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Availability of basic life support courses for the general populations in India, Nigeria and the United Kingdom: An internet-based analysis

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World Journal of Emergency Medicine 2020年第3期11卷 133-139页

作者： Alexei Birkun Fatima Trunkwala Adhish Gautam Miriam Okoroanyanwu Adesokan Oyewumi Department of Anaesthesiology Resuscitation and Emergency MedicineMedical Academy named after S.I.Georgievsky of V.I.Vernadsky Crimean Federal University295051Lenin Blvd5/7SimferopolRussian Federation

BACKGROUND:The number of lay people willing to attempt cardiopulmonary resuscitation(CPR)in real life is increased by effective education in basic life support(BLS).However,little is known about access of general public to BLS training across the globe.This study aimed to investigate availability and key features of BLS courses proposed for lay people in India,Nigeria and the United Kingdom(UK).METHODS:A Google search was done in December 2018,using English keywords relevant for community resuscitation training.Ongoing courses addressing BLS and suitable for any adult layperson were included in the analysis.On-site training courses were limited to those provided within the country's territory.RESULTS:A total of 53,29 and 208 eligible courses were found for India,Nigeria and the UK,respectively.In the UK,the number of courses per 10 million population(31.5)is 79 and 21 times higher than that in India(0.4)and Nigeria(1.5).Course geography is limited to 28%states and one union territory in India,30%states and the Federal Capital Territory in Nigeria.In the UK,the training is offered in all constituent countries,with the highest prevalence in England.Courses are predominantly classroom-based,highly variable in duration,group size and instructors'qualifications.For India and Nigeria,mean cost of participation is exceeding the monthly minimum wage.CONCLUSION:In contrast to the UK,the availability and accessibility of BLS courses are critically limited in India and Nigeria,necessitating immediate interventions to optimize community CPR training and improve bystander CPR rates.

关键词： Basic life support Cardiopulmonary resuscitation Courses Training India Nigeria United Kingdom

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Acupuncture price in forty-one metropolitan regions in the United States: An out-of-pocket cost analysis based on Ok ***

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Journal of Integrative Medicine 2019年第5期17卷 315-320页

作者： Arthur Yin Fan David Dehui Wang Hui Ouyang Haihe Tian Hui Wei Deguang He Changzhen Gong Jipu Wen Ming Jin Chong He Sarah Faggert Alemi Sudaba Rahimi Acupuncture Profession Survey Project American Traditional Chinese Medicine AssociationViennaVA 22182USA Tongrentang Ming Qi Clinic New YorkNY 10016USA Oriental Asclepius LLCPlantationFL 33317USA Eastern Roots Wellness PLCMcLeanVA 22101USA McLean Center for Complementary and Alternative Medicine PIC.ViennaVA 22182USA Ohio State Integrative Medicine Wexner Medical CenterOhio State UniversityColumbusOH 43221USA YIN & YANG Healthcare FriendswoodTX 77546USA Chinese Acupuncture and Herbs Center LargoFI 33778USA Wei's Chinese Medical Center Lake WorthFL 33467USA New England School of Acupuncture NewtonMA 02458USA American Academy of Acupuncture Oriental Medicine RosevilleMN 55113USA TCMzone TempeAZ 85281USA

Few studies have focused on the cost of acupuncture treatments although acupuncture has become popular in the United States(U.S.). The purpose of the current study was to examine the out-of-pocket costs incurred from acupuncture services based on an online website, Ok ***. We examined descriptive statistics(range, median and 20% intervals) for the cost of acupuncture "first-time visits"and "follow-up visits" in 41 metropolitan regions in the U.S. The acupuncture prices of 723 clinics throughout 39 metropolitan regions were included, except for Birmingham, Alabama and Detroit, Michigan as there was no online data available at the time of the study for these two regions. The cost range for a first-time acupuncture visit was $15–400;the highest median was $150 in Charleston, South Carolina,while the lowest was $45 in St. Louis, Missouri. The top 10 cities for the highest median were:Baltimore, Washington, D.C., New York, San Francisco, San Jose, Boston, Atlanta, Seattle, Portland and Indianapolis, with the median $120, while the median for all 723 clinics was $112. For the follow-up visits,the cost range was $15–300;the highest median was $108 in Charleston, South Carolina, and the lowest$40 in Miami, Florida. The 10 cities with highest median follow-up acupuncture visit costs were: New York, Baltimore, New Orleans, Washington, D.C., Philadelphia, San Francisco, San Jose, Seattle, Boston and Atlanta, with the median $85, while for all 723 clinics the median price was $80. The estimation of the average gross annual income of each acupuncturist from the regions studied was $95,760, while the total annual cost of patients seeking acupuncture services in the U.S. was about $3.5 billion in 2018.

