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Determination of 27 pharmaceuticals and personal care products(PPCPs)in water:The benefit of isotope dilution

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Frontiers of Environmental Science & Engineering 2020年第1期14卷 127-136页

作者： Xueqi Fan Jie Gao Wenchao Li Jun Huang Gang Yu State Key Joint Laboratory of Environment Simulation and Pollution Control(SKJLESPC) Beijing Key Laboratory for Emerging Organic Contaminants Control(BKLEOC)School of EnvironmentTsinghua UniversityBeijing 100084China CSD IDEA(Beijing)Environment Test&Analysis Co. Ltd.Beijing 100192China

Pharmaceuticals and personal care products(PPCPs)are a unique group of emerging and nonpersistent *** this study,27 PPCPs in various water samples were extracted by solid phase extraction(SPE),and determined by isotope dilution method using liquid chromatography coupled to tandem triple quadruple mass spectrometer(LC-MS/MS).A total of 27 isotopically labeled standards(ILSs)were applied to correct the concentration of PPCPs in spiked ultrapure water,drinking water,river,effluent and influent *** corrected recoveries were 73%-122%with the relative standard deviation(RSD)<16%,except for *** matrix effect for all kinds of water samples was<22%and the method quantitation limits(MQLs)were 0.45-8.6 ng/*** developed method was successfully applied on environmental water *** SPE extracts of spiked ultrapure water,drinking water,river and wastewater effluent were stored for 70 days,and the ILSscorrected recoveries of 27 PPCPs were obtained to evaluate the correction ability of ILSs in the presence of variety *** recoveries of 27 PPCPs over 70 days were within the scope of 72%-140%with the recovery variation<37%in all *** isotope dilution method seems to be of benefit when the extract has to be stored for long time before the instrument analysis.

关键词： Pharmaceuticals and personal care products(PPCPs) Isotopically labeled standard(ILSs) Water Solid-phase extraction(SPE) LC-MS/MS

The efficacy and effectiveness of machine learning for weaning in mechanically ventilated patients at the intensive care unit: a systematic review

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Bio-Design and Manufacturing 2019年第1期2卷 31-40页

作者： Man Ting Kwong Glen Wright Colopy Anika M.Weber Ari Ercole Jeroen H.M.Bergmann Department of Engineering Science University of OxfordParks Road. Oxford OXI 3PJ. UK snap40 Inc.125 Princess Street Edinburgh EH2 4AD UK CRUK/MRC Oxford Institute for Radiation Oncology.Roosevelt Drive Oxford OX3 7DQ. UK Division of Anaesthesia Addenbrooke's Hospital University of Cambridge Hills Road Cambridge CB2 0QQ. UK

Weani ng from mechanical ventilation in the in tensive care unit (ICU) is a complex clinical problem and relevant for future organ engineering. Prolonged mechanical ventilation (MV) leads to a range of medical complications that increases length of stay and costs as well as contributes to morbidity and even mortality and long-term quality of life. The need to reduce MV is both clinical and economical. Artificial intelligence or machine learning (ML) methods are promising opportunities to positively influence patient outcomes. ML methods have been proposed to enhance clinical decisions processes by using the large amount of digital information generated in the ICU setting. There is a particular interest in empirical methods (such as ML) to improve management of "difficult-to-wean" patients, due to the associated costs and adverse events associated with this population. A systematic literature search was performed using the OVID, IEEEXplore, PubMed, and Web of Science databases. All publications that included (1) the application of ML to weaning from MV in the ICU and (2) a clinical outcome measurement were reviewed. A checklist to assess the study quality of medical ML publications was modified to suit the critical assessment of ML in MV weaning literature. The systematic search identified nine studies that used ML for weaning management from MV in critical care. The weaning management application areas included (1) prediction of successful spontaneous breathing trials (SBTs),(2) prediction of successful extubation,(3) prediction of arterial blood gases, and (4) ventilator setting and oxygenation-adjustment advisory systems. Seven of the nine studies scored seven out of eight on the quality index. The remaining two of the nine studies scored one out of eight on the quality index. This scoring may, in part, be explained by the publications' focus on technical novelty, and therefore focusing on issues most important to a technical audience, instead of issues most impor

关键词： Artificial intelligence Patient-centred medicine Clinical trial Critical care Data science

Auriculotherapy in primary health care: A large-scale educational experience in Brazil

