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Common Methods of Contraception Used at Monkey Bay Community hospital in Mangochi District, Malawi

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Advances in Infectious Diseases 2021年第1期11卷 13-20页

作者： David s. Chung Peter s. Park sohyun Jeon sue Min shin Ji Woo Han Chaieun Lee Andrew Mun William Mun Yun Jae shin Lorie Kim Jairos B. Makangano Fatsani Manase Thomas Nyirenda school of medicine University of Virginia Charlottesville VA USA Youth with Talents Fairfax VA USA perelman school of medicine University of Pennsylvania Philadelphia PA USA Clinical Research Education and Management service Lilongwe Malawi

To determine commonly used methods of contraception at Monkey Bay Community hospital, to compare different methods of contraception used by people of various age groups, parity, Human Immunodeficiency Virus (HIV) and Marital status, a clinical audit of family planning methods used by clients at Monkey Community hospital from January 2018 to June 2019 was done. Data was collected from the registers. A total number of 1734 clients reported at family planning clinic of Monkey-Bay Community hospital between January 2018 and June 2019. All the clients were females. Most of these clients were in the age range of 15 - 34 years (83.33%). There were 1,486 (87%) HIV negative clients, 208 (12%) HIV positive clients and 24 (1%) had unknown HIV status. Most clients had a parity of 1 - 2 (905, 52.71%) followed by 3 - 4 (540, 31.45%) and 5 or plus (272, 15.84%). There were more married people (1641, 97.23%) than unmarried ones (46, 2.73%). There was only one person who was divorced (1, 0.05%). Education status was not recorded. The five commonly used contraceptive methods were: Intramuscular (IM) injectable Depo-IM (1366, 79.51%), Jadelle (122, 7.10%), subcutaneous (sC) injectable Depo-sC (65, 3.78%), Combined Oral Contraceptives (COC) (60, 3.49%) and Implanon (40, 2.33%). None of the clients was used female condoms as a method of contraception. The contraceptive use was common between the age group of 15 - 24 (707, 44.92%) and 25 - 34 (709, 45%). Depo-IM was most used in age group 25 - 34 (44.5%) while Jadelle was mostly used by 15 - 24 years old (48%). 1181 clients (79.5%) of HIV negative clients used Depo-IM as the contraceptive method while 164 clients (78.8%) of HIV positive clients used Depo IM as a method of contraception. More HIV negative clients used Jadelle and COC as compared to HIV positive clients. The choice of a particular method of contraception was influenced by many factors. Parity, marital status, age as well as HIV status did have some association with the pre

关键词： Contraception Parity HIV Mangochi Malawi

水合氯醛镇静用于足月儿和早产儿的疗效和并发症的分析

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麻醉与镇痛 2012年第6期8卷 72-79页

作者：周全红张昕(译) 江伟(校) University of Pennsylvania school of medicine Jefferson Medical College Biostatistics and Data Management Core The Children's Hospital of Philadelphia Philadelphia Pennsylvania

背景足月和早产的婴幼儿在全身麻醉后存在呼吸暂停的风险。目前对于这类人群使用水合氯醛镇静后发生呼吸暂停的风险还不清楚。本研究观察水合氯醛用于未满1岁婴儿做磁共振成像（magneticresonanceimaging，MRI）检查的镇静效果，是否需... 详细信息

