US

糖尿病
  • 文章类型: Journal Article
    人们越来越关注使用亚硝酸钠(SN)作为一种新兴的自杀手段,尤其是年轻人。鉴于传统公共卫生监测来源关于该主题的信息有限,我们研究了一个网上自杀论坛的帖子,\"被制裁的自杀,“这是有关SN使用和采购的主要信息来源。
    本研究旨在确定SN购买和使用的趋势,通过数据挖掘从论坛上的订阅者帖子获得。我们还旨在确定与SN共同出现的物质和主题,以及SN的用户和来源的地理分布。
    我们收集了该网站于2018年3月成立至2022年10月的所有公开可用信息。使用数据驱动方法,包括自然语言处理和机器学习,我们分析了SN提及随着时间的推移,包括SN消费者的位置和采购SN的来源。我们开发了基于变压器的源和位置分类器,以确定SN源的地理分布。
    与SN有关的帖子显示受欢迎程度上升,与疾病控制和预防中心(CDC)广泛的流行病学研究在线数据(=0.727;P<.001)和国家毒物数据系统(=0.866;P=.001)的数据相比,SN的实际使用与自杀意图之间存在统计学上的显着相关性。我们观察到止吐药的频繁出现,苯二氮卓类药物,和具有SN的酸调节剂。我们提出的基于机器学习的源和位置分类器可以检测到潜在的SN源,准确率为72.92%,并显示在美国和其他地方的消费。
    可以从在线论坛获得有关SN和其他新兴自杀机制的重要信息。
    UNASSIGNED: There is growing concern around the use of sodium nitrite (SN) as an emerging means of suicide, particularly among younger people. Given the limited information on the topic from traditional public health surveillance sources, we studied posts made to an online suicide discussion forum, \"Sanctioned Suicide,\" which is a primary source of information on the use and procurement of SN.
    UNASSIGNED: This study aims to determine the trends in SN purchase and use, as obtained via data mining from subscriber posts on the forum. We also aim to determine the substances and topics commonly co-occurring with SN, as well as the geographical distribution of users and sources of SN.
    UNASSIGNED: We collected all publicly available from the site\'s inception in March 2018 to October 2022. Using data-driven methods, including natural language processing and machine learning, we analyzed the trends in SN mentions over time, including the locations of SN consumers and the sources from which SN is procured. We developed a transformer-based source and location classifier to determine the geographical distribution of the sources of SN.
    UNASSIGNED: Posts pertaining to SN show a rise in popularity, and there were statistically significant correlations between real-life use of SN and suicidal intent when compared to data from the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (⍴=0.727; P<.001) and the National Poison Data System (⍴=0.866; P=.001). We observed frequent co-mentions of antiemetics, benzodiazepines, and acid regulators with SN. Our proposed machine learning-based source and location classifier can detect potential sources of SN with an accuracy of 72.92% and showed consumption in the United States and elsewhere.
    UNASSIGNED: Vital information about SN and other emerging mechanisms of suicide can be obtained from online forums.
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  • 文章类型: Journal Article
    阿片类药物和物质滥用已成为美国普遍存在的问题,导致“阿片类药物危机”。“药物滥用与心理健康之间的关系已经得到了广泛的研究,一种可能的关系是滥用药物会导致不良的心理健康。然而,缺乏关于这种关系的证据导致阿片类药物在很大程度上无法通过法律手段获得。
    本研究旨在分析与物质使用和通过加密市场列表出售的阿片类药物相关的社交媒体帖子。该研究旨在使用最先进的深度学习模型从社交媒体帖子中产生情感和情感,以了解用户对社交媒体的看法。该研究还旨在调查人们对哪种合成阿片类药物持乐观态度等问题,中性,或消极;什么样的药物会引起恐惧和悲伤;人们喜欢或感激什么样的药物;人们对哪些药物持负面看法;哪些阿片类药物几乎不会引起情感反应。
    该研究使用了药物滥用本体论和最先进的深度学习模型,包括来自基于变压器的模型的知识感知双向编码器表示,从社交媒体帖子中产生情绪和情感,这些帖子与物质使用和通过加密市场列表出售的阿片类药物有关。该研究抓取了加密市场数据并提取了芬太尼的帖子,芬太尼类似物,和其他新型合成阿片类药物。该研究进行了与产生的情绪和情绪相关的主题分析,以了解哪些主题与人们对各种药物的反应相关。此外,该研究分析了基于这些特征构建的时间感知神经模型,同时考虑了与药物相关的帖子的历史情绪和情绪活动.
