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  • 文章类型: Journal Article
    由于以前的研究检查与COVID-19疫苗以外的疫苗相关的心肌炎和心包炎的不良报告的局限性,在全球范围内建立对疫苗安全性的全面了解存在挑战。因此,本研究的目的是研究疫苗相关心包炎和心肌炎的全球负担以及与这些适应症相关的疫苗.本研究利用世界卫生组织国际药物警戒数据库,从其中提取了1969年至2023年之间疫苗相关心包炎和心肌炎的记录(超过1.3亿份报告)。我们计算了全球报告计数,报告赔率比(ROR),和信息成分(IC)来辨别156个国家和地区的19种疫苗与心包炎和心肌炎的发生之间的关联。我们确定了49096例报告(男性,n=30013)在73590例全因性心包炎和心肌炎的报告中,疫苗相关的心包炎和心肌炎。随着时间的推移,疫苗相关心脏不良事件的报告显着增加,2020年后观察到值得注意的激增,这归因于与COVID-19mRNA疫苗相关的心包炎病例。天花疫苗与大多数心包炎和心肌炎报告相关(ROR:73.68[95%CI,67.79-80.10];IC[IC0.25]:6.05[5.91]),其次是COVID-19mRNA疫苗(37.77[37.00-38.56];3.07[3.05]),炭疽疫苗(25.54[22.37-29.16];4.58[4.35]),伤寒疫苗(6.17[5.16-7.38];2.59[2.29]),脑炎疫苗(2.00[1.48-2.71];0.99[0.47]),流感疫苗(1.87[1.71-2.04];0.90[0.75]),和Ad5载体COVID-19疫苗(1.40[1.34-1.46];0.46[0.39])。关于年龄和性别特定的风险,疫苗相关心包炎和心肌炎的报告在男性和年龄较大的人群中更为普遍.12至17岁的年龄组表现出明显的性别不相称。大多数这些不良事件的发病时间短(中位时间:1天),死亡率为0.44%。我们对全球数据的分析显示,与疫苗相关的心包炎和心肌炎报告有所增加,特别是像天花和炭疽这样的活疫苗,尤其是年轻男性。虽然这些不良事件通常是罕见且轻微的,谨慎是必要的,特别是对于医护人员来说,由于潜在的心肌损伤相关的院内死亡率。经过验证的报告的进一步研究对于提高评估疫苗与心脏病之间的相关性以采取预防措施的准确性至关重要。
    Due to the limitation of previous studies examining adverse reports of myocarditis and pericarditis associated with vaccines other than the COVID-19 vaccine, there are challenges in establishing a comprehensive understanding of vaccine safety on a global scale. Hence, the objective of this study was to examine the worldwide burden of vaccine-associated pericarditis and myocarditis and the vaccines associated with these indications. This study utilized the World Health Organization international pharmacovigilance database, from which records of vaccine-associated pericarditis and myocarditis between 1969 and 2023 were extracted (over 130 million reports). We calculated global reporting counts, reported odds ratios (RORs), and information components (ICs) to discern the association between 19 vaccines and the occurrence of pericarditis and myocarditis across 156 countries and territories. We identified 49 096 reports (male, n = 30 013) of vaccine-associated pericarditis and myocarditis among 73 590 reports of all-cause pericarditis and myocarditis. There has been a significant increase in reports of vaccine-related cardiac adverse events over time, with a noteworthy surge observed after 2020, attributed to cases of pericarditis associated with COVID-19 mRNA vaccines. Smallpox vaccines were associated with most pericarditis and myocarditis reports (ROR: 73.68 [95% CI, 67.79-80.10]; IC [IC0.25]: 6.05 [5.91]), followed by COVID-19 mRNA vaccine (37.77 [37.00-38.56]; 3.07 [3.05]), anthrax vaccine (25.54 [22.37-29.16]; 4.58 [4.35]), typhoid vaccine (6.17 [5.16-7.38]; 2.59 [2.29]), encephalitis vaccine (2.00 [1.48-2.71]; 0.99 [0.47]), influenza vaccine (1.87 [1.71-2.04]; 0.90 [0.75]), and Ad5-vectored COVID-19 vaccine (1.40 [1.34-1.46]; 0.46 [0.39]). Concerning age and sex-specific risks, reports of vaccine-associated pericarditis and myocarditis were more prevalent among males and in older age groups. The age group between 12 and 17 years exhibited significant sex disproportion. Most of these adverse events had a short time to onset (median time: 1 day) and fatality rate was 0.44%. Our analysis of global data revealed an increase in pericarditis and myocarditis reports associated with vaccines, particularly live vaccines like smallpox and anthrax, notably in young males. While these adverse events are generally rare and mild, caution is warranted, especially for healthcare workers, due to potential myocardial injury-related in-hospital mortality. Further study with validated reporting is crucial to enhance accuracy in evaluating the correlation between vaccines and cardiac conditions for preventive measures.
