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简介：ObjectiveAlongwithchangesintheecologysystemandundertheinfluenceofvariousenvironmentalfactors,theincidenceoftumorhasbeenincreasingyearafteryear.Thereisatrendincancertherapytomovetocombinedtherapiesinvolvingsurgery,radiationchemotherapyandgenetherapy.Cancergenetherapyinrecentyearshasbroughtnewopportunitiesfortreatmentoftumor.Itsadvantagesincludelowrateoftolerance,insensitivitytocellcycles,highspecificityandcoverageforbothprimaryandmetastatictumors1,2.However,thisisanewfieldofclinicalresearch.RegardingthecorrelationamongtheSTAT3,CyclinD1andP21genesandtumors,researchhasfocusedontheirexpressionandregulation.Thisarticleprovidesasummaryofrelatedresearch.

简介：Background:Commercialsexworkersandclientsareimportantcorepopulationsinthetransmissionofsexuallytransmitteddiseases(STDs)andhumanim-munodeficiencyvirus(HIV)infection.Researchonthefrequencyanddeterminantsofcondomuseincom-mercialsexworkersandtheirclientsisimportantinincreasingcondomuseandreductionoftheSTD/HIV.Burden.Objectives:Toestablishthefrequencyofandfac-torsrelatedtointentiontousecondomsandactualcondomuseincommercialsexcontactsandtodeter-minethedifferencesincondomusebetweensexwork-ersandclients.Methods:Incarceratedcommercialsexworkers(ICSW)andmaleSTDclinicattendeeswererecruitedintoacross-sectionalstudytoobtaindataonthefre-quencyandfactorsassociatedwithintentiontousecondomsandcondomuseincommercialsexualcon-tactswithaninterviewer-administeredquestionnaire.ConsistentcondomuseinICSWsandneverusingcondomsinmaleSTDclinicattendeeswereanalyzedusingunivariateandmultivariatelogisticregressionmodels.Results:Thefrequencyofreportedconsistentin-tentiontousecondomsandreportedactualcondomusewas62%and50.6%,respectivelyamong158ICSWs.FormaleSTDclinicattendees,thepropor-tionofreportedconsistentintentiontousecondomsandreportedactualcondomusewas10%and20.7%,respectively.ThefactorspositivelyinfluencingtheconsistentintentiontousecondomswerepregnancypreventingmeasuresandthebeliefofcondomefficacyinthepreventionofSTD/HIV,whereasthefactoras-sociatedwithactuallyconsistentcondomusewaspreg-nancy-preventingmeasureinICSWs.Factorsassoci-atedwithnointentiontousecondomswerelowincome,lowSTD/HIVknowledgelevelandthefrequencyofvisitingCSW.ThelatterfactorwasalsoassociatedwithneverusingcondomsinmaleSTDclinicattendees.Conclusions:Consistentcondomuseduringcom-mercialsexcontactswaslow,especiallyinclients.Greatereffortisneededincondompromotionprograminordertorais

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简介：AbstractPurpose:Trauma is a major health concern. Length of hospital stay (LOS) has been targeted as an important metric to assess trauma care. This study aims to evaluate the risk factors that affect LOS among trauma patients in a trauma center in Southwestern Iran.Methods:This cross-sectional study was conducted on patients admitted to Rajaee Trauma Center, Shiraz, Iran between January 1, 2018 and December 30, 2018. The inclusion criteria were age above 15 years and having traffic accident injuries, including car, motorcycle and pedestrian injury mechanisms. The exclusion criteria were existing diseases including cardiovascular, cerebral, renal, and pulmonary diseases prior to this study, dead upon arrival or within 48 h after admission, and stay at the hospital for less than 6 h. The risk variables analyzed for prolonged LOS were age, gender, mechanism of traffic accident injury, infection during hospital stay, type of injury, injury severity score, surgery during hospitalization, and survival. Poisson regression was performed to evaluate the partial effects of each co- variate on trauma hospitalization (≥3 days as longer stay).Results:This study was conducted on 14,054 patients with traffic accident injury and the mean age was (33.89 ± 15.78) years. Additionally, 74.35% of the patients were male, with male to female ratio of 2.90. The result of Poisson regression indicated that male patients, higher age, combination of thoracic injuries, onset of infected sites, and surgery patients were more susceptible to have a longer LOS. Considering the site of injury, patients with face injuries followed by those with thorax injuries had the highest means of LOS (3.74 days and 3.36 days, respectively). Simultaneous existence of surgical inter- vention and infection in a patient had the greatest impact on prolonged LOS.Conclusion:This study identified that age, gender, mechanism of injury, infection, type of injury, survival, and ISS could lead to prolongation of LOS, but the affect can be reduced by eliminating modifiable risk factors.

简介：ＳｔｕｄｙｏｎｃｏｒｒｅｌａｔｉｖｉｔｙａｍｏｎｇｃａｐａｃｉｔｙｄｉｍｅｎｓｉｏｎＤ０，ｉｎｆｏｒ－ｍａｔｉｏｎｄｉｍｅｎｓｉｏｎＤ１，ａｌｇｏｒｉｔｈｍｉｃｃｏｍｐｌｅｘｉｔｙＣ（ｎ）ａｎｄｂＶａｌｕｅＷＥＩ－ＢＩＮＨＡＮ（韩渭宾），ＧＵＩ－Ｘ...

简介：在四川省的Liangshan府，中国，有HIV感染的高流行，它在从注射药使用(IDU)的传播的模式的一个变化是反射的到异性爱的交际。然而，很少研究在多数Yi人口之中集中于HIV相关的异性爱的风险行为。这研究的目的是探索一个利已的性网络的特征并且估计随便性行为的流行。Yi村民(n=108)15-35年，报导了的人，在上一年以内性交至于他们的性行为和网络被会见。深入的会见和焦点组讨论在性标准上提供了增补信息。逻辑回归分析被用来计算unadjusted机会比率(ORs)和95%；信心间隔(CI)。大多数回答者报导了在他们的生活，和66.7%在一些时间有随便性别；报导多重性合伙。仅仅21.3%；曾经报导了使用了避孕套。在学习年期间，137个搭挡的一个总数涉及153性合伙。在报导性合伙之中，67.3%；从一种随便性关系发源。为在尺寸≥的部件的网络成员；3，56.9%；涉及并发的性合伙。从来没结婚了过(或：2.11；95%；CI：1.03-4.33)并且更年轻的年龄(或：0.89；95%；CI：0.83-0.95)两个都与在尺寸≥的一个部件被联系；3。尺寸(或：2.99；95%；CI：1.17-7.66)，对(或：0.54；95%；CI：0.39-0.74)，利已的性网络的弱部件的数字(或：30.04；95%；CI：6.47-139.46)并且性(或：0.19；95%；CI：0.06-0.67)都与在并发的性合伙被联系。为在四川省的Yi种族少数的HIV相关的干预必须因此探讨并发的性合伙并且支持避孕套使用。