    研究发现,最有效的模型表现良好(具有统计学意义,在识别物质使用障碍方面,宏F1得分为82.12,召回率为83.58)。研究还发现,与不同的合成阿片类药物相关的情绪和情绪水平各不相同,某些药物比其他药物引起更多的积极或消极反应。该研究确定了与人们对各种药物的反应相关的主题,如疼痛缓解,上瘾,和戒断症状。
    该研究基于社交媒体帖子中表达的情绪和情感,深入了解用户对合成阿片类药物的看法。该研究的发现可用于为旨在减少药物滥用和解决阿片类药物危机的干预措施和政策提供信息。该研究证明了深度学习模型在分析社交媒体数据以深入了解公共卫生问题方面的潜力。
    UNASSIGNED: Opioid and substance misuse has become a widespread problem in the United States, leading to the \"opioid crisis.\" The relationship between substance misuse and mental health has been extensively studied, with one possible relationship being that substance misuse causes poor mental health. However, the lack of evidence on the relationship has resulted in opioids being largely inaccessible through legal means.
    UNASSIGNED: This study aims to analyze social media posts related to substance use and opioids being sold through cryptomarket listings. The study aims to use state-of-the-art deep learning models to generate sentiment and emotion from social media posts to understand users\' perceptions of social media. The study also aims to investigate questions such as which synthetic opioids people are optimistic, neutral, or negative about; what kind of drugs induced fear and sorrow; what kind of drugs people love or are thankful about; which drugs people think negatively about; and which opioids cause little to no sentimental reaction.
    UNASSIGNED: The study used the drug abuse ontology and state-of-the-art deep learning models, including knowledge-aware Bidirectional Encoder Representations From Transformers-based models, to generate sentiment and emotion from social media posts related to substance use and opioids being sold through cryptomarket listings. The study crawled cryptomarket data and extracted posts for fentanyl, fentanyl analogs, and other novel synthetic opioids. The study performed topic analysis associated with the generated sentiments and emotions to understand which topics correlate with people\'s responses to various drugs. Additionally, the study analyzed time-aware neural models built on these features while considering historical sentiment and emotional activity of posts related to a drug.
    UNASSIGNED: The study found that the most effective model performed well (statistically significant, with a macro-F1-score of 82.12 and recall of 83.58) in identifying substance use disorder. The study also found that there were varying levels of sentiment and emotion associated with different synthetic opioids, with some drugs eliciting more positive or negative responses than others. The study identified topics that correlated with people\'s responses to various drugs, such as pain relief, addiction, and withdrawal symptoms.
    UNASSIGNED: The study provides insight into users\' perceptions of synthetic opioids based on sentiment and emotion expressed in social media posts. The study\'s findings can be used to inform interventions and policies aimed at reducing substance misuse and addressing the opioid crisis. The study demonstrates the potential of deep learning models for analyzing social media data to gain insights into public health issues.