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  • 文章类型: Journal Article
    成瘾医学是一个充满活力的领域,涵盖社会背景下的临床实践和研究,经济,以及当地的文化因素,国家,区域,和全球层面。在过去的几十年中,该领域在范围和活动方面发生了深刻的发展,全球成瘾医学科学家和专业人员的贡献。全球一级吸毒成瘾的动态性质导致迫切需要发展成瘾社会的国际合作网络,治疗方案和专家,以监测新兴的国家,区域,和全球关注。本协议文件介绍了在国家进行纵向调查的方法细节,区域,通过国际成瘾医学学会全球专家网络(ISAM-GEN)和全球层面。该网络的初步形成包括招聘阶段和一轮滚雪球抽样,为来自全球78个国家的354名专家提供了服务。此外,数据库中还包括43个国家/区域成瘾协会/协会。这些调查将由全球成瘾医学专家就治疗服务制定,服务范围,同时发生的疾病,治疗标准和障碍,新出现的成瘾和/或全球治疗需求的动态变化。(1)成瘾协会/协会类别的调查参与者,(2)成瘾治疗方案,(3)成瘾专家/临床医生和(4)相关利益相关者将对这些全球纵向调查做出回应。将对结果进行分析,并使用可用数据进行盘问,并进行同行评审以发表。
    Addiction medicine is a dynamic field that encompasses clinical practice and research in the context of societal, economic, and cultural factors at the local, national, regional, and global levels. This field has evolved profoundly during the past decades in terms of scopes and activities with the contribution of addiction medicine scientists and professionals globally. The dynamic nature of drug addiction at the global level has resulted in a crucial need for developing an international collaborative network of addiction societies, treatment programs and experts to monitor emerging national, regional, and global concerns. This protocol paper presents methodological details of running longitudinal surveys at national, regional, and global levels through the Global Expert Network of the International Society of Addiction Medicine (ISAM-GEN). The initial formation of the network with a recruitment phase and a round of snowball sampling provided 354 experts from 78 countries across the globe. In addition, 43 national/regional addiction societies/associations are also included in the database. The surveys will be developed by global experts in addiction medicine on treatment services, service coverage, co-occurring disorders, treatment standards and barriers, emerging addictions and/or dynamic changes in treatment needs worldwide. Survey participants in categories of (1) addiction societies/associations, (2) addiction treatment programs, (3) addiction experts/clinicians and (4) related stakeholders will respond to these global longitudinal surveys. The results will be analyzed and cross-examined with available data and peer-reviewed for publication.
