Public Health Boston United States of America

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

关键词： Autism Spectrum Disorder Program Evaluation Case-Based Training Provider Burnout Continuing Medical Education

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Case Study for Undetermined Mosquito Species by Polymerase Chain Reaction in Western Burkina Faso

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American Journal of Molecular Biology 2024年第2期14卷 43-53页

作者： Koudraogo Bienvenue Yaméogo Sassan Simplice Kambou Domonbabélé François de Sales Hien Logotio rachel Angela Traore Franck Adama Yao Rakiswendé Serge Yerbanga Centre National de la Recherche Scientifique et Technologique CNRST Institut de Recherche en Sciences de la Sante (IRSS) Laboratoire de recherche sur les maladies infectieuses et parasitaires Bobo-Dioulasso Burkina Faso Institut des Sciences et Techniques (INSTech Bobo) Avenue de Sya Bobo-Dioulasso Burkina Faso

Introduction: Malaria eradication campaigns all over the world are largely based on parasite and vector control. Vector identification, whether morphological or molecular, is an essential component of vector control. This study analyzed the possible causes of indeterminate polymerase chain reaction (PCR) results for mosquito species in Western part of Burkina Faso. Methodology: From July 2021 to November 2021, mosquitoes were collected during the period of high malaria transmission in the village of Séguéré, Houet province, Burkina Faso, and morphologically identified. After DNA extraction, samples were amplified by sine 200× PCR to identify species of the Anopheles gambiae complex. Indeterminate samples were then selected for further analysis. The parameters studied were: DNA dilution, the effect of protocol adjusting, and the type of protocol used. Results: A total of 130 “indeterminate” DNAs diluted 1:10 were analyzed. After dilution, the mean amount was 14.73 ± 3.59 ng/μL and absorbance 1.71 ± 0.1. PCR chain reaction yielded 94.62% (123/130) anopheline species in SINE PCR, 5.38% (7/130) “negative”. A significant difference between SINE PCR before dilution and after dilution was observed (P < 0.001). Identification tests carried out using other protocols gave no positive results. From these results, we note that the adaptation of the protocol significantly reduced the polymerase amplification results of the species. Conclusion: It is therefore necessary to respect the amplification protocols. However, the persistence of “indeterminate” results suggests that further studies should be carried out to shed more light on the subject.

关键词： Malaria Vector DNA PCR

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感受建筑的温度

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艺术与设计 2024年第1期 122-125页

作者：楚琦无不详广州设计三年展

新年之初,“广州设计三年展2024”的开幕可谓是2024年开年第一场“设计盛宴”。无论从平面设计、产品设计,或是建筑设计及设计思维方面,来自27个国家的100位/组设计师,都围绕“有温度的设计”这一展览主题给出了自己的答案。

关键词：建筑设计平面设计产品设计设计思维展览主题温度设计师

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Spinal Analgesia with Intrathecal Morphine versus Conventional Analgesia after Laparoscopic Colectomy: A Retrospective Cohort Study

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Open Journal of Anesthesiology 2024年第7期14卷 159-174页

作者： Lionel Diyamona Manon Colin Marc Léone Laurent Zieleskiewicz Joseph Nsiala Wilfrid Mbombo rachel Mbala Bruno Pastene Chris Nsituavibidila Dan Kankonde Gracia Likinda Jean Claude Mubenga Khazy Anga Noelly Mukuna Christel Isengingo Department of Anaesthesia and Intensive Care University Clinics of Kinshasa University of Kinshasa Kinshasa Democratic Republic of the Congo Department of Anaesthesia and Intensive Care Marseilles Nord Hospital Marseille France General Hospital of Kinshasa ex Mama Yemo Kinshasa Democratic Republic of the Congo Department of Anaesthesia and Intensive Care Monkole Hospital Centre Kinshasa Democratic Republic of the Congo

Objective: Postoperative pain (POP) following abdominal surgery can vary from a few hours to several days. This acute, unrelieved pain can become chronic, requiring patients to take analgesics on an almost daily basis for comfort. Analgesia using general opioids has many side effects and intrathecal morphine is a good alternative. This study was conducted to evaluate the efficacy of intrathecal morphine (ITM) versus conventional analgesia in the management of postoperative pain in colectomy performed by laparoscopic surgery. Methods: Cohort study conducted at the Hôpital Nord in Marseille, from 01 January to 31 July 2021 in patients aged at least 18 years undergoing anaesthesia for scheduled colectomy by laparoscopic surgery. The primary endpoint was postoperative pain intensity and the secondary endpoints were morphine consumption, treatment side effects and length of hospital stay. Statistical analysis was performed using XLSTAT software. Results: We included 193 patients: 131 in the control group (conventional analgesia) and 62 in the ITM group. We observed: a significant decrease in pain (assessed by numerical scale) in favour of the ITM group in the post-anaesthetic care room, i.e. 3 (±4) vs 1 (±2), p 0 and H2: 2 (±2) vs. 1 (±2);p Conclusion: These results suggest that intrathecal morphine (ITM) in laparoscopic colectomy provides effective postoperative analgesia with low morphine consumption, and a reduction in morphine side-effects compared with conventional analgesia.