关键词： Acupuncture Price Out-of-pocket cost Annual cost City, United States

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Modeling Impact of Natural Hazard-Induced Disasters on Income Distribution in the United States

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International Journal of Disaster Risk Science 2017年第4期8卷 435-444页

作者： Lin Fang Jiayu Wu Tatjana Miljkovic Department of Statistics Miami UniversityOxfordOH 45056USA

Economic damage due to hurricane activities has been shown to impact income inequality in the coastal states of the United States. We consider 17 other natural hazards, in addition to hurricanes, that affected the entire United States for the period 1970–2013. Two fixed effects models were developed to quantify the relationship between income inequality and economic and demographic variables, including crop and property losses from natural hazard-induced disasters. These models include state-byyear and region-by-year fixed effects models. Our findings show that the damages from all natural hazards impact income distribution across the United States, not only in hurricane-affected areas, but also in non-hurricane states.The results of our study have important implications for the insurance industry and government policymakers.

关键词： Disaster insurance Gini coefficient Income distribution Natural hazard-induced disasters United States

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Prevalence of anal fistula in the United Kingdom

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World Journal of Clinical Cases 2019年第14期7卷 1795-1804页

作者： Suvi RK Hokkanen Naomi Boxall Javaria Mona Khalid Dimitri Bennett Haridarshan Patel Real World Evidence Solutions IQVIALondon N19JYUnited Kingdom Evidence and Value Generation Global Medical AffairsTakeda Pharmaceuticals International Inc.London WC2B 4AEUnited Kingdom Department of Epidemiology Takeda Pharmaceuticals International Inc.CambridgeMA 02139United StatesAdjunctPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA 19104United States Evidence and Value Generation Global Medical AffairsTakeda Pharmaceuticals International Inc.DeerfieldIL 6001United States

BACKGROUND Anal fistula is a pathological connection between the anal canal and perianal skin, which most commonly develops from an infected anal crypt. While the majority of anal fistulas are idiopathic, they are also associated with Crohn’s disease (CD) and other inflammatory conditions. The prevalence of anal fistula is estimated to be 1-2 per 10000 patients, but population-based studies on anal fistula epidemiology are limited and outdated. AIM To assess the prevalence of anal fistula and relevant comorbidities, with and without CD in the United Kingdom and Europe. METHODS A retrospective population-representative observational cohort study was performed in The Health Improvement Network (THIN), a United Kingdom primary care database. Mid-year point prevalence of anal fistula was calculated on the first of July for each year between 2014 and 2017. Estimates were calculated for anal fistula overall and by CD status and standardized to the United Kingdom and European population. Prevalence of relevant comorbidities including lymphogranuloma venereum, hidradenitis suppurativa, anal presentation of sexually transmitted diseases, diabetes mellitus, and radiation in the pelvic area was reported. RESULTS The United Kingdom-standardized overall point prevalence of anal fistula was 1.80 (95%CI: 1.65-1.94) per 10000 patients in 2017, while the Europe standardized estimate was 1.83 (95%CI: 1.68-1.98) per 10000 patients. Both these standardized point prevalence estimates ranged from 1.89 to 2.36 between 2014-2016. The United Kingdom-standardized point prevalence of anal fistula without CD was 1.35 (95%CI: 1.23-1.48) per 10000 patients, while the Europe-standardized estimate was 1.39 (95%CI: 1.26-1.52) per 10000 patients. In contrast, the standardized point prevalence estimate of anal fistula with CD was lower for both United Kingdom and Europe (0.44;95%CI United Kingdom: 0.37-0.52, 95%CI Europe: 0.37-0.51) per 10000 patients in 2017. In 2017, 19% of anal fistula patients without CD and 13% of anal fistula patients with C

关键词： Anal fistula United Kingdom Europe Crohn's disease Comorbidities Prevalence

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The 2 ℃ Global Temperature Target and the Evolution of the Long-TermGoal of Addressing Climate Change-From the United Nations FrameworkConvention on Climate Change to the Paris Agreement

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Engineering 2017年第2期3卷 272-278页