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  • 文章类型: Journal Article
    鉴于受欢迎程度,reach,以及在线平台作为高等教育机构(HEI)非正式教育渠道的可变可访问性,在实际和理论上,更好地了解影响任何此类互联网提供的ICT非正式学习的影响和影响的因素变得很重要。因此,这项研究分析了来自一个非正式的观众数据,科普动漫教育频道是目前最受关注的在线平台,YouTube,衡量影响视频影响和影响范围的特征。该研究的结果确定了该频道上观看次数最多的视频,包括使用滴灌进行的生存园艺,木炭水过滤,以及结核病预防和特征需求,时间,location,和视频访问量。尽管基本发现重申了先前的研究,该研究测量了用户活动与YouTube参与度指标(包括观看时间,视图计数,喜欢,和订户),他们还展示了使这些内容广泛适用于人口统计和全球的能力。使用YouTube等平台,为促进HEI参与非正式教育科学动画和ICT学习实践提供一定的见解,尤其是围绕水的主题,农业,粮食安全,和改善健康结果-调查结果还指出,需要改进在线接触非正式教育的预期接受者的方法,才能最好地利用此类平台的潜力。
    Given the popularity, reach, and variable accessibility of online platforms as channels for informal education by higher-education institutions (HEIs), it becomes practically and theoretically important to better understand the factors that affect the impact and reach of any such Internet-delivered ICT informal learning. Accordingly, this study analysed viewer data from one informal, science animation educational channel on currently the most-watched online platform, YouTube, to measure characteristics affecting the videos\' impact and reach. Results from the study identified the most watched videos on the channel-including survival gardening using drip irrigation, charcoal water filtration, and tuberculosis prevention-and characteristic demand, time, location, and volume of video access. While the basic findings reaffirm prior research measuring statistically significant correlations between user-activity and YouTube engagement metrics (including watch-time, view counts, likes, and subscribers), they also demonstrate the and ability to make such content broadly applicable across demographics and globally. Offering some measure of insights for boosting HEI participation in informal educational science animation and ICT learning practices using platforms like YouTube-especially around the topics of water, agriculture, food security, and improved health outcomes-the findings also point to where improved methods for reaching the intended recipients of informal education online are needed to best leverage the potential of such platforms.
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  • 文章类型: Journal Article
    背景:在预定的手术日期取消手术会影响手术室的效率,这会给患者带来巨大的经济损失,医院,和整个国家的医疗保健费用。这项系统和荟萃分析旨在提供全球患病率和在预期手术日期取消病例的决定因素的证据。
    方法:从2010年1月至2020年5月,在PubMed/Medline;Sciencedirect和LILACS中进行了全面搜索,没有语言限制。纳入研究的异质性与森林地块进行了检查,χ2检验,I2测试,和p值。纳入所有报告患病率和决定因素的观察性研究。
    结果:从不同的数据库中进行初步检索,共识别出1207篇文章。在连续筛选后,选择8个堡文章进行评估。纳入了33篇文章,有306635名参与者。荟萃分析显示,在预期的手术日期取消病例的全球患病率为18%(95%CI:16至20)。荟萃分析还表明,手术室设施的缺乏是取消的主要原因,其次是没有护理人员和医疗条件的变化。
    结论:荟萃分析显示,在低收入和中等收入国家,病例取消的患病率非常高,大多数是可以避免的,这需要对手术室设施进行严格的活动,术前评估和准备,患者和医疗保健提供者沟通。
    背景:本系统评价和荟萃分析已在https://www上的研究注册表(researchregistry5746)中注册。researchregistry.com/browse-the-registry#home/.
    BACKGROUND: Cancellation of operation on the intended day of surgery affects the efficiency of Operation Room which incurs a significant financial loss for the patient, hospital, and health care cost of a country at large. This systematic and Meta-Analysis was intended to provide evidence on the global prevalence and determinants of case cancellation on the intended day of surgery.
    METHODS: A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from January 2010 to May 2020 without language restriction. The Heterogeneity among the included studies was checked with forest plot, χ2 test, I2 test, and the p-values. All observational studies reporting prevalence and determinants were included.
    RESULTS: A total of 1207 articles were identified from different databases with an initial search. Fort-eight articles were selected for evaluation after the successive screening. Thirty-three Articles with 306,635 participants were included. The Meta-Analysis revealed that the global prevalence of case cancellation on the intended day of surgery was 18% (95% CI: 16 to 20). The Meta-Analysis also showed that lack of operation theatre facility accounted for the major reason for cancellation followed by no attendant and change in medical condition.