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Journal of Integrative Medicine 2019年第4期17卷 302-309页

作者： Charles Dalcanale Tesser Ari Ojeda Ocampo More Melissa Costa Santos Emiliana Domingues Cunha da Silva Fatima Terezinha Pelachini Farias Lucio Jose Botelho Department of Public Health Federal University of Santa Catarina Floriandpolis Santa Catarina 88036-800 Brazil Post-graduate Program in Public Health Federal University of Santa Catarina Florianopolis Santa Catarina 88036-800 Brazil Integrative Medicine and Acupuncture Service University Hospital Federal University of Santa Catarina Floriandpolis Santa Catarina 88036-800 Brazil Floriandpolis Municipality Health Office Florianopolis Santa Catarina 88036-800 Brazil

Auriculotherapy consists of physical stimuli applied to the outer ear and is commonly associated with traditional Chinese medicine (TCM). The authors present and discuss the development of a course that offers a semi-on-site auriculotherapy course for Brazilian primary health care (PHC) professionals. The course was funded by the Brazilian Ministry of Health and developed at the Federal University of Santa Catarina in 2015 by a team of experts in auriculotherapy. It consisted of 75 h of distance learning (five sequential modules) and 5 h of on-site learning. The modules included the following items:(1) introduction to integrative practices;(2) ear reflexology;(3) introduction to TCM;(4) biomedical view of auriculotherapy;and (5) auriculotherapy in PHC. The teaching material in eluded a workbook for each module, 14 video lectures and an interactive ear(on line resource) to study location and application to the main auricular points. The on-site lectures follow a structured script of ear palpation techniques, auricular seed insertion practice and clinical case discussions, under the supervision of trained instructors. The course was offered in 2016 and 2017 and on-site lectures took place in 25 cities, covering all Brazilian regions, in coordination with municipal or state boards of health. A total of 4273 health professionals concluded the training and their evaluation of the course was highly positive. The Brazilian experience of large-scale training shows the potential to disseminate auriculotherapy in the context of PHC, given that its practice is fast, easy to learn, safe, effective for different health problems and well accepted by the patients.

关键词： Auriculotherapy Traditional Chinese medicine Primary health care Health education Distance learning

Periconceptional care and offspring health at birth and long term,from the perspective of Avicenna

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Journal of Integrative Medicine 2019年第2期17卷 80-86页

作者： Mohammad Ansaripour Mohsen Naseri Mohammad Mahdi Esfahani Iraj Nabipour Fatemeh Rakhshani Arman Zargaran Roya Kelishadi Department of Iranian Traditional Medicine Faculty of Medicine Shahed University Traditional Medicine Clinical Trial Research Center Shahed University Traditional Medicine Department Tehran University of Medical Sciences School of Iranian Traditional Medicine The Persian Gulf Biomedical Research Institute Bushehr University of Medical Sciences Health Education and Promotion Department Shahid Beheshti University of Medical Sciences School of Public Health Department of History of Medicine School of Traditional Medicine Tehran University of Medical Sciences Child Growth and Development Research Center Research Institute for Primordial Prevention of Noncommunicable Disease Isfahan University of Medical Sciences

Periconceptional care such as lifestyle plays an important impact role in offspring health. The aim of the present study was to clarify the perspective of Avicenna on periconceptional care. Avicenna(980–1037 A.D.) was one of the outstanding Persian physicians, who made great contributions to the field of medical sciences, in particular, obstetrics. In advance, Avicenna's book, Canon of Medicine, was considered to find his perspectives on periconceptional care. Then, his ideas and theories were compared to the current findings by searching the keywords in main indexing systems including PubMed/MEDLINE,Scopus and Institute for Scientific Information Web of Science as well as the search engine of Google Scholar. Current investigations show that gamete quality, pregnancy outcome, and offspring health at birth and long term depend on both parents' lifestyle in pre-and periconceptional period, as well as the intrauterine environment. Avicenna believed that seminal fluid, sperm, ovum, and developing conditions in utero were influenced by the stages of food digestion and the function of some *** the other hand, food digestion and function of the organs also depend on each parent's lifestyle and environmental factors. He mentioned 6 principles of healthy lifestyle: exercise, nutrition, sleep and awareness, excretion of body wastes and retention of necessary materials, psychic features, as well as air and climate. Thus, a multicomponent healthy lifestyle should be considered by parents of child-bearing age in an appropriate period before and in early pregnancy as well as elimination of any disorders in parents, to give birth to more healthy offspring.

