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A Comparison of the Best Place to Fix Endotracheal Tubes for Men and Women When Men and Women Are in the Same Height

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Open Journal of Anesthesiology 2014年第7期4卷 153-158页

作者： Shahram Nafisi Mehdi Rajabi Mohammad Afshar Morteza Rashidian Mitra Mohammadzadeh Department of Anesthesiology Advocate Illinois Masonic Medical CenterChicagoILUSA Department of Anesthesia and Critical Care Kashan University of Medical SciencesKashanIran Faculty of Nursing and Midwifery Kashan University of Medical SciencesKashanIran Clinical Innovation Ins Trials Costa MesaCAUSA Shahid Beheshti University of medical Sciences TehranIran

Background: Comparison of the tracheal tube depth over the same body height of men and women based upon intubation depth markings. Methods: Kashan University of medical Sciences ethics committee approved the study and written informed consent was taken for each patient. Patients undergoing surgery requiring general anesthesia with oro-tracheal intubation were included in a prospective observational study. After induction of general anesthesia, the endotracheal tube was secured at the point at which the cuff was just below the vocal cord on laryngoscopy. Results: In a statistical study of 682 intubated patients which consisted of 499 women and 183 men, 28 cases of laryngoscopic view grade III and IV were excluded from the study. The measurement markings on the ETT at the level of right corner of the mouth were 20.65 ± 0.13 and 18.52 ± 0.08 for men and women respectively (CI 95%). Patient’s height has a meaningful correlation with the measurement of the fixation point of the ETT. Pearson correlation coefficient between the securing point of the tube and height was 0.2 and 0.357 for men and women respectively. In most cases of men and women of the same height, Mann-Whitney U test rejected the hypothesis that the tube can be fixed in the particular point. Conclusions: In general, men are taller than women. Comparing the fixation depth of the tube, even when man and woman have the same body height, the endotracheal tube might be placed in a deeper level for men rather than women.

关键词： Intubation Endotracheal Tube General Anesthesia Height Cuffed

Subtle skills: Using objective structured clinical examinations to assess gastroenterology fellow performance in system based practice milestones

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World Journal of Gastroenterology 2020年第11期26卷 1221-1230页

作者： Marianna Papademetriou Gabriel Perrault Max Pitman Colleen Gillespie Sondra Zabar Elizabeth Weinshel Renee Williams Division of Gastroenterology Georgetown University Medical CenterWashingtonDC 20007United States Division of Gastroenterology Washington DC VA Medical CenterWashingtonDC 20422United States Department of Medicine New York University Medical CenterNew YorkNY 10016United States Division of Gastroenterology New York University Medical CenterNew YorkNY 10016United States Department of Medicine New York University School of MedicineNew YorkNY 10016United States Department of Gastroenterology VA New York Harbor Healthcare SystemNew YorkNY 10010United States

BACKGROUND System based practice(SBP) milestones require trainees to effectively navigate the larger health care system for optimal patient care. In gastroenterology training programs, the assessment of SBP is difficult due to high volume, high acuity inpatient care, as well as inconsistent direct supervision. Nevertheless,structured assessment is required for training programs. We hypothesized that objective structured clinical examination(OSCE) would be an effective tool for assessment of *** To develop a novel method for SBP milestone assessment of gastroenterology fellows using the *** For this observational study, we created 4 OSCE stations: Counseling an impaired colleague, handoff after overnight call, a feeding tube placement discussion, and giving feedback to a medical student on a progress note. Twentysix first year fellows from 7 programs participated. All fellows encountered identical case presentations. Checklists were completed by trained standardized patients who interacted with each fellow participant. A report with individual and composite scores was generated and forwarded to program directors to utilize in formative assessment. Fellows also received immediate feedback from a faculty observer and completed a post-session program evaluation *** Survey response rate was 100%. The average composite score across SBP milestones for all cases were 6.22(SBP1), 4.34(SBP2), 3.35(SBP3), and 6.42(SBP4)out of 9. The lowest composite score was in SBP 3, which asks fellows to advocate for cost effective care. This highest score was in patient care 2, which asks fellows to develop comprehensive management plans. Discrepancies were identified between the fellows’ perceived performance in their self-assessments and Standardized Patient checklist evaluations for each case. Eighty-seven percent of fellows agreed that OSCEs are an important component of their clinical training,and 83% stated that the cases were similar to actual clinical encoun