背景足月和早产的婴幼儿在全身麻醉后存在呼吸暂停的风险。目前对于这类人群使用水合氯醛镇静后发生呼吸暂停的风险还不清楚。本研究观察水合氯醛用于未满1岁婴儿做磁共振成像（magneticresonanceimaging，MRI）检查的镇静效果，是否需要其他镇静药物，血氧饱和度降低的发生率以及是否需要供氧。本研究的目的在于观察这些因素与足月儿的实足年龄（chronologicalage）或早产儿（小于37周）的孕后年龄（postconceptionalage，PCA）及孕龄（gestationalage）的关系。方法这是一项回顾性队列研究。有1394例新生儿在进行MRI检查时使用水合氯醛镇静。排除条件包括气管内插管、气管切开或先天性心脏病患儿。通过患者MRI检查后24小时内的病史记录来发现独立风险因素和相关的结果变量。运用单因素和多因素分析来决定影响结果的危险因素。结果手术后血氧饱和度下降更有可能发生在住院的（P〈0．001），低体重（3．9±2．1kgVs6．6±3．0kg；P=0．001），有呼吸暂停吏（33．3％Vs9．9％；P=0．001），高AsA评分（P=0．002）和实足年龄小（58．7±82．8天vs152±105．9天；P〈0．0001）的患儿。如果将早产儿单独统计，术后血氧饱和度下降的风险直接与实足年龄低（56．0±41．5天vs150．6±107．1天；P=0．012）和孕后年龄小（39．5±4．1周vs54．4±15．2周；P=0．005）有关，但与孕龄无关。早产儿术后心动过缓发生率高于足月儿（P=0．005）。手术后血氧饱和度下降没有一例发生在PCA大于48周的早产儿中。可能因为早产儿中手术后血氧饱和度下降的发生率低（262例中只有8例），我们无法确定其在足月儿和早产儿中发生率的差别。追加水合氯醛的剂量或辅助使用咪达唑仑并没有增加并发症的发生率。结论手术后血氧饱和度下降直接与足月儿的低实足年龄，早产儿的孕后年龄小有关。那些需要长时间供氧的足月新生儿是住院的患儿，并常伴有其他的疾病。

关键词：水合氯醛镇静效果早产儿足月儿并发症血氧饱和度降低 MRI检查孕后年龄

The Identity of Human Tissue-Emigrant CD8+T Cells

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四川生理科学杂志 2020年第4期42卷 426-426页

作者： Marcus Buggert Department of Microbiology Perelman School of Medicine University of Pennsylvania Philadelphia PA USA Institute for Immunology Perelman School of Medicine University of Pennsylvania Philadelphia PA USA Center for Infectious medicine Department of Medicine Huddinge Karolinska Institutet Karolinska University Hospital Huddinge Stockholm Sweden Genome Analysis Core Vaccine Research Center National Institute of Allergy and Infectious Diseases National Institutes of Health Bethesda MD USA Neuroimmunology Unit Montreal Neurological Institute McGill University Montreal QC Canada Division of Human Genetics Children’s Hospital of Philadelphia Philadelphia PA USA Vaccine and Gene Therapy Institute and Oregon National Primate Research Center Oregon Health & Science University Beaverton OR USA Division of surgery Department of Clinical Science Intervention and Technology Karolinska Institutet Stockholm Sweden Division of Infection and Immunity Cardiff University School of Medicine Cardiff UK Human Immunology section Vaccine Research Center National Institute of Allergy and Infectious Diseases National Institutes of Health Bethesda MD USA Center for Lymphatic Disorders Department of Radiology Perelman School of Medicine University of Pennsylvania Philadelphia PA USA

Lymphocyte migration is essential for adaptive immune ***,our current understanding of this process is rudimentary,because most human studies have been restricted to immunological analyses of blood and various *** address this knowledge gap,we used an integrated approach to characterize tissue-emigrant lineages in thoracic duct lymph(TDL).The most prevalent immune cells in human and non-human primate efferent lymph were T *** CD8+T cell subsets with effector-like epigenetic and transcriptional signatures were clonotypically skewed and selectively confined to the intravascular circulation,whereas non-cytolytic CD8+T cell subsets with stem-like epigenetic and transcriptional signatures predominated in tissues and ***,these anatomically distinct gene expression profiles were recapitulated within individual clonotypes,suggesting parallel differentiation programs independent of the expressed antigen *** collective dataset provides an atlas of the migratory immune system and defines the nature of tissue-emigrant CD8+T cells that recirculate via TDL.