关键词： Intrathecal Morphine Colectomy Laparoscopy Conventional Analgesia

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Determinants of Sexual Activity among HIV-Infected Adolescents in Cameroon

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Open Journal of Pediatrics 2024年第5期14卷 921-936页

作者： Calixte Ida Penda rachel Fotso Yogue Nelly Noubi Kamgaing Sena Mouna Penda Loïc Boupda Francis Atéba Ndongo Christian Eyoum Ritha Mbono Betoko Grace Dalle Ngondi Patricia Epee Eboumbou Francisca Monebenimp Essome Henri Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon General Hospital of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound 1 Yaound Cameroon University Hospital Centre of Yaound Yaound Cameroon Mokolo Regional Hospital Annex Mokolo Cameroon University of Garoua Garoua Cameroon Mother and Child Centre of the Chantal Biya Foundation in Yaound Yaound Cameroon Douala Laquintinie Hospital Douala Cameroon District Hospital of Bonassama Douala Cameroon

Introduction: Adolescence is a period of transition to adulthood, including for HIV-infected adolescents (HIA), when sexual problems emerge. Few studies have been carried out on the sexuality of HIA. This study aimed to assess the sexual behavior of HIV-infected adolescents in Cameroon. Methodology: A cross-sectional study was conducted in three hospitals in the cities of Yaoundé and Douala, from November 2019 to June 2020. All HIA aged 13 to 19 years followed in the study who knew their HIV status were included in the study after obtaining their assent and their parent’s consent. Socio-demographic and clinical characteristics were collected, as well as sexual practices and the determinants of their sexual activity. A multivariate analysis was performed to explore the relationship between the different variables studied and the sexual activity of these adolescents. Results: Of 204 HIA enrolled in the study, 64 (31.7%) were sexually active, the mean age at first sexual intercourse was 15.6 ± 2.8 years and the sex ratio was 0.94. Of the adolescents in the study, 75.7% of girls and 61.2% of boys had regular sexual activity, while 21.3% of girls and 35.4% of boys had multiple sexual relationships in the six months preceding the study. Nearly 16 (25.0%) of the sexually active HIA had more than 2 sexual encounters per month, 6 (9.3%) of these encounters had been paid for and 9 (27.2%) of the girls had already had at least one pregnancy. More than 7 out of 10 HIA (79.6%) had used a condom the last time they had sex. Age less than 18 years [OR = 11.1 (95% CI: 3.1 - 39.4), p = 0.001], lack of remuneration [OR = 9.8 (95% CI: 2.0 - 47.4), p = 0.001] and self-care were significantly associated with sexual activity in HIA, while school attendance was a protective factor. Self-funded HIAs were 21 times more likely to be sexually active [OR = 21.6 (95% CI: 2.3 - 179), p = 0.004]. Conclusion: More than a third of HIV-infected adolescents were sexually active and risky sexual practi

关键词： HIV Adolescent Sexual Behavior Cameroon

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On the effects of spatial resolution on effective distance measurement in digital landscapes

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Ecological Processes 2021年第1期10卷 659-677页

作者： rachel Mundeli Murekatete Takeshi Shirabe KTH Royal Institute of Technology School of Architecture and the Built EnvironmentTeknikringen 10A11428 StockholmSweden University of Rwanda College of Science and TechnologyCentre for Geographic Information Systems and Remote SensingKN 67 Street NyarugengeKigaliRwanda

Background:Connectivity is an important landscape attribute in ecological studies and conservation practices and is often expressed in terms of effective *** the cost of movement of an organism over a landscape is effectively represented by a raster surface,effective distances can be equated with the cost-weighted distance of least-cost *** is generally recognized that this measure is sensitive to the grid’s cell size,but little is known if it is always sensitive in the same way and to the same degree and if not,what makes it more(or less)*** conducted computational experiments with both synthetic and real landscape data,in which we generated and analyzed large samples of effective distances measured on cost surfaces of varying cell sizes derived from those *** particular focus was on the statistical behavior of the ratio—referred to as‘accuracy indicator’—of the effective distance measured on a lower-resolution cost surface to that measured on a higher-resolution cost ***:In the experiment with synthetic cost surfaces,the sample values of the accuracy indicator were generally clustered around 1,but slightly greater with the absence of linear sequences(or barriers)of high-cost or inadmissible cells and smaller with the presence of such *** latter tendency was more dominant,and both tendencies became more pronounced as the difference between the spatial resolutions of the associated cost surfaces *** two real satellite images(of different resolutions with fairly large discrepancies)were used as the basis of cost estimation,the variation of the accuracy indicator was found to be substantially large in the vicinity(1500 m)of the source but decreases quickly with an increase in distance from ***:Effective distances measured on lower-resolution cost surfaces are generally highly correlated with—and useful predictors of—effective distances measured on higher-resolution cost *** relationship t