    CONCLUSIONS: The meta-analysis revealed that the prevalence of case cancellation was very high in low and middle-income countries and the majorities were avoidable which entails rigorous activities on operation theatre facilities, preoperative evaluation and preparation, patient and health care provider communications.
    BACKGROUND: This Systematic Review and Meta-Analysis was registered in a research registry (researchregistry5746) available at https://www.researchregistry.com/browse-the-registry#home/.
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  • 文章类型: Journal Article
    UNASSIGNED: The outbreak of novel coronavirus (Covid-19) has a significant burden on global health and could be associated with significant mortality. Limited information exists about determinants of its fatality worldwide. Thus, this ecological study examined the association of various predictors with Covid-19 fatality.
    UNASSIGNED: International data bases of Covid-19 statistics and health metrics available primarily at WHO were reviewed to collect information for 113 countries. The dependent variable was Covid-19 case fatality rate. Independent variables were demographic, social, clinical, economic, heath care and child health factors.
    UNASSIGNED: Case fatality rate of Covid-19 varies across countries with an average of 4.2 ± 3.8%, and about half of countries had fatality rate >3.2% (median). Significant relationships were observed between Covid-19 fatality rate and socio-economic, clinical, and health variables at the unadjusted regression analysis. At the multivariate adjusted model, percentage of population with age>60 years was positively associated with Covid-19 fatality (B = 0.032, p = 0.005), while Polio-3 immunization at 1-year old was inversely related (B = -0.057, p = 0.017).
    UNASSIGNED: This ecological investigation highlights the higher risk of death among elderly with Covid-19 pandemic and suggests that Polio-3 immunization coverage among 1-year-olds may be associated with better survival. Future research is warranted to validate these findings.
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  • 文章类型: Journal Article
    2019年,EAT-Lancet委员会制定了标准,以协助全球决策者和医疗保健系统维持自然资源,以在2050年之前养活预计的100亿人口。尽管美国的饮食习惯和基本的食品生产实践对土地产生了不成比例的负面影响,温室气体(GHG),和水资源,关于该人群如何满足EAT-Lancet标准的信息有限.为了解决这个问题,我们测量了美国(美国)总体和跨种族/族裔亚组的EAT-Lancet饮食评分标准的改编版本(即,黑色,Latinx,和白色)。此外,我们从节省的环境资源的角度评估了坚持的好处(即,土地,GHG,和水)。通过实现这些目标,我们为在美国制定有效的干预策略提供了重要信息,并有足够的改进来解决边缘化人群对人类健康和环境的影响.我们的研究结果表明,平均而言,美国人总体上或跨种族/族裔小组不符合EAT-Lancet标准。改变饮食摄入量以达到标准可以减少28%至38%的环境退化。此外,这些方法可以适用于其他国家,以制定有意义的解决粮食问题的战略,能源,和我们时代的水挑战。
    In 2019, The EAT-Lancet Commission developed criteria to assist policymakers and health care systems worldwide in sustaining natural resources to feed a forecasted 10 billion people through the year 2050. Although American dietary habits and underlying food production practices have a disproportionately negative impact on land, greenhouse gas (GHG), and water resources, there is limited information on how this population can meet the EAT-Lancet criteria. To address this, we measured adherence to an adapted version of the EAT-Lancet diet score criteria in United States (U.S.) populations overall and across racial/ethnic subgroups (i.e., black, Latinx, and white). In addition, we assessed the benefits of adherence in terms of saved environmental resources (i.e., land, GHG, and water). By performing these objectives, we provide vital information for the development of effective intervention strategies in the U.S. with enough refinement to address the human health and environmental implications of marginalized populations. Our results demonstrate that, on average, Americans do not meet EAT-Lancet criteria overall or across racial/ethnic subgroups. Shifting dietary intakes to meet the criteria could reduce environmental degradation between 28% and 38%. Furthermore, these methods can be adapted to other nations for the development of meaningful strategies that address the food, energy, and water challenges of our time.