关键词： signature collective Human

儿科日间手术中超重（或肥胖症）与胃液特性的关系：在禁食指南和误吸风险评估方面的意义

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麻醉与镇痛 2010年第6期6卷 38-49页

作者： scott D. Cook-sather Paul R. Gallagher Lydia E. Kruge Jonathan M. Beus Brian P. Ciampa Kevin Conor Welch sina shah-Hosseini Jieun s. Choi Reshma Pachikara Kim Minger Ronald s. Litman Mark s. schreiner 周洁(译) 李士通(校) Departments of Anesthesiology and Critical Care medicine Departments of Biostatistics and Epidemiology Nursing The Children's Hospital of Philadelphia The University of Pennsylvania School of Medicine Philadelphia Pennsylvania 不详

背景超重或肥胖的日间手术儿科患者手术前2小时禁水的安全性尚未得到证实。健康的儿童和肥胖的成人在手术前禁水2小时后残留胃液量（GFVs）并不多，因此认为误吸风险并不高。因此我们将测算日间手术患者中超重症或肥胖症的患病率，并假... 详细信息

背景超重或肥胖的日间手术儿科患者手术前2小时禁水的安全性尚未得到证实。健康的儿童和肥胖的成人在手术前禁水2小时后残留胃液量（GFVs）并不多，因此认为误吸风险并不高。因此我们将测算日间手术患者中超重症或肥胖症的患病率，并假设不管是体重指数还是禁食时间均不会对GFV或胃液pH值产生显著的影响。所有受试儿童均于手术前禁清水2小时，并假设超重或肥胖患儿的GFV不会多于偏瘦或正常体重患儿，而呕吐或误吸的风险也很低。方法本研究中连续纳入了1000例2－12岁行日间手术的患儿，记录人口统计学资料、病史、身高和体重。另外纳入1000例需全麻插管的日间手术患儿（2。12岁）进行研究。气管插管后，经口插入一根14—18F的胃管，抽空胃内容物。用药情况、禁食时间、GFV、pH值和呕吐事件均被详细记录。采用疾病预防及控制中心的生长图表（2000）评定理想体重（IBW=第50个百分位数），并对患儿进行分层：偏瘦或正常体重（BMI在第25—75个百分位数）、超重（第95个百分位数〈BMI≥第85个百分位数）、肥胖（BMI≥第95个百分位数）。结果在所有的日间手术患儿中有14％属于超重，13．3％属于肥胖。肥胖儿按公斤体重算出的GFV较低（P〈0．001）。当我们用IBW进行校正后，所有BMI组中GFV（mw校正后）的容量都相等（均值为0．96ml／kg，sD为0．71；中位数为0．86ml／kg，IQR为0．96）。手术前使用对乙酰氨基酚和咪达唑仑均导致GFV（1BW校正后）增加（P=0．025和P=0．001）。而AsA11I级（P=0．024）、男性（P=0．012）、胃食管反流性疾病（P=0．049）和使用质子泵抑制剂（P=0．018）患儿的GFV（mw校正后）较低。GFV（IBw校正后）与禁食时间和年龄无关。胃液酸度较低与年龄较小（P=0．005）、BMI较高（P=0．036）和美国非洲裔（P=0．033）患儿等因素相关。有8例患儿在全麻诱导时发生了呕吐（其中50％有肥胖症，P=0．052，75％患有阻塞性睡眠呼吸暂停症，P=0．061）。呕吐与AsA分级较高有关，但却与禁食时间的长短无关。研究中没有出现误吸事件。结论27％的儿科日闻手术患儿属超重或肥胖儿童。无论进食时间长短或BMI如何，GFV（IBw校正后）均为1ml／kg，因此这些患儿均可以在手术前2小时饮清水。在此研究群体中，罕见的呕吐事件与禁食时间的缩短并无相关性。

关键词：禁食时间儿科患者风险评估肥胖症超重症胃液量误吸阻塞性睡眠呼吸暂停症

Preventing bad behavior in academia

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四川生理科学杂志 2024年第7期46卷 1615-1615页