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  • 文章类型: Journal Article
    人口老龄化是21世纪的全球性人口特征,健康饮食是健康衰老的核心组成部分。然而,在老年人中,关于饮食质量与昼夜节律综合征(CircS)之间的关联的证据有限.因此,这项研究调查了美国中老年人代表性样本的膳食模式与CircS之间的关联.样本包括参加2016年健康与退休研究(HRS)核心浪潮的中老年人及其子研究之一,2013年医疗保健和营养研究(HCNS)。食物频率问卷用于量化习惯性食物摄入量并使用因子分析确定饮食模式。CircS的定义是基于代谢综合征的≥4个成分的存在以及睡眠障碍和抑郁的指标。该研究共纳入4253名平均年龄(SD)为65.4(10.0)岁的中老年人。CircS的患病率为35.9%。比较“谨慎模式”的极端四分位数,CircS的比值比(95%CI)为0.72(0.55-0.94),“西方模式”为1.47(1.10-1.95)。在中老年人中,“西方模式”与CircS的几率呈正相关,而“谨慎模式”与CircS的几率呈负相关。
    Population aging is a global demographic characteristic of the 21st century, and healthy eating is a core component of healthy aging. However, limited evidence is available among older adults for associations between diet quality and circadian syndrome (CircS). Thus, this study examined associations between dietary patterns and CircS among a representative sample of middle-older adults in the US. The sample comprised middle-older adults enrolled in the 2016 core wave of the Health and Retirement Study (HRS) and one of its sub-studies, the 2013 Health Care and Nutrition Study (HCNS). A food frequency questionnaire was used to quantify habitual food intake and identify dietary patterns using a factor analysis. CircS was defined based on the existence of ≥4 components of metabolic syndrome and indicators of sleep disorders and depression. A total of 4253 middle-older adults with a mean age (SD) of 65.4 (10.0) years were included in the study. The prevalence of CircS was 35.9%. Comparing extreme quartiles of the \"Prudent Pattern\", the odds ratio (95% CI) for CircS was 0.72 (0.55-0.94), and it was 1.47 (1.10-1.95) for the \"Western Pattern\". The \"Western Pattern\" was positively associated while the \"Prudent Pattern\" was inversely associated with the odds of CircS among middle-older adults.
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  • 文章类型: Journal Article
    背景:酒精滥用是美国第四大死亡原因,也是美国军方的重大问题。简短的酒精干预措施可以减少平民和军事人口的负面酒精结果,但是需要额外的可扩展干预措施来减少暴饮暴食和大量饮酒。短信干预可以满足这一需求,但迄今为止,没有针对军事人口的计划。
    目的:我们旨在开发一种短信干预措施,以解决美国空军技术培训中飞行员的暴饮暴食和酗酒问题。
    方法:我们实施了2个阶段,研究开发短信干预的混合方法。在第一阶段,共有149名受访者就49条专家制定的信息的说服力提供了反馈,有关消息频率的首选项,接收消息的时间和天数,和建议的信息,定性编码。在第二阶段,共有283名受访者就77条新讯息的说服力提供了反馈,包括通过对第1阶段的消息进行细化而开发的消息,这些消息是根据行为变化技术分类(BCTT)进行编码和评估的。对于这两个阶段,根据年龄(<21岁或≥21岁)和性别计算并比较平均说服力评分(范围1-5).考虑将来自第2阶段的排名最高的消息包含在最终消息库中。
    结果:在第1阶段中,评分最高的消息主题是关于不良结果的警告(例如,受损的判断和财务成本),建议减少饮酒,引用价值观和目标。通过对建议的消息进行定性编码,我们确定了与不良结果警告相关的主题,recommendations,优先考虑长期目标,团队和归属感,引用价值观和目标。受访者希望每周收到1至3条消息(124/137,90.5%),并在周五发送消息,星期六,和周日(65/142,45.8%)。在第2阶段,最终消息库中消息的平均得分范围为3.31(SD1.29)至4.21(SD0.90)。在排名最高的5条信息中,4分为2种行为改变技术(BCT):有价值的自我认同和有关健康后果的信息。最终消息库包括13个BCT中的28个BCTT通知消息,不同性别的信息得分相似。超过四分之一(8/28,29%)的最终消息由来自阶段1的建议消息通知。由于年龄<21岁的飞行员因饮酒而面临更严厉的纪律处分,该计划是根据美国法定饮酒年龄量身定制的。
    结论:这项研究涉及目标人群的成员在干预开发的2个形成阶段,以设计BCTT知情的SMS短信干预措施,以减少暴饮暴食和大量饮酒,目前正在疗效试验中进行测试。结果将确定干预措施对美国空军暴饮暴食和饮酒的影响。
    BACKGROUND: Alcohol misuse is the fourth leading cause of death in the United States and a significant problem in the US military. Brief alcohol interventions can reduce negative alcohol outcomes in civilian and military populations, but additional scalable interventions are needed to reduce binge and heavy drinking. SMS text messaging interventions could address this need, but to date, no programs exist for military populations.