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  • 文章类型: Journal Article
    This article contains data on country-specific variability in Covid-19 prevalence, incidence, and case fatality rate among the 238 countries globally. We used the World Health Organization worldwide Covid-19 tracking site to determine the number of confirmed Covid-19 cases, the number of fatalities attributed to Covid-19, and the case fatality rate for each of 238 countries. Using data from the United Nations Department of Economic and Social Affairs, we extracted key country-specific metrics with potential associations with Covid-19 including total population, land area, population density, percentage of residents living in urban areas, and median age. We extracted country-specific economic indicators from The World Bank Group Open Data database. All data were extracted on August 15, 2020. We developed consolidated data sets and calculated the country-specific point prevalence and incidence of Covid-19 and associated deaths. These data are associated with the article \"Spatial Analysis of Global Variability in Covid-19 Burden\". Data are stored in a comma separated value format and can be downloaded from the Data in Brief website.
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  • 文章类型: Journal Article
    大宗商品市场超级周期和粮食价格危机与猖獗的粮食不安全和阿拉伯之春有关。许多因素被确定为商品市场过度波动的罪魁祸首。然而,至于肥料,解释极端价格事件出现的市场驱动因素的明确归属仍然缺失。在本文中,我们对2008年全球磷肥市场的价格飙升进行了定量评估,重点是磷酸二铵(DAP)。我们发现印度的化肥市场政策,磷肥和磷矿的全球最大进口国,事实证明,这是全球价格飙升的主要原因。2008年,当价格翻了一番时,印度的磷肥进口量翻了一番。通过对与2008年磷肥市场价格飙升相关的一系列广泛因素的分析,我们发现了价格飙升的放大倍数和触发机制。我们发现,一方面由于化肥供应商的保护性贸易措施导致全球磷肥出口下降19%,价格飙升被放大。另一方面,印度的化肥补贴计划导致农民没有调整他们对化肥的需求。触发机制似乎是印度磷肥的生产中断,导致DAP的额外进口需求约占全球年供应量的20%。主要结论是,这三个因素共同导致了尖峰,强调需要在国家和国际层面上事先改善肥料市场监管。
    The commodity market super-cycle and food price crisis have been associated with rampant food insecurity and the Arab spring. A multitude of factors were identified as culprits for excessive volatility on the commodity markets. However, as it regards fertilizers, a clear attribution of market drivers explaining the emergence of extreme price events is still missing. In this paper, we provide a quantitative assessment of the price spike of the global phosphorus fertilizer market in 2008 focusing on diammonium phosphate (DAP). We find that fertilizer market policies in India, the largest global importer of phosphorus fertilizers and phosphate rock, turned out to be a major contributor to the global price spike. India doubled its import of P-fertilizer in 2008 at a time when prices doubled. The analysis of a wide set of factors pertinent to the 2008 price spike in phosphorus fertilizer market leads us to the discovery of a price spike magnification and triggering mechanisms. We find that the price spike was magnified on the one hand by protective trade measures of fertilizer suppliers leading to a 19% drop in global phosphate fertilizer export. On the other hand, the Indian fertilizer subsidy scheme led to farmers not adjusting their demand for fertilizer. The triggering mechanism appeared to be the Indian production outage of P-fertilizer resulting in the additional import demand for DAP in size of about 20% of annual global supply. The main conclusion is that these three factors have jointly caused the spike, underscoring the need for ex ante improvements in fertilizer market regulation on both national and international levels.
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  • 文章类型: Comparative Study
    The WHO application of the tenth edition of the International Classification of Diseases (ICD-10) to deaths during the perinatal period (ICD Perinatal Mortality, ICD-PM) captures the essential characteristics of the mother-baby dyad that contribute to perinatal deaths. We compare the capture of maternal conditions in the existing ICD-PM with the maternal codes from the WHO application of ICD-10 to deaths during pregnancy, childbirth, and the puerperium (ICD Maternal Mortality, ICD-MM) to explore potential benefits in the quality of data received.
    Retrospective application of ICD-PM.
    South Africa and the UK.
    Perinatal death databases.
    The maternal conditions were classified using the ICD-PM groupings for maternal condition in perinatal death, and then mapped to the ICD-MM groupings of maternal conditions.