作者： Rayane da Cruz Albino Faculty of Pharmacy Federal University of Rio de Janeiro Rio de Janeiro RJ Brazil. Department of Host-Microbe Interactions St. Jude Children’s Research Hospital Memphis TN USA. school of the Environment The University of Queensland Whiterock QLD Australia. KU Leuven Ghent Belgium. Laboratory for Computational social systems Indraprastha Institute of Information Technology Delhi New Delhi India. University Medical College Shantou Guangdong China. Department of Ecoscience Aarhus Universitet Aarhus Denmark. Institute of Environment and sustainable Development Banaras Hindu University Varanasi Uttar Pradesh India. Department of Medical Parasitology Faculty of Medicine and Health Sciences Sana’a University Sana’a Yemen and Tropical Disease Research Center Faculty of Medicine and Health Sciences University of Science and Technology Sana’a Yemen. Department of medicine University of Montreal Montreal QC Canada. Electricity Infrastructure and Buildings Division Pacific Northwest National Laboratory Portland OR USA. Department of Biological sciences University of New Brunswick Saint John Saint John NB Canada. Department of Biomedical Engineering The University of Melbourne Melbourne VIC Australia. Vagelos Molecular Life sciences Program University of Pennsylvania Philadelphia PA USA. Doctoral Program in Neurobiology and Behavior Columbia University New York NY USA. Department of Genetics and Genomic sciences Icahn School of Medicine at Mount Sinai New York NY USA. Department of Engineering University of Cambridge Cambridge Cambridgeshire UK. Department of Geography Liverpool John Moores University Liverpool UK. Department of Biology Stanford University Stanford CA USA. Department of Psychology University of Nicosia Nicosia Cyprus. Department of Global Ecology Carnegie Institution for Science Stanford CA USA. Research and support Division Stellenbosch University Cape Town South Africa.

We gave young scientists this prompt:Describe one change to scientific policy or culture that would substantially decrease incidents of scientific misconduct or other unethical behavior.

关键词： behavior. prompt culture

Infant with cardiomyopathy: When to suspect inborn errors of metabolism?

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World Journal of Cardiology 2014年第11期6卷 1149-1155页

作者： stephanie L Byers Can Ficicioglu The children’s hospital of philadelphia Section of Metabolic Disease Perelman School of Medicine at the University of Pennsylvania Philadelphia PA 19104 United States

Inborn errors of metabolism are identified in 5%-26% of infants and children with cardiomyopathy. Although fatty acid oxidation disorders, lysosomal and glycogen storage disorders and organic acidurias are well-known to be associated with cardiomyopathies, emerging reports suggest that mitochondrial dysfunction and congenital disorders of glycosylation may also account for a proportion of cardiomyopathies. This review article clarifies when primary care physicians and cardiologists should suspect inborn errors of metabolism in a patient with cardiomyopathy, and refer the patient to a metabolic specialist for a further metabolic work up, with specific discussions of "red flags" which should prompt additional evaluation.

关键词： cardiomyopathy metabolism glycogen congenital hypertrophic prompt dilated mitochondrial Infant dehydrogenase

Effectiveness of BNT162b2 Vaccine against Critical Covid-19 in Adolescents

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四川生理科学杂志 2021年第11期43卷 1723-1723页