简介：Background:Thewell-roundeddevelopmentofthechild,includingphysical,cognitive,emotional,andsocialhealth,maybethemostefficientroutetowell-beingandacademicsuccess.Theprimarygoalwastoinvestigatethefeasibilityofimplementinga12-weekstructuredprogramofphysicalactivity(PA)incorporatingcognitive,social,andemotionalelementsinpreschool.Additionally,thisstudy,usingawithin-subjectdesign,examinedtheacuteeffectsofaPAsessiononclassroomengagementandchangesonperceivedcompetenceandpeeracceptancefromthefirsttothelastweekoftheprogram.Methods:Twenty-sevenpreschoolers(meanage=4.2years)completedthePictorialScaleofPerceivedCompetenceandSocialAcceptanceforYoungChildrenbeforeandafteratwice-weeklyPAprogram.Unobtrusiveclassroomobservationswereconductedforverbal,social,andaffectiveengagementduringthefirstandlastweekoftheprogram,bothfollowingastructuredPAsession(experimentalday)andonadaywithoutPA(controlday).Treatmentfidelitywasmonitoredtoensurethattheinterventionwasdeliveredasdesigned.Results:ThechildrenexhibitedlongerperiodsofverbalandsocialengagementduringclassroomperiodsthatfollowedPAsessionsthanonnon-PAdays.ChildrenalsoexpressedmorepositiveaffectfollowingPAsessionsduringthelastweekofthePAprogram.Despitehighbaselinescores,perceptionsofgeneralcompetenceincreasedmeaningfully(η2=0.15,p=0.05),drivenbyincreaseinperceptionsofcognitivecompetence(η2=0.15,p=0.06).Conclusion:ThisstudydemonstratesthefeasibilityofprovidingstructuredPAprogramtopreschoolers.Moreover,theseinitialfindingssuggestthatpurposelydesigned,structuredPAmayhelpadvancethesocial–emotionalengagementandperceivedcompetenceofpreschoolchildren.

简介：AbstractBackground:Pregnancy-associated breast cancer (PABC) is a special type of breast cancer that occurs during pregnancy and within 1 year after childbirth. With the rapid social development and the adjustment of reproductive policies in China, the average age of females at first childbirth is increasing, which is expected to lead to an increase in the incidence of PABC. This study aimed to accumulate clinical experience and to investigate and summarize the prevalence, diagnosis, and treatment of PABC based on large multicenter samples in China.Methods:According to the Chinese Society of Breast Surgery, a total of 164 patients with PABC in 27 hospitals from January 2016 to December 2018 were identified. The pregnancy status, clinicopathological features, comprehensive treatment methods, and outcomes were retrospectively analyzed. Survival curves were plotted using the Kaplan-Meier method.Results:A total of 164 patients of PABC accounted for 0.30% of the total number of cases in the same period; of which, 83 patients were diagnosed during pregnancy and 81 patients during lactation. The median age of PABC was 33 years (24-47 years). Stage I patients accounted for 9.1% (15/164), stage II 54.9% (90/164), stage III 24.4% (40/164), and stage IV 2.4% (4/164). About 9.1% (15/164) of patients were luminal A. Luminal B patients accounted the most (43.3% [71/164]). About 15.2% (25/164) of patients were human epidermal growth factor receptor 2 (Her-2) overexpression and 18.9% (31/164) of patients were triple-negative breast cancer. For pregnancy breast cancer, 36.1% (30/83) of patients received direct surgery and 20.5% (17/83) received chemotherapy during pregnancy. About 31.3% (26/83) chose abortion or induction of labor. The median follow-up time was 36 months (3-59 months); 11.0% (18/164) patients had local recurrence or distant metastasis and 3.0% (5/164) died.Conclusions:It is safe and feasible to standardize surgery and chemotherapy for PABC.

简介：AbstractImportance:Several studies conducted worldwide (mostly in Western countries) highlighted the negative effects of problematic internet use, particularly among adolescents aged 12 to 17, including depression, impulsivity, aggression, and social fear and avoidance. In Lebanon, literature on the prevalence and impact of problematic internet use among adolescents is limited.Objective:This study aim was to study the association between problematic internet use and depression, impulsivity, anger, aggression and social phobia among Lebanese adolescents.Methods:A cross-sectional study was performed on 1103 young adolescents (14-17 years), recruited from October 2017 till April 2018. The Internet Addiction Test (IAT) was used to evaluate the level of problematic internet use. Data were analyzed using the MANCOVA analysis. The main independent variable of interest was the IAT, while the dependent variables included the psychological scales.Results:The multivariate analysis taking the psychological scales as the dependent variables and the problematic internet use (IAT score) as an independent variable, showed that problematic internet use was associated with higher depression, impulsivity, aggression, anger, hostility and social anxiety.Interpretation:Problematic internet use has become an important health issue that should not be overlooked, particularly because of the increased use of the internet by adolescents. Educational programs on early exposure to the internet should be developed.