关键词： Objective structured clinical exams medical education medical error System based practice Milestones Gastroenterology

Demographic and Assisted Reproduction Related Factors Associated with Dichorionic Triplet Gestations

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Open Journal of Obstetrics and Gynecology 2015年第13期5卷 740-745页

作者： Barbara V. Parilla Brett Goldman Sue Jasulaitis Suela Sulo Angeline Beltsos Department of Obstetrics and Gynecology Advocate Lutheran General Hospital Park Ridge USA Chicago medical School North Chicago USA Fertility centers of Illinois Chicago USA James R. & Helen D. Russell Institute for Research & Innovation Advocate Lutheran General Hospital Park Ridge USA

Our objective was to evaluate which demographic factors or assisted reproductive technologies were associated with IVF triplet gestations where one of the embryos split, resulting in a dichorionic triplet gestation. This was a case-control study of dichorionic versus trichorionic triplet gestations that underwent assisted reproductive technology over the last 5 years at our fertility center. There were 53 cases of dichorionic triamniotic triplet gestations compared to 119 trichorionic triplet controls. There were no significant demographic differences between the cases and controls. 51/53 dichorionic triplets and 86/119 trichorionic triplets were conceived through IVF, the remaining utilized intrauterine insemination. ICSI was performed in virtually all patients that underwent IVF. Of the potential risk factors studied, hatching was used in 70.6% of dichorionic compared to 89.5% of trichorionic IVF triplets (p = 0.005);embryo transfer was performed on Day 5 or 6 compared to Day 3 in 88.0% dichorionic vs 71.8% trichorionic (p = 0.028). Frozen sperm was utilized more frequently with dichorionic than with trichorionic triplets, 26.0% vs 10.9% (p < 0.011). Only 4 (7.5%) of the IVF cases underwent pre-implantation genetics. Certain assisted reproductive technologies appear to be associated with embryo splitting and a dichorionic triplet gestation. More research is needed in this area to further elucidate these findings.

关键词： Monochorionic Triplets Embryo Splitting

An Outbreak of Serogroup Y Meningococcal Meningitis in a Private Secondary Vocational School-Guangzhou City,Guangdong Province,China,2023

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China CDC weekly 2024年第12期6卷 242-246,I0005页

作者： Xiang Zeng Qing He Yilan Li Yong Zhou Xiaoping Shao Pei Hu Jian Liang Yudan Song Chao Ma Lijie Zhang Limei Sun Lei Luo Chinese Field Epidemiology Training Program Chinese Center for Disease Control and PreventionBeijingChina Zhuhai center for Disease Control and Prevention Zhuhai CityGuangdong ProvinceChina Guangdong center for Disease Control and Prevention Guangzhou CityGuangdong ProvinceChina Guangzhou center for Disease Control and Prevention Guangzhou CityGuangdong ProvinceChina Institute of Public Health Guangzhou Medical University&Guangzhou Center for Disease Control and PreventionGuangzhou CityGuangdong ProvinceChina Department of the National Immunization Programme Chinese Center for Disease Control and PreventionBeijingChina

What is already known about this topic?The inclusion of meningococcal vaccines in the National Immunization Program(NIP)over several years has significantly reduced the incidence of meningococcal meningitis in China to historic ***,there has been a diversification of meningococcal serogroups,leading to a shift in dominant serogroups in China from serogroup A to serogroups C and B,accompanied by a rise in reports of serogroups Y and *** is added by this report?An outbreak of serogroup Y Neisseria meningitidis(Nm)in a secondary vocational school involved a single confirmed severe case and 24 individuals with laboratory-confirmed Nm *** investigation revealed that the outbreak was localized to the classroom of the confirmed *** close contact within a confined space was identified as a significant risk factor for Nm *** genotype sequence identified was type 1655(ST-1655),which is categorized under clonal complex 23(CC-23)and bears resemblance to 8 previously confirmed cases of serogroup Y meningococcal meningitis within Guangdong *** suggests that serogroup Y infections continue to sporadically emerge and have become prevalent *** are the implications for public health practice?This outbreak underscores the critical need to enhance surveillance of meningococcal serogroups and population carrier,and advocate for vaccination with MenY-containing vaccines.