    OBJECTIVE: We aimed to develop an SMS text messaging intervention to address binge and heavy drinking among Airmen in Technical Training in the US Air Force.
    METHODS: We implemented a 2-phase, mixed methods study to develop the SMS text messaging intervention. In phase 1, a total of 149 respondents provided feedback about the persuasiveness of 49 expert-developed messages, preferences regarding message frequency, timing and days to receive messages, and suggested messages, which were qualitatively coded. In phase 2, a total of 283 respondents provided feedback about the persuasiveness of 77 new messages, including those developed through the refinement of messages from phase 1, which were coded and assessed based on the Behavior Change Technique Taxonomy (BCTT). For both phases, mean persuasiveness scores (range 1-5) were calculated and compared according to age (aged <21 or ≥21 years) and gender. Top-ranking messages from phase 2 were considered for inclusion in the final message library.
    RESULTS: In phase 1, top-rated message themes were about warnings about adverse outcomes (eg, impaired judgment and financial costs), recommendations to reduce drinking, and invoking values and goals. Through qualitative coding of suggested messages, we identified themes related to warnings about adverse outcomes, recommendations, prioritizing long-term goals, team and belonging, and invoking values and goals. Respondents preferred to receive 1 to 3 messages per week (124/137, 90.5%) and to be sent messages on Friday, Saturday, and Sunday (65/142, 45.8%). In phase 2, mean scores for messages in the final message library ranged from 3.31 (SD 1.29) to 4.21 (SD 0.90). Of the top 5 highest-rated messages, 4 were categorized into 2 behavior change techniques (BCTs): valued self-identity and information about health consequences. The final message library includes 28 BCTT-informed messages across 13 BCTs, with messages having similar scores across genders. More than one-fourth (8/28, 29%) of the final messages were informed by the suggested messages from phase 1. As Airmen aged <21 years face harsher disciplinary action for alcohol consumption, the program is tailored based on the US legal drinking age.
    CONCLUSIONS: This study involved members from the target population throughout 2 formative stages of intervention development to design a BCTT-informed SMS text messaging intervention to reduce binge and heavy drinking, which is now being tested in an efficacy trial. The results will determine the impact of the intervention on binge drinking and alcohol consumption in the US Air Force.