简介：AbstractBackground:Chagas disease is a parasitic disease endemic to Latin America, but it has become a disease of global concern due to migration flows. Asymptomatic carriers may host the parasite for years, without knowing they are infected. The aim of this study is to assess prevalence of Chagas disease and evaluate the participants’ level of knowledge between Latin American migrants attending a community-based screening campaign.Methods:Three community-based campaigns were performed in Alicante (Spain) in 2016, 2017 and 2018, including educational chats and blood tests for Trypanosoma cruzi serology. Participants completed a questionnaire assessing knowledge about the mechanisms of transmission, disease presentation, diagnosis, and treatment. People seropositive for T. cruzi underwent diagnostic confirmation by two different tests. Results were analyzed by multivariable logistic regression and expressed as adjusted odds ratios (aORs), adjusting for age, sex, and time in Spain.Results:A total of 596 participants were included in the study; 17% were aged under 18 years. Prevalence in adults was 11% [54/496; 95% confidence interval (CI): 8.3-14.5%] versus 0% among children. All but one case were in Bolivians. Diagnosis was independently associated with having been born in Bolivia (aOR: 102, 95% CI: 13-781) and a primary school-level education (aOR: 2.40, 95% CI: 1.14-5.06). Of 54 people diagnosed with Chagas disease (most of whom were asymptomatic), 42 (77.7%) returned to the clinic at least once, and 24 (44.4%) received treatment. Multivariable analysis showed that coming from Argentina (aOR: 13, 95% CI: 1.61-1188) or Bolivia (aOR: 1.90, 95% CI: 1.19-3.39) and having received information about Chagas disease in Spain (aOR: 4.63, 95% CI: 2.54-8.97) were associated with a good level of knowledge on the disease. Having primary level studies (aOR: 0.59, 95% CI: 0.34-0.98) and coming from Ecuador (aOR: 4.63, 95% CI: 2.52-847) were independently associated with a lower level of knowledge.Conclusions:Community-based interventions are a good strategy for diagnosing neglected diseases such as Chagas disease in non-endemic countries and for identifying and treating infected, asymptomatic individuals.

简介：Objective:Toinvestigatetheuptakerateofprostatespecificantigen(PSA)testingamongHongKongChinesemalesaged50orabove,andidentifyfactorsassociatedwiththelikelihoodofundergoingaPSAtest.Methods:Apopulation-basedtelephonesurveywasconductedinHongKongin2007.Thesurveycovereddemographicinformation,perceivedhealthstatus,useofcomplementarytherapy,cancerscreeningbehavior,perceivedsusceptibilitytocancerandfamilyhistoryofcancer.Descriptivestatistics,percentagesandlogisticregressionanalysiswereusedfordataanalysis.Results:Atotalof1,002menaged50orabovetookpartinthestudy(responserate=67%),andtheuptakerateofPSAtestingwasfoundtobe10%.Employmentstatus,useofcomplementarytherapy,perceivingregularvisitstoadoctorasgoodforhealthandtherecommendationsofhealthprofessionalsweresignificantfactorsassociatedwithPSAtesting.Conclusion:TheuptakerateofPSAtestinginthestudypopulationwasverylow.Amongallthefactorsidentified,recommendationsfromhealthprofessionalshadthestrongestassociationwiththeuptakeofPSAtesting,andtheyshouldthereforetakeanactiveroleineducatingthispopulationaboutcancerpreventionanddetection.