作者： Yun Gao Xiang Gao Xiaohua Zhang Department of Sdence & Technology and Climate Change China Meteorological Administration Beijing 100081 China Energy Research Institute National Development and Reform Commission Beijing 100038 China National Center for Climate Change Strategy and International Cooperation (NCSC) Beijing 100038 China

The Paris Agreement proposed to keep the increase in global average temperature to well below 2 ℃ abovepre-industrial levels and to pursue efforts to limit the temperature increase to 1.5 ℃ above pre-industriallevels. It was thus the first international treaty to endow the 2 ℃ global temperature target with legal effect.The qualitative expression of the ultimate objective in Article 2 of the United Nations Framework Conventionon Climate Change （UNFCCC） has now evolved into the numerical temperature rise target in Article 2 of theParis Agreement. Starting with the Second Assessment Report （SAR） of the Intergovernmental Panel on Cli-mate Change （IPCC）, an important task for subsequent assessments has been to provide scientific informa-tion to help determine the quantified long-term goal for UNFCCC negotiation. However, due to involvementin the value judgment within the scope of non-scientific assessment, the IPCC has never scientifically af-firmed the unacceptable extent of global temperature rise. The setting of the long-term goal for addressingclimate change has been a long process, and the 2 ℃ global temperature target is the political consensuson the basis of scientific assessment. This article analyzes the evolution of the long-term global goal foraddressing climate change and its impact on scientific assessment, negotiation processes, and global low-carbon development, from aspects of the origin of the target, the series of assessments carried out by the 1PCCfocusing on Article 2 of the UNFCCC, and the promotion of the global temperature goal at the political level.

关键词： Climate change International negotiationln tergovernmental Panel on Climate Change United Nations Framework Convention on Climate ChangeLong-term goal Critical vulnerability Intuitive building

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A current render of pediatric otolaryngology in the United States

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Pediatric Investigation 2019年第3期3卷 133-136页

作者： Diego Preciado Division of Pediatric Otolaryngology Head and Neck SurgeryChildren's National Health SystemWashingtonDCUSA

Introduction Complex pediatric otolaryngology can be generally regarded as a subspecialty within otolaryngology focusing on the care of children with complex diseases of the head and neck and aerodigestive tract, or in some cases more common diseases in this anatomical region in otherwise medically complex children. This concept of the specialty was succinctly articulated by Charles Bluestone in 1995 when he wrote pediatric otolaryngologists treat 'special problems or special children, or both'.1 Increasingly, this care is delivered by multi-disciplinary pediatric health care providers working at highly specialized tertiary care centers for children. This review will briefly cover the historical evolution of the specialty's origins, along with its current state of graduate medical education training and sub-certification efforts.

关键词： pediatric otolaryngology the United States a subspecialty

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Impact of diabetes mellitus on risk of cardiovascular disease and all-cause mortality: Evidence on health outcomes and antidiabetic treatment in United States adults

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World Journal of Diabetes 2016年第18期7卷 449-461页

作者： Longjian Liu Barbara Simon Jinggaofu Shi Arshpreet Kaur Mallhi Howard J Eisen Department of Epidemiology and Biostatistics Drexel University Dornsife School of Public Health Division of Endocrinology Drexel University College of Medicine Division of Cardiology Drexel University College of Medicine

AIMTo examine the epidemic of diabetes mellitus (DM) and its impact on mortality from all-cause and cardiovascular disease (CVD), and to test the effect of antidiabetic therapy on the mortality in United States adults. METHODS The analysis included a randomized population sample of 272149 subjects ages ≥ 18 years who participated in the National Health Interview Surveys (NHIS) in2000-2009. Chronic conditions (hypertension, DM and CVD) were classified by participants’ self-reports of physician diagnosis. NHIS-Mortality Linked Files, and NHIS-Medical Expenditure Panel Survey Linkage Fileson prescribed medicines for patients with DM were used to test the research questions. χ 2, Poisson and Cox’s regression models were applied in data analysis.RESULTS Of all participants, 22305 (8.2%) had DM. The prevalence of DM significantly increased from 2000 to 2009 in all age groups (P United States. Patients with DM have significantly higher risk of death from all-cause and CVD than those without DM. Antidiabetic mediations,specifically for metformin use, sho

关键词： Epidemic of diabetes mellitus Cardiovascular disease Pharmacoepidemiologic profiles United States

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A United Framework for Large-Scale Resource Description Framework Stream Processing