关键词： Avicenna Epigenetic diseases Healthy lifestyle Offspring health Periconceptional care Persian medicine

US children with special health care needs and ethnic discrimination: results from multivariate modeling

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World Journal of Pediatrics 2019年第2期15卷 182-189页

作者： Guillermo Montes St.John Fisher College Alesi 106C3690 East Ave.RochesterNY 14618USA Children's Institute Inc. RochesterNYUSA

Background To determine the prevalence of parent-reported ethnic/racial discrimination,and to determine if children with special health care needs are more likely to experience ethnic discrimination than other children who have similar family income,age,sex,race,parental education and Hispanic *** Using the National Survey of Children's Health 2011-2012 (n =95,677),ethnic discrimination was measured by two questions that asked 'was child ever treated or judged unfairly because of his/her race or ethnic group?' and if so,how often it occurred in the last 12 months prior to the *** An estimated 3 million US children aged 0-17 years have experienced parent-reported ethnic discrimination (1.4% White,9.1% Black,9.9% other race,4.7% Hispanic).The likelihood to experience ethnic discrimination is much higher for Black and other race children,compared to White *** with special health care needs were two times more likely to experience ethnic discrimination frequently in the 12 months prior to the survey than comparable children in terms of age,sex,race,family income,parental education,and social *** family income did not prevent the exposure to ethnic discrimination but was associated with fewer *** Theoretical frameworks,such as social determinants of health,must account for the bidirectional nature of the relationship between health and ethnic *** care must assess if ethnic discrimination has occurred and whether trauma-informed approaches are needed.

关键词： Children with special health care needs Ethnic discrimination United States

Current state of cancer patient care incorporating Thai traditional medicine in Thailand: A qualitative study

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Journal of Integrative Medicine 2020年第1期18卷 41-45页

作者： Preecha Nootim Nattiya Kapol Waranee Bunchuailua Panoopat Poompruek Parankul Tungsukruthai Department of Thai Traditional and Alternative Medicine Ministry of Public HealthMueangNonthaburi 11000Thailand Faculty of Pharmacy Silpakorn UniversityMueangNakhon Pathom 73000Thailand Department of Community Pharmacy Faculty of PharmacySilpakorn UniversityMueangNakhon Pathom 73000Thailand Chulabhorn International College of Medicine Thammasat UniversityKhlong LuangPathum Thani 12120Thailand

Objective: To assess the current state of cancer treatment incorporating Thai traditional medicine(TTM)and to identify problems in the system, by using the health system framework of the World Health ***: A qualitative study was conducted by interviewing three groups of people involved in the healthcare system. The groups were constructed via purposive sampling of patients with cancer, caregivers and service providers. The study groups included 37 individuals from five TTM hospitals. Indepth interviews were conducted from October 2017 to March 2018. The interview questions were developed based on the six building blocks of a health system framework. Free form answers from participants were analyzed and interpreted to develop the study ***: All five TTM hospitals provided treatment to patients with cancer based on provincial public health policy. The policy allows patients with cancer to obtain TTM services in outpatient and inpatient departments and via home visits;most patients used outpatient services. The TTM services were primarily provided by TTM practitioners and included massage, herbal steam, herbal compress and *** medicines were widely used and included Benja-amarit, an anticancer formulation made from Wat Khampramong and Phytoplex. The problems included poor acceptance of TTM practitioners by other healthcare practitioners, lack of experience among TTM practitioners in treating patients with cancer,lack of herbal medicine research trials, contamination in herbal medicine preparations and absence of practical treatment ***: TTM is an alternative treatment modality for patients with cancer and is supported by a national policy in Thailand. To increase accountability to patients and other practitioners, TTM treatments should be refined to rely on scientific principles and practitioners of TTM should receive academic training. Practical treatment guidelines need to be established and thoroughly

关键词： Cancer Hospital Qualitative research Traditional medicine Patient care

Can an 8^(th) grade student learn point of care ultrasound?