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  • 文章类型: Journal Article
    目的:神经胶质瘤是中枢神经系统最常见的原发性恶性肿瘤。近年来,微波消融有望应用于脑肿瘤的微创治疗。本研究旨在评估剪切波弹性成像(SWE)微波消融离体脑组织的可行性和准确性,探讨实时SWE在监测脑组织MWA过程中的应用价值。方法:采用不同微波功率和消融时间对30例离体脑组织进行治疗。观察MWA组织的形态和显微变化,并测量消融区域的直径。在这个实验中,SWE用于定量评估消融后立即脑组织的热损伤程度。结果:本研究发现,消融后SWE测得的消融范围与病理范围[ICCSWEL1-L1=0.975(95%CI:0.959-0.985),ICCSWEL2-L2=0.887(95%CI:0.779-0.938)]。同时,消融后的SWE值显着高于消融前(平均值±SD,9.88±2.64kPavs.23.6±13.75kPa;p<0.001)。在这项研究中,通过ROC曲线进一步分析不同病理状态下组织的SWE值(AUC=0.86),消融后区分正常组织和组织的阈值为13.7kPa。用SWE评价消融组织的准确率可达84.72%,为实时定量观察消融范围提供数据支持。结论:结论:通过实时SWE可以实现对MWA过程组织变革范围的准确可视化和实时评估。
    Objective: Glioma constitutes the most common primary malignant tumor in the central nervous system. In recent years, microwave ablation (MWA) was expected to be applied in the minimally invasive treatment of brain tumors. This study aims to evaluate the feasibility and accuracy of microwave ablation in ex vivo brain tissue by Shear Wave Elastography (SWE) to explore the application value of real-time SWE in monitoring the process of MWA of brain tissue.Methods: Thirty ex vivo brain tissues were treated with different microwave power and ablation duration. The morphologic and microscopic changes of MWA tissues were observed, and the diameter of the ablation areas was measured. In this experiment, SWE is used to quantitatively evaluate brain tissue\'s degree of thermal injury immediately after ablation.Results: This study It is found that the ablation range measured by SWE after ablation is in good consistency with the pathological range [ICCSWEL1-L1 = 0.975(95% CI:0.959 - 0.985), ICCSWEL2-L2 = 0.887(95% CI:0.779 - 0.938)]. At the same time, the SWE value after ablation is significantly higher than before (mean ± SD,9.88 ± 2.64 kPa vs.23.6 ± 13.75 kPa; p < 0.001). In this study, the SWE value of tissues in different pathological states was further analyzed by the ROC curve (AUC = 0.86), and the threshold for distinguishing normal tissue from tissue after ablation was 13.7 kPa. The accuracy of evaluating ablation tissue using SWE can reach 84.72%, providing data support for real-time quantitative observation of the ablation range.Conclusion: In conclusion the accurate visualization and real-time evaluation of the organizational change range of the MWA process can be realized by real-time SWE.
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  • 文章类型: Journal Article
    HPV感染与宫颈癌的发生密切相关,对人类生命健康有重要的不良影响。这项研究使用了NHANES2003-2016年的数据来调查20岁及以上美国人PIR与HPV感染状况之间的关系。
    这项横断面调查的数据来自2003-2016年国家健康与营养检查调查(NHANES),其中包括9580名20岁或以上的女性.使用多元线性回归和平滑曲线拟合研究了PIR与HPV感染之间的线性和非线性相关性。使用亚组分析和交互检验检查了组间关系的稳定性。
    9580名20岁及以上的成年参与者中有2232个贫困家庭和2543个富裕家庭。在调整所有其他协变量后,发现PIR(收入与贫困的比率)与HPV感染的存在显着负相关[0.91(0.89,0.94)],即使将PIR分为高收入和低收入组(PIR>4和PIR<1),这种趋势仍然存在。此外,在25至59岁女性的亚组分析中发现了显着的负相关[0.90(0.88,0.93)],非西班牙裔白人[0.80(0.70,0.92)],非糖尿病患者[0.91(0.88,0.94)],和那些曾经从事性行为的人[0.91(0.89,0.94)]。
    在20岁及以上的美国女性中,PIR与HPV感染的存在高度负相关。本研究结果对预防HPV感染、提高HPV筛查的准确性具有重要意义。
    UNASSIGNED: HPV infection is closely related to the occurrence of cervical cancer and has an important adverse effect on human life and health. This study used data from the NHANES 2003-2016 to investigate the relationship between PIR and HPV infection status among Americans aged 20 and older.
    UNASSIGNED: The data for this cross-sectional investigation came from the 2003-2016 National Health and Nutrition Examination Survey (NHANES), which included 9580 women who were 20 years of age or older. The linear and nonlinear correlations between PIR and the presence of HPV infection were investigated using multiple linear regression and smooth curve fitting. The stability of the relationship across groups was examined using subgroup analysis and interaction tests.