关键词： break Secondary Guangdong

Enhancing the utility of tuberous sclerosis complex-associated neuropsychiatric disorders checklist in China

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儿科学研究(英文) 2024年第3期8卷 171页

作者： Zhang Jing Zhu Gang Liang Yan Wan Lin Liu Xinting Yan Huimin Liu Guoyin Zhang Bo Yang Guang Senior Department of Pediatrics the Seventh Medical Center of Chinese PLA General Hospital Beijing China Department of Pediatrics the First Medical Center of Chinese PLA General Hospital Beijing China medical School of Chinese PLA Beijing China Department of Neurology Boston Children’s Hospital Harvard Medical School Boston Massachusetts USA Biostatistics and Research Design center Institutional Centers for Clinical and Translational Research Boston Children’s Hospital Harvard Medical School Boston Massachusetts USA

[...]it aims to advocate for the adoption and recognition of the TAND Checklist within the Chinese TSC patient community.In a study of 2093 patients in the TuberOus SClerosis registry to increase disease Awareness (TOSCA) cohort, it was found that diagnoses of TAND were often delayed, with 30%–50% of patients not undergoing evaluation.13 A pilot study of the TAND Checklist, involving 20 professionals and 62 parents and caregivers from 28 countries, found that 93% of participants experienced four or more lifetime TAND behavioral difficulties.20 A study utilizing questionnaires with disease-specific questions on the burden of illness (BOI) and validated quality of life questionnaires, analyzed individual outcomes of 143 participants in the TOSCA study, emphasizing the burden of TSC on the personal lives of TSC patients and their families.The findings indicated high BOI and low quality of life within this population, underscoring the importance of early identification and intervention for TAND to enhance the quality of life for these individuals.21 Therefore, the TAND Checklist should serve as a valuable resource for identifying and evaluating TAND-related disorders, contributing to the enhancement of care and management for individuals with TSC.15,20 In 2023, Heunis et al.22 introduced a self-report quantified TAND Checklist (TAND-SQ), distinct from the clinician-completed lifetime version (TAND-L).DIAGNOSIS AND TREATMENT OF TSC IN CHINA Following the establishment of recommendations and standards by the 2012 International TSC Consensus Conference and the subsequent update of international TSC diagnostic criteria, along with surveillance and management recommendations in 2021, the scientific diagnosis and treatment of TSC have been effectively implemented and disseminated in China.2 This successful translation of scientific research findings into clinical practice has notably improved the quality of life for patients with this rare disease in China.

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Salivary C-reactive protein and mean platelet volume as possible diagnostic markers for late-onset neonatal pneumonia

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World Journal of Clinical Pediatrics 2024年第1期13卷 41-51页

作者： Wafaa Ahmed Metwali Abdelrahman Mohamed Elmashad Sahar Mohey Eldin Hazzaa Mohammed Al-Beltagi Mohamed Basiony Hamza Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlgahrbiaEgypt Department of Clinical Pathology Faculty of MedicineTanta UniversityTanta 31511AlgahrbiaEgypt Department of Pediatric University Medical CenterDr.Suliaman Al Habib Medical GroupManama 26671ManamaBahrain Department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671ManamaBahrain

BACKGROUND Neonatal sepsis,a formidable threat to newborns,is a leading cause of neonatal mortality,with late-onset sepsis manifesting after 72 hours post-birth being particularly ***,a prevalent sepsis presentation,poses a significant risk,especially during the neonatal phase when lung defenses are *** diagnosis of pneumonia is imperative for timely and effective ***,a minimally invasive diagnostic medium,holds great promise for evaluating infections,especially in *** To investigate the potential of serum C-reactive protein(CRP),salivary CRP(sCRP),and mean platelet volume(MPV)as diagnostic markers for late-onset neonatal pneumonia(LONP).METHODS Eighty full-term neonates were systematically examined,considering anthropometric measurements,clinical manifestations,radiology findings,and essential biomarkers,including serum CRP,sCRP,and *** The study reveals noteworthy distinctions in serum CRP levels,MPV,and the serum CRP/MPV ratio between neonates with LONP and healthy *** exhibited a robust discriminatory ability[area under the curve(AUC)=0.87]with high sensitivity and specificity at a cutoff value of>*** between serum CRP,sCRP,and MPV were also ***,sCRP demonstrated excellent predictive value for serum CRP levels(AUC=0.89),underscoring its potential as a diagnostic *** This study underscores the diagnostic promise of salivary and serum biomarkers,specifically MPV and CRP,in identifying and predicting LONP among *** findings advocate for further research to validate their clinical utility in larger neonatal cohorts.