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World Journal of Emergency Medicine 2019年第2期10卷 109-113页

作者： Alexander S.Kwon Shadi Lahham John C.Fox Sage Hill School Department of Emergency Medicine UC Irvine Medical Center UC Irvine School of Medicine

BACKGROUND: Point-of-care ultrasound has gained widespread use in developing countries due to decreased cost and improved telemedicine capabilities. Ultrasound training, specifi cally image acquisition skills, is occurring with more frequency in non-medical personnel with varying educational levels in these underdeveloped areas. This study evaluates if students without a high school education can be trained to acquire useful FAST images, and to determine if an 8^(th) grade student can teach peers these ***: The 8^(th) grade students at a small middle school were divided into two groups. One group received training by a certified medical sonographer, while the other group received training by a peer 8^(th) grade student trainer who had previously received training by the sonographer. After training, each student was independently tested by scanning the four FAST locations. A blinded ultrasound expert evaluated these images and deemed each image adequate or inadequate for clinical ***: Eighty video image clips were obtained. The overall image adequacy rate was 74%. The splenorenal window had the highest rate at 95%, followed by retrovesical at 90%, hepatorenal at 75%, and subxiphoid cardiac at 35%. The adequacy rate of the sonographer-trained group was 78%, while the adequacy rate of the student-trained group was 70%. The difference in image adequacy rate between the two groups was not signifi cant(P-value 0.459).CONCLUSION: The majority of 8^(th) graders obtained clinically adequate FAST images after minimal training. Additionally, the student-trained group performed as well as the sonographer-trained group.

关键词： Point of care ultrasound FAST Image acquisition Training

Model of Healthcare-Associated Infection Control in Primary Health care Institutions:A Structural Equation Modeling

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Current Medical Science 2019年第1期39卷 153-158页

作者： Zi-nan ZHANG Xin-ping ZHANG Xiao-quan LAI School of Medicine and Health Management Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Nosocomial Infection Tongji Hospital Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

The purpose of this study was to construct the model of organization system,managemcnt,training and surveillance in healthcare-associated infection prevention and control(IC)of primary health care institutions and identify its efleet on patient safety and decreasing economic burden by standardizing IC.A cross-sectional survey was conducted with *** were collected from 268 primary health care institutions in Hubei province,*** on the model of IC were analyzed by means of confirmatory factor analysis and structural equation *** results showed that the fit indices of the hypothesized model of IC satisfied recommended levels:root mean square error of approximation(RMSEA)=0.071;comparative fit index(CFI)=0.965;tucker lewis index(TLI)=0.956:weighted root mean square residual(WRMR)=*** model showed that organization system had a direct effect on management(β=0.311.Pcare institutions is valuable tor guiding IC practice.

关键词： model organization system:management training surveillance infection control primary health care institutions

First Italian outbreak of VIM-producing Serratia marcescens in an adult polyvalent intensive care unit, August-October 2018: A case report and literature review

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World Journal of Clinical Cases 2019年第21期7卷 3535-3548页

作者： Maria Rosaria Iovene Vincenzo Pota Massimiliano Galdiero Giusy Corvino Federica Maria Di Lella Debora Stelitano Maria Beatrice Passavanti Maria Caterina Pace Aniello Alfieri Sveva Di Franco Caterina Aurilio Pasquale Sansone Vettakkara Kandy Muhammed Niyas Marco Fiore Department of Experimental Medicine University of Campania"Luigi Vanvitelli"Naples 80138Italy Department of Women Child and General and Specialized SurgeryUniversity of Campania"Luigi Vanvitelli"Naples 80138Italy Department of Medicine All India Institute of Medical SciencesNew Delhi 110029India

BACKGROUND Carbapenem-resistant Enterobacteriaceae has become a significant public health concern as hospital outbreaks are now being frequently reported and these organisms are becoming difficult to treat with the available *** SUMMARY An outbreak of VIM-producing Serratia marcescens occurred over a period of 11 wk(August,1 to October,18)in patients admitted to the adult polyvalent intensive care unit of the University of Campania“Luigi Vanvitelli”located in *** episodes occurred in three patients(two patients infected,and one patient colonized).All the strains revealed the production of *** After three decades of carbapenem antibiotics use,the emergence of carbapenemresistance in Enterobacteriaceae has become a significant concern and a stricter control to preserve its clinical application is *** is,to our knowledge,the first outbreak of VIM-producing Serratia marcescens in *** policies must be implemented to avoid future outbreaks.

关键词： Serratia marcescens Carbapenamase VIM Intensive care unit Outbreak Case report