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简介：AbstractImportance:Clostridium difficile-associated diarrhea (CDAD) is a severe type of antibiotic-associated diarrhea (AAD). However, the risk factors for CDAD in children with AAD have not yet been clarified.Objective:To investigate the distribution and risk factors for CDAD among hospitalized children in Beijing Children’s Hospital.Methods:Stool samples from 197 children with AAD were tested for the C. difficile pathogenic genes (tcdA, tcdB, tcdC, tcdD, tcdE, cdtA, and cdtB) using polymerase chain reaction between January 2011 and January 2014. Children who tested positive for tcdA or tcdB were included in the CDAD group, and those remaining comprised the non-CDAD group.Results:The rate of CDAD among the 197 children with AAD was 42.6% (84/197). The age distribution was 1-15.6 years, among which the majority of children (54.8%, 46/84) were aged 1-4 years. Differences in the CDAD-positive rates among AAD children belonging to different age groups were not statistically significant. Univariate analysis revealed that the duration of antibiotic therapy, the length of hospitalization prior to diarrhea, and gastrointestinal tract operations were significant risk factors (P < 0.05). Children with CDAD underwent more antibiotic therapy and had longer periods of hospitalization prior to diarrhea onset than children in the non-CDAD group. Using multivariate regression analysis, hospitalization for ≥ 10 days prior to diarrhea was found to be an independent risk factor for CDAD.Interpretation:This study revealed that the length of hospitalization (≥ 10 days) prior to diarrhea was an independent risk factor for CDAD in children with AAD.

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简介：ectoparasitoidHabrobraconhebetor攻击和envenomate的女性众多的主人个人在oviposition期间。entomopathogenic真菌Beauveriabassiana的vectoring在实验室条件下面在由在蜡蛾幼虫街郎mellonella之中的ectoparasitoid女性的粘附阶段期间被探索。Vectoring从感染的parasitoids两个都发生了到蜡蛾幼虫并且从由parasitoids感染了到健康的蜡蛾幼虫。在两个盒子中的vectoring的功效是剂量依赖者。Parasitoid女性是不能的在迷宫测试认出感染的幼虫。另外，H的存在。(1.5-13褶层)hebetor女性显著地在G的簇增加了mycoses水平。mellonella，与感染真菌的conidia的40%幼虫。由H的Envenomation。hebetor由4.4褶层在蜡蛾幼虫的表皮上增加了conidia萌芽。提高的萌芽率(2褶层)与健康幼虫的相比在envenomated幼虫的nhexaneepicuticular摘录被登记。envenomation和mycoses提高了phenoloxidase(PO)在G的覆盖物的活动。mellonella并且相反，减少了在hemolymphs的封装率。我们假设在覆盖物性质和细胞的免疫的抑制的变化向entomopathogenic真菌的最高的感染功效提供H。hebetor。

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简介：Thispaperpresentsacopulatechniquetodeveloptime-variantseismicfragilitycurvesforcorrodedbridgesatthesystemlevelandconsiderstherealistictime-varyingdependenceamongcomponentseismicdemands.Basedonmaterialdeteriorationmechanismsandincrementaldynamicanalysis,thetime-evolvingseismicdemandsofcomponentswereobtainedintheformofmarginalprobabilitydistributions.Thetime-varyingdependencesamongbridgecomponentswerethencapturedwiththebestfittingcopulafunction,whichwasselectedfromthecommonlyusedcopulaclassesbytheempiricaldistributionbasedanalysismethod.Thesystemtime-variantfragilitycurvesatdifferentdamagestatesweredevelopedandtheeffectsoftime-varyingdependencesamongcomponentsonthebridgesystemfragilitywereinvestigated.Theresultsindicatethetime-varyingdependenceamongcomponentssignificantlyaffectsthetime-variantfragilityofthebridgesystem.Thecopulatechniquecapturesthenonlineardependenceamongcomponentseismicdemandsaccuratelyandeasilybyseparatingthemarginaldistributionsandthedependenceamongthem.