作者： samantha M Olson From the Covid-19 Response Team Centers for Disease Control and Prevention (S.M.O. A.M.P. L.D.Z. A.P.C. M.M.P.) and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics Emory University School of Medicine (S.K.) - both in Atlanta the Department of Anesthesiology Critical Care and Pain Medicine Boston Children's Hospital (M.M.N. A.G.R.) and the Departments of Anaesthesia and Pediatrics Harvard Medical School (A.G.R.) - both in Boston the Division of Pediatric Infectious Diseases Department of Pediatrics Vanderbilt University Medical Center Nashville (N.B.H.) the Department of Pediatrics Baylor College of Medicine Immunization Project Texas Children's Hospital Houston (J.A.B. L.C.S.) and the Department of Pediatrics Division of Critical Care Medicine University of Texas Southwestern Children's Medical Center Dallas Dallas (M.M.) the Division of Infectious Diseases Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology University of Southern California Los Angeles (P.S.P.) the Division of Pediatric Hospital Medicine UC San Diego-Rady Children's Hospital San Diego (M.A.C.) the Division of Critical Care Medicine UCSF Benioff Children's Hospital Oakland (N.Z.C.) and the Department of Pediatrics Divisions of Critical Care Medicine and Allergy Immunology and Bone Marrow Transplant University of California San Francisco San Francisco (M.S.Z.) - all in California section of Pediatric Critical Care Department of Pediatrics Arkansas Children's Hospital Little Rock (K.I.) the Department of Pediatrics University of North Carolina at Chapel Hill Children's Hospital Chapel Hill (T.C.W. S.P.S.) the Department of Pediatrics Section of Critical Care Medicine University of Colorado School of Medicine and Children's Hospital Colorado Aurora (A.B.M.) the Division of Pediatric Critical Care medicine Medical University of South Carolina Charleston (E.H.M.) the Department of

Background:The increasing incidence of pediatric hospitalizations associated with coronavirus disease 2019(Covid-19)caused by the B.1.617.2(delta)variant of severe acute respiratory syndrome coronavirus 2(sARs-CoV-2)in the United states has offered an opportunity to assess the real-world effectiveness of the BNT162b2 messenger RNA vaccine in adolescents between 12 and 18 years of ***:We used a case-control,test-negative design to assess vaccine effectiveness against Covid-19 resulting in hospitalization,admission to an intensive care unit(ICU),the use of life-supporting interventions(mechanical ventilation,vasopressors,and extracorporeal membrane oxygenation),or *** July 1 and October 25,2021,we screened admission logs for eligible case patients with laboratory-confirmed Covid-19 at 31 hospitals in 23 *** estimated vaccine effectiveness by comparing the odds of antecedent full vaccination(two doses of BNT162b2)in case patients as compared with two hospitalbased control groups:patients who had Covid-19-like symptoms but negative results on testing for sARs-CoV-2(test-negative)and patients who did not have Covid-19-like symptoms(syndrome-negative).

关键词： vaccine doses acute

Hypothesizing That Pediatric Autoimmune Neuropsychiatric Associated streptococcal (PANDAs) Causes Rapid Onset of Reward Deficiency syndrome (RDs) Behaviors and May Require Induction of “Dopamine Homeostasis”

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Open Journal of Immunology 2022年第3期12卷 65-75页

作者： Kenneth Blum Catherine A. Dennen Eric R. Braverman Ashim Gupta David Baron Bernard William Downs Debasis Bagchi Panayotis Thanos Maureen Pollock Jag Khalsa Igor Elman Abdalla Bowirrat Rajendra D. Badgaiyan Center for Mental Health and sports Psychiatry Western University Health Sciences Pomona USA The Kenneth Blum Behavioral & Neurogenetic Institute Austin USA Department Psychiatry Boonshoff School of Medicine Wright University Dayton USA Institute of Psychology ELTE E&#246tv&#246s Loránd University Budapest Hungary Department of Psychiatry School of Medicine University of Vermont Burlington USA Division of Nutrigenomics Victory Nutrition International Inc. Bonita Springs USA Department of Molecular Biology Adelson School of Medicine Ariel University Ariel Israel Department of Family medicine Jefferson Health Northeast Philadelphia USA Future Biologics Lawrenceville USA Department of Pharmaceutical sciences Texas Southern University Houston USA Department of Psychology & Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA) Research Institute on Addictions University at Buffalo Buffalo USA Department of Microbiology Immunology and Tropical Medicine School of Medicine George Washington University Washington DC USA Cambridge Health Alliance Harvard Medical School Cambridge USA Department of Psychiatry Ichan School of Medicine at Mount Sinai New York USA Department of Psychiatry South Texas Veteran Health Care System Audie L. Murphy Memorial VA Hospital Long School of Medicine University of Texas Health Science Center San Antonio USA