    Main maternal conditions in perinatal deaths.
    We reviewed 9661 perinatal deaths. The largest group (4766 cases, 49.3%) in both classifications captures deaths where there was no contributing maternal condition. Each of the other ICD-PM groups map to between three and six ICD-MM groups. If the cases in each ICD-PM group are re-coded using ICD-MM, each group becomes multiple, more specific groups. For example, the 712 cases in group M4 in ICD-PM become 14 different and more specific main disease categories when the ICD-MM is applied instead.
    As we move towards ICD-11, the use of the more specific, applicable, and relevant codes outlined in ICD-MM for both maternal deaths and the maternal condition at the time of a perinatal death would be preferable, and would provide important additional information about perinatal deaths.
    Improving the capture of maternal conditions in perinatal deaths provides important actionable information.
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  • 文章类型: Journal Article
    预测显示,全球卫生行业的劳动力短缺约430万。需要确保全世界卫生工作者的充足供应,为这些专业人员的全球移徙增加创造了环境。卫生专业人员移徙的全球趋势引起了国际招聘行业,以促进卫生工作者从来源国到目的地国的通行。在美国尤其如此,大多数移民卫生专业人员都是通过招聘行业来的。这个行业在美国和许多其他国家基本上不受监管,为此,自愿守则已被用作提高招聘过程透明度的手段,塑造专业行为,减轻对受过外国教育的卫生工作者的伤害。本文介绍的CGFNS联盟案例研究描述了美国多方利益相关者为促进道德招聘实践所做的努力。这些守则不仅补充了《世卫组织全球业务守则》,而且对于最大限度地提高这些全球标准对当地环境的影响是必要的。本案例研究提供了历史视角和概念框架,用于研究影响人力资源迁移的多种因素。从来源国和目的地国的角度,吸取的经验教训为与《世卫组织守则》的相关性和有效性有关的因素提供了重要的见解。这项研究提供了一个概念模型,用于检查世卫组织守则的有用性以及如何最好地确保其可行性,可持续性相关性,以及在全球环境中的有效性。本案例研究最后提出了关于不断发展的商业模式的建议,这些建议需要到位,以加强《世卫组织准则》在市场上的有效性,并确保其对国际招聘行业在推进道德实践方面的影响。这些建议包括使用有效的筛选机制来确定卫生专业人员是否准备好迁移,以及实施认证流程,以提高那些直接参与招聘技术工人和管理迁移流程的人员的实践标准。
    Projections indicate a global workforce shortage of approximately 4.3 million across the health professions. The need to ensure an adequate supply of health workers worldwide has created a context for the increased global migration of these professionals. The global trend in the migration of health professionals has given rise to the international recruitment industry to facilitate the passage of health workers from source to destination countries. This is particularly the case in the United States, where the majority of immigrant health professionals have come by way of the recruiting industry. This industry is largely unregulated in the United States as well as in many other countries, for which voluntary codes have been used as a means to increase transparency of the recruitment process, shape professional conduct, and mitigate harm to foreign-educated health workers. The CGFNS Alliance case study presented herein describes a multi-stakeholder effort in the United States to promote ethical recruitment practices. Such codes not only complement the WHO Global Code of Practice but are necessary to maximize the impact of these global standards on local settings. This case study offers both a historical perspective and a conceptual framework for examining the multiplicity of factors affecting the migration of human resources for health. The lessons learned provide critical insights into the factors pertaining to the relevancy and effectiveness of the WHO Code from the perspectives of both source and destination countries. This study provides a conceptual model for examining the usefulness of the WHO Code as well as how best to ensure its viability, sustainability, relevancy, and effectiveness in the global environment. This case study concludes with recommendations for evolving business models that need to be in place to strengthen the effectiveness of the WHO Code in the marketplace and to ensure its impact on the international recruitment industry in advancing ethical practices. These recommendations include using effective screening mechanisms to determine health professionals\' readiness for migration as well as implementing certification processes to raise the practice standards for those directly involved in recruiting skilled workers and managing the migration flow.
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