    UNASSIGNED: There were 2232 impoverished homes and 2543 rich households among the 9580 adult participants aged 20 and above. PIR (ratio of income to poverty) was found to be significantly inversely related to the presence of HPV infection [0.91 (0.89, 0.94)] after adjusting for all other covariates, and the trend persisted even after categorizing PIR into high- and low-income groups (PIR>4 and PIR<1). In addition, significant negative relationships were discovered in subgroup analyses for women aged 25 to 59 [0.90 (0.88, 0.93)], non-Hispanic whites [0.80 (0.70, 0.92)], non-diabetics [0.91 (0.88, 0.94)], and those who had ever engaged in sex [0.91 (0.89, 0.94)].
    UNASSIGNED: PIR was highly and negatively correlated with the presence of HPV infection in American women aged 20 and older. The results of this study are of great significance for preventing HPV infection and improving the accuracy of HPV screening.
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  • 文章类型: Journal Article
    背景:成像对于识别和诊断肌肉骨骼(MSK)症状至关重要,这是系统性红斑狼疮(SLE)最典型的表现之一。对于关节,肌腱,和可怕的网站,超声检查对炎症和结构损伤的诊断是敏感和准确的。
    目的:当前调查的目的是确定SLE患者中异常的患病率和分布,使用肌肉骨骼超声检查(MSUS)并评估前后超声改变与SLE疾病活动之间的关系。
    方法:研究了168名受试者(56名SLE患者,56例银屑病关节炎(PSA)患者,和56例正常病例)。为了比较急性介入的频率和分布,采用高分辨率MSUS,根据马德里超声声像描记器末端炎指数(MASEI)评估所有患者的起始部位.
    结果:使用利兹附件炎指数在39.3%的SLE患者中发现了临床附件炎,而通过美国检查发现了71%,表明在我们的SLE患者中,亚临床附着性炎的比例很高。最常见的受累是胫骨结节处髌腱的远端插入,在41%的SLE患者中检测到。与SLE患者(71.4%)相比,PSA患者(100%)的结膜炎明显更频繁(p<0.05),而与健康对照组相比,SLE患者的结膜炎发生率更高(19.6%)。MASI和SLEDAI评分之间存在显著相关性(r=0.250*,p=0.048)和24小时总蛋白(r=0.289*,p=0.031)。此外,MASEI与血清白蛋白呈负相关(r=-0.324*,p=0.015)。
    结论:在SLE患者中,附着物炎经常是临床和超声证实的。受影响最大的是股四头肌腱的插入。炎症的存在和MASI评分的升高可以作为SLE疾病严重程度的指标。关键点•受影响最大的末端部位位于股四头肌腱的插入处。•MASEI评分的存在和升高可以作为SLE疾病严重程度的指标。
    BACKGROUND: Imaging is crucial for identifying and diagnosis of the musculoskeletal (MSK) symptoms, which are one of the most typical manifestations of systemic lupus erythematosus (SLE). For the joints, tendons, and entheseal sites, ultrasonography has shown to be sensitive and accurate for the diagnosis of both inflammation and structural damage.
    OBJECTIVE: The goal of the current investigation is to determine the prevalence and the distribution of entheseal abnormalities in SLE patients, using musculoskeletal ultrasonography (MSUS) and to assess the relationship between entheseal sonographic changes and the SLE disease activity.
    METHODS: One hundred sixty-eight subjects were studied (56 SLE patients, 56 psoriatic arthritis (PSA) patients, and 56 normal cases). To compare the frequency and the distribution of entheseal involvement, high-resolution MSUS was conducted to assess the entheseal sites of all patients in accordance with the Madrid Sonographic Enthesitis Index (MASEI).