关键词： Landscape connectivity Effective distance Raster-based least-cost path model Accuracy Spatial resolution

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Pharmacological inhibition of cation-chloride cotransporters for neurological diseases

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Neural Regeneration Research 2015年第12期10卷 1924-1925页

作者： rachel Nepomuceno Dandan Sun Department of Neurology University of Pittsburgh Veterans Affairs Pittsburgh Health Care System Geriatric ResearchEducational and Clinical Center

γ-Aminobutyric acid（GABA）is a major neurotransmitter and plays important roles in both the developing and mature central nervous system（CNS）.One way that GABA can act is by binding to fast,ionotropic GABAA recept... 详细信息

关键词： Cl Pharmacological inhibition of cation-chloride cotransporters for neurological diseases GABAA

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The key piece of the airway remodeling puzzle revealed-LIGHT signaling in the lung

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Genes & Diseases 2023年第4期10卷 1131-1132页

作者： Ziyan rachel Chen Jim Hu Programmes in Translational Medicine Research InstituteHospital for Sick ChildrenTorontoOntario M5G 0A4Canada Department of Laboratory Medicine and Pathobiology University of TorontoTorontoOntario M5S 1A8Canada Department of Paediatrics University of TorontoTorontoOntario M5S 1A8Canada

Asthma is a chronic lung disease that primarily affects the lower respiratory tract in more than 300 million people *** is often triggered by exposure to certain substances or conditions,such as allergens or cold *** overreaction to the allergens causes inflammation and narrowing of the airway,which leads to episodic or persistent symptoms including shortness of breath,nocturnal cough,chest tightness,and wheezing.

关键词： airway lung inflammation

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2024年日光奖:裹着光的建筑

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艺术与设计 2024年第5期 112-115页

作者：楚琦日光奖(图) 不详

时隔两年,在2024年联合国教科文组织国际光日(5月16日)这一天,我们得以再次见证日光带给建筑的奇妙之感。今年的日光奖(The Daylight Award)评委会将建筑日光类荣誉授予了来自西班牙的建筑师兼教授阿尔伯托·坎波·巴埃萨(Alberto Campo... 详细信息

时隔两年,在2024年联合国教科文组织国际光日(5月16日)这一天,我们得以再次见证日光带给建筑的奇妙之感。今年的日光奖(The Daylight Award)评委会将建筑日光类荣誉授予了来自西班牙的建筑师兼教授阿尔伯托·坎波·巴埃萨(Alberto Campo Baeza),他用近乎洁白明亮的建筑空间紧紧裹住了充满温暖的自然日光。

关键词：阿尔伯托·坎波·巴埃萨日光联合国教科文组织建筑师

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Von Hippel-Lindau tumor suppressor pathways&corresponding therapeutics in kidney cancer

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Journal of Genetics and Genomics 2021年第7期48卷 552-559页

作者： Maxwell Shulman rachel Shi Qing Zhang Department of Pathology University of Texas Southwestern Medical CenterDallasTXUSA

The identification and application of the Von Hippel-Lindau(VHL)gene is a seminal breakthrough in kidney cancer *** and its protein p VHL are the root cause of most kidney cancers,and the cascading pathway below them is crucial for understanding hypoxia,in addition to the aforementioned tumorigenesis routes and *** reviewed the history and functions of VHL/pVHL and Hypoxia-inducible factor(HIF),their well-known activities under low-oxygen environments as an E3 ubiquitin ligase and as a transcription factor,respectively,as well as their non-canonical functions revealed ***,we discussed how their dysregulation promotes tumorigenesis:beginning with chromosome 3 p-arm(3p)loss/epigenetic methylation,followed by two-allele knockout,before the loss of complimentary tumor suppressor genes leads cells down predictable oncological *** different pathways can ultimately determine the grade,outcome,and severity of the deadliest genitourinary *** finished by investigating current and proposed schemes to therapeutically treat clear cell renal cell carcinoma(cc RCC)by manipulating the hypoxic pathway utilizing Vascular Endothelial Growth Factor(VEGF)inhibitors,mammalian target of rapamycin complex 1(mTORC1)inhibitors,small molecule HIF inhibitors,immune checkpoint blockade therapy,and synthetic lethality.

关键词： VHL HIF ccRCC Kidney cancer Hypoxia

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