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Journal of Computer Science & Technology 2019年第4期34卷 762-774页

作者： Hong Fang Bo Zhao Xiao-Wang Zhang Xuan-Xing Yang College of Arts and Sciences Shanghai Polytechnic UniversityShanghai 201209China College of Intelligence and Computing Tianjin UniversityTianjin 300350China Tianjin Key Laboratory of Cognitive Computing and Application Tianjin 300350China

Resource description framework(RDF)stream is useful to model spatio-temporal data.In this paper,we propose a framework for large-scale RDF stream processing,LRSP,to process general continuous queries over large-scale RDF streams.Firstly,we propose a formalization(named CT-SPARQL)to represent the general continuous queries in a unified,unambiguous way.Secondly,based on our formalization we propose LRSP to process continuous queries in a common white-box way by separating RDF stream processing,query parsing,and query execution.Finally,we implement and evaluate LRSP with those popular continuous query engines on some benchmark datasets and real-world datasets.Due to the architecture of LRSP,many efficient query engines(including centralized and distributed engines)for RDF can be directly employed to process continuous queries.The experimental results show that LRSP has a higher performance,specially,in processing large-scale real-world data.

关键词： resource description framework(RDF)stream continuous query United framework stream processing large-scale RDF stream processing(LRSP)

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Mercantilist Origin of United States’ Trade Protectionism

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China Economist 2019年第5期14卷 31-40页

作者：伍山林 School of Economics Shanghai University of Finance and Economics (SUFE)

During its rise as a world power, the United States(U.S.) adopted a traditional form of mercantilism, and most US politicians followed a protectionist approach. From the end of the Civil War to the eve of World War I, the United States blazed a new trail of industrial development and implemented protective policies such as high tariffs. This historical tradition has had a profound influence on some current US politicians. After the collapse of the Bretton Woods system, the United States developed a new form of mercantilism, as manifested in the emergence of nontariff barriers instead of tariff barriers to restrict imports and protect domestic industries and employment. Although export regulations have avoided affecting the technology industry, they have led to hefty trade deficits for the United States. National interests have prevailed in U.S. decision-making and have influenced its choices to accede to or walk away from international organizations or treaties. The dollar's hegemony has played a pivotal role in U.S. economic policymaking. These factors have led to the twin deficits in the U.S. economy, i.e. a trade deficit and a fiscal deficit. The real intention of the United States in waging a trade war against China is to maintain and even strengthen the dollar's hegemony and the U.S.' international predominance.

关键词： the United States trade protectionism mercantilism twin deficits trade war

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Multitarget stool DNA for colorectal cancer screening:A review and commentary on the United States Preventive Services Draft Guidelines

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World Journal of Gastrointestinal Oncology 2016年第5期8卷 450-458页

作者： Barry M Berger Bernard Levin Robert J Hilsden Medical Affairs Exact Sciences Corporation Scientific Advisory Board Exact Sciences Departments of Medicine and Community Health Sciences University of Calgary

Multitarget stool DNA(mt-sDNA) testing was approved for average risk colorectal cancer(CRC) screening by the United States Food and Drug Administration and thereafter reimbursed for use by the Medicare program(2014).The United States Preventive Services Task Force(USPSTF) October 2015 draft recommendation for CRC screening included mt-s DNA as an "alternative" screening test that "may be useful in select clinical circumstances",despite its very high sensitivity for early stage CRC.The evidence supporting mt-s DNA for routine screening use is robust.The clinical efficacy of mt-s DNA as measured by sensitivity,specificity,life-years gained(LYG),and CRC deaths averted is similar to or exceeds that of the other more specifically recommended screening options included in the draft document,especially those requiring annual testing adherence.In a population with primarily irregular screening participation,tests with the highest point sensitivity and reasonable specificity are more likely to favorably impact CRC related morbidity and mortality than those depending on annual adherence.This paper reviews the evidence supporting mt-s DNA for routine screening and demonstrates,using USPSTF's modeling data,that mt-s DNA at three-year intervals provides significant clinical net benefits and fewer complications per LYG than annual fecal immunochemical testing,high sensitivity guaiac based fecal occult blood testing and 10-year colonoscopy screening.

关键词： Colorectal cancer screening Multitarget stool DNA Stool DNA The United States Preventive Services Task Force Cancer Intervention Surveillance Modeling Network Fecal immunological technique Modeling Interval

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