    RESULTS: Clinical enthesitis was detected in 39.3% of the SLE patients using the Leeds Enthesitis Index compared to 71% detected via US examination, indicating a high proportion of subclinical enthesitis in our SLE patients. The most frequently affected enthesis was the distal insertion of the patellar tendon at the tibial tuberosity which was detected in 41% of SLE patients. Enthesitis was significantly more frequent in PSA patients (100%) compared to SLE patients (71.4%) (p < 0.05) and more significantly frequent in SLE patients compared to the healthy controls (19.6%). There was a significant correlation between MASI and SLEDAI scores (r = 0.250*, p = 0.048) and the total protein in 24 h (r = 0.289*, p = 0.031). In addition, there was an inverse significant correlation between MASEI and serum albumin (r =  - 0.324*, p = 0.015).
    CONCLUSIONS: In SLE patients, enthesitis is frequently clinical and ultrasound-verified. The most impacted enthesis is at the insertion of the quadriceps tendon. Enthesitis presence and the rise in the MASI score can serve as indicators of the severity of the SLE disease. Key Points • The most impacted entheseal site lies at the insertion of the quadriceps tendon. • The presence and the rise in MASEI score can serve as indicators of the severity of the SLE disease.
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  • 文章类型: Journal Article
    这项前瞻性试点研究的目的是评估一种新的混合成像模式的可行性。免费单光子计算机断层扫描/超声检查(fhSPECT/US),用于甲状旁腺腺瘤的术前定位,并与常规超声和SPECT/CT进行比较。12例诊断为原发性甲状旁腺功能亢进症的患者依次接受了US和甲状旁腺闪烁显像,包括SPECT/CT,其次是fhSPECT/US,允许美国和徒手生成的伽马相机图像之间的实时融合。fhSPECT/US检出率与组织病理学相关,当可用时,或者成像模式显示最多病变。根据每位患者的分析,将SPECT/CT与fhSPECT/US进行比较时,检出率显着不同(p=0.03),当比较SPECT/CT与US(p=0.16)和US与fhSPECT/US(p=0.08)时,没有显着差异。根据每个病变的分析,SPECT/CT的检出率明显高于US(p=0.01)和fhSEPCT/US(p=0.003),当US与fhSPECT/US比较时,检出率没有显着差异(p=0.08)。fhSPECT/US在病变检测中的主要感知局限性是:(i)位于深度≥4.5cm的病变;(ii)由于组织压缩而导致的图像融合不完善;(iii)SPECT移动相机手持式探头的空间操作能力有限;(iv)检测到的活动范围广泛。总之,临床使用fhSPECT/US定位甲状旁腺腺瘤是可行的,但显示出比常规模式更低的灵敏度,需要技术改进。
    The aim of this prospective pilot study was to evaluate the feasibility of a new hybrid imaging modality, free-hand single-photon computed tomography/ultrasonography (fhSPECT/US), for preoperative localization of parathyroid adenomas and to compare its performance with conventional ultrasonography and SPECT/CT. Twelve patients diagnosed with primary hyperparathyroidism underwent sequentially US and parathyroid scintigraphy, including SPECT/CT, followed by fhSPECT/US, allowing for real-time fusion between US and freehand-generated gamma-camera images. The fhSPECT/US detection rates were correlated with histopathology, when available, or with the imaging modality showing the most lesions. Based on a per patient analysis, the detection rate was significantly different when comparing SPECT/CT to fhSPECT/US (p = 0.03), and not significantly different when comparing SPECT/CT to US (p = 0.16) and US to fhSPECT/US (p = 0.08). Based on a per-lesion analysis, the detection rate of SPECT/CT was significantly higher than that of US (p = 0.01) and fhSEPCT/US (p = 0.003), and there was no significant difference in detection rate when comparing US to fhSPECT/US (p = 0.08). The main perceived limitations of fhSPECT/US in lesion detection were: (i) lesions localized at a depth ≥4.5 cm; (ii) imperfect image fusion due to tissue compression; (iii) limited spatial manipulation ability of the SPECT mobile camera handheld probe; and (iv) a wide spread of detected activity. In conclusion, clinical use of fhSPECT/US for localization of parathyroid adenomas is feasible, but shows lower sensitivity than conventional modalities and requires technical improvements.