Pediatric autoimmune neuropsychiatric disorders associated with group A streptococcal infections (PANDAs) is a concept that is used to characterize a subset of children with neuropsychiatric symptoms, tic disorders, or obsessive-compulsive disorder (OCD), whose symptoms are exacerbated by group A streptococcal (GAs) infection. PANDAs has been known to cause a sudden onset of reward deficiency syndrome (RDs). RDs includes multiple disorders that are characterized by dopaminergic signaling dysfunction in the brain reward cascade (BRC), which may result in addiction, depression, avoidant behaviors, anxiety, tic disorders, and/or OCD. According to research by Blum et al., the dopamine receptor D2 (DRD2) gene polymorphisms are important prevalent genetic determinants of RDs. The literature demonstrates that infections like Borrelia and Lyme, as well as other infections like group A beta-hemolytic streptococcal (GABHs), can cause an autoimmune reaction and associated antibodies target dopaminergic loci in the mesolimbic region of the brain, which interferes with brain function and potentially causes RDs-like symptoms/behaviors. The treatment of PANDAs remains controversial, especially since there have been limited efficacy studies to date. We propose an innovative potential treatment for PANDAs based on previous clinical trials using a pro-dopamine regulator known as KB220 variants. Our ongoing research suggests that achieving “dopamine homeostasis” by precision-guided DNA testing and pro-dopamine modulation could result in improved therapeutic outcomes.

关键词： PANDAs CANs Reward Deficiency syndrome Group A Beta-Hemolytic streptococcal (GABHs) Pro-Dopamine Regulation Dopamine Homeostasis Molecular Mimicry Lyme Borrelia

武汉市美沙酮门诊治疗者丙型肝炎病毒基因分型

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中华流行病学杂志 2007年第12期28卷 1207-1210页

作者：彭劲松周敦金裴德恩周玉刘满清唐力许骏吴雄文霍文哲周旺华中科技大学同济医学院武汉430030 武汉市疾病预防控制中心 Division of Allergy & Immunology Joseph StokesJr.Research Institute at The Children's Hospital of PhiladelphiaDepartment of PediatricsUniversity of Pennsylvania School of MedicinePhiladelphiaUSA

目的探讨武汉市美沙酮门诊治疗者丙型肝炎病毒(HCV)及不同基因型感染状况。方法用酶标记免疫(ELIsA)法检测抗-HCV抗体,在86份抗-HCV抗体阳性的血清标本中,分别提取HCV RNA,通过逆转录巢式聚合酶链反应(RT-nested PCR)扩增C基因的羧基至E... 详细信息

目的探讨武汉市美沙酮门诊治疗者丙型肝炎病毒(HCV)及不同基因型感染状况。方法用酶标记免疫(ELIsA)法检测抗-HCV抗体,在86份抗-HCV抗体阳性的血清标本中,分别提取HCV RNA,通过逆转录巢式聚合酶链反应(RT-nested PCR)扩增C基因的羧基至E1基因的氨基端长度为474 bp的片段,测定其核苷酸序列,与GenBank中已知的HCV序列进行系谱分析,确定HCV基因型。结果武汉市美沙酮门诊332名治疗者中抗-HCV IgG阳性率为94.3%;其中86份血清的HCV序列通过系谱显示6a型71例,占82.5%;3b 7例,占8.2%;1a 5例,占5.8%;1b 3例,占3.5%。结论武汉市美沙酮门诊入组的吸毒者HCV感染以6a型为优势株,其次为3b,吸毒者中HCV感染率较高,且基因亚型呈现多样性。

关键词：丙型肝炎病毒基因分型美沙酮门诊