关键词： Neonatal sepsis Late-onset pneumonia Salivary C-reactive protein Mean platelet volume Diagnostic markers Newborn infections

Should atrial fibrillation patients with hypertension as an additional risk factor of the CHA2DS2-VASc score receive oral anticoagulation？

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Journal of Geriatric Cardiology 2018年第3期15卷 229-234页

作者： Juan WANG Da-Peng ZHANG Hong-Bin LIU Jiu-Chang ZHONG Xin-Chun YANG Heart center and Beijing Key Laboratory of Hypertension Beijing Chaoyang Hospital Affiliated to Capital Medical University Beijing China Department of Cardiology People's Liberation Army General Hospital Beijing China

Hypertension has been found to be increased a risk of stroke in atrial fibrillation （AF）. Both the European and U.S. guidelines advocate the use of the CHA2DSz-VASc （congestive heart failure, hypertension, age 〉 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category） scheme for risk stratification. Although vitamin K antagonists is more effective than acetyl-salicylic acid at preventing ischaemic stroke, its benefit is offs by an increased haemorrhage risk. The risk of ischemic stroke in patients with AF and a CHA2DS2-VASc score of 1 are considered to be low risk and may be not expected to benefit from anticoagulation therapy. Hyper-tension carries an increased risk of ischemic stroke, however, it is also a clear risk factor for hemorrhage in AF. Therefore, the optimal anti-thrombotic management is highlighted in patients with AF with only one risk factor especially hypertension.

关键词： Atrial fibrillation Hypertension Stroke

Healthy Environment Promotion Campaign in Healthy China Initiative

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China CDC weekly 2020年第10期2卷 160-163页

作者： Bo Sun Yibin Cheng Yonghong Li Xianliang Wang Kangfeng Zhao Xiaoyuan Yao Lin Wang Shilu Tong Xiaoming Shi National Institute of Environmental Health Chinese Center for Disease Control and PreventionBeijingChina Shanghai Children’s medical center Shanghai Jiao-Tong University School of MedicineShanghaiChina School of Public Health Institute of Environment and Population HealthAnhui Medical UniversityHefeiChina School of Public Health and Social Work Queensland University of TechnologyBrisbaneAustralia

On July 15,2019,the State Council of China issued new guidelines for the implementation of the country’s Healthy China Initiative(2019–2030)and for the promotion of population health across the *** article interprets Healthy Environment Promotion Campaign(HEPC)in the Healthy China Initiative from four main aspects—background,major indices,strategies,and *** outcome indices and four advocacy indices are proposed by the HEPC,and the strategies are mainly embodied at three levels:individual/family,society and *** strategies have the following features:1)the strategies are developed on the basis of scientific evidence;2)the strategies advocate that citizens must be responsible for their own health;3)the administrative impetus provided by the Chinese government to integrate health into all policies is an important driver for developing and implementing the HEPC;and 4)HEPC is not an isolated campaign,so it is necessary to coordinate all 15 campaigns in order to proactively and properly implement HEPC.

关键词： indices properly promotion

Response of Global Health Towards the Challenges Presented by Population Aging

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China CDC weekly 2023年第39期5卷 884-887页

作者： Chenlu Hong Linjuan Sun Guangwen Liu Boyuan Guan Chengfu Li Yanan Luo Department of Global Health School of Public HealthPeking UniversityBeijingChina Department of Neurology China Academy of Chinese Medical Sciences Xiyuan HospitalBeijingChina Department of International and Domestic Cooperation Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Population and Development Research center BeijingChina.

Adopted in 2015,the Sustainable Development Goals(SDGs)represent a global commitment to eradicating poverty,safeguarding the planet,and championing well-being,peace,and prosperity for all by the year 2030(1).This advancement ties closely to the inescapable trajectory of the global population development and the significant challenges presented by population aging—a matter pertinent to every *** SDGs not only prioritize poverty eradication and healthy living at all ages,but also encourage gender equality,comprehensive and productive employment opportunities,and the reduction of inequality both within and between *** addition,the goals advocate for inclusive,safe,resilient,and sustainable cities and human settlements.

关键词： inequality equality Population