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  • 文章类型: Journal Article
    背景:大麻使用和大麻使用障碍(CUD)与心理健康障碍有关,然而,这件事在怀孕和最近产后的程度(例如,新妈妈)美国女性未知。大麻使用之间的关联,DSM-5CUD和DSM-5精神健康障碍(情绪,焦虑,在全国代表性的孕妇和产后妇女样本中检查了人格和创伤后应激障碍)。
    方法:2012-2013年全国酒精和相关疾病流行病学调查-III用于检查过去一年大麻使用之间的关联,CUD和心理健康障碍。使用加权逻辑回归模型来估计未调整和调整的比值比(aOR)。样本(N=1316)包括414名孕妇和902名产后妇女(过去一年怀孕),年龄18-44岁。
    结果:过去一年大麻使用和CUD的患病率分别为9.8%和3.2%,分别。与没有过去一年情绪的女性相比,使用大麻的几率(aORs范围为2.10-3.87,p值<0.01)和CUD(aORs范围为2.55-10.44,p值<0.01)更高,焦虑或创伤后应激障碍或任何终身人格障碍。aors为大麻使用与特定情绪的关联,焦虑或人格障碍的范围为1.95至6.00(p值<0.05)。用于CUD与特定情绪的关联的OR,焦虑或人格障碍的范围为2.36至11.60(p值<0.05)。
    结论:从怀孕到产后一年是妇女可能特别容易受到精神健康障碍的关键时期,大麻使用和CUD。治疗和预防至关重要。
    BACKGROUND: Cannabis use and cannabis use disorder (CUD) are associated with mental health disorders, however the extent of this matter among pregnant and recently postpartum (e.g., new moms) women in the US is unknown. Associations between cannabis use, DSM-5 CUD and DSM-5 mental health disorders (mood, anxiety, personality and post-traumatic stress disorders) were examined among a nationally representative sample of pregnant and postpartum women.
    METHODS: The 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III was used to examine associations between past-year cannabis use, CUD and mental health disorders. Weighted logistic regression models were used to estimate unadjusted and adjusted odds ratios (aORs). The sample (N=1316) included 414 pregnant and 902 postpartum women (pregnant in the past year), aged 18-44 years old.
    RESULTS: The prevalence of past-year cannabis use and CUD was 9.8% and 3.2%, respectively. The odds of cannabis use (aORs range 2.10-3.87, p-values<0.01) and CUD (aORs range 2.55-10.44, p-values< 0.01) were higher among women with versus without any past-year mood, anxiety or posttraumatic stress disorders or any lifetime personality disorder. aORs for the association of cannabis use with specific mood, anxiety or personality disorders ranged from 1.95 to 6.00 (p-values<0.05). aORs for the association of CUD with specific mood, anxiety or personality disorders ranged from 2.36 to 11.60 (p-values<0.05).
    CONCLUSIONS: From pregnancy up to one year postpartum is a critical period where women may be particularly vulnerable to mental health disorders, cannabis use and CUD. Treatment and prevention are essential.
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  • 文章类型: Journal Article
    背景:大量文献表明,无论年龄大小,接种COVID-19疫苗对所有个体的健康都至关重要。通过出生对美国样本中疫苗接种状况的研究有限。
    目的:我们研究的目的是扩大关于大流行和美国出生期间COVID-19疫苗接种的有限文献,同时考虑通过全国分布调查收集的社会人口统计学和社会经济因素。
    方法:对2021年5月至2022年1月在美国进行的116项全面调查进行了描述性分析。COVID-19疫苗接种情况为自我报告。对于没有接种疫苗的参与者,我们问他们是否“根本不可能”,“轻微到中等可能性”,或“非常有可能”接种疫苗。耶稣诞生按出生国分类,即,美国出生或外国出生的。种族和民族被归类为白人,黑人或非裔美国人,亚洲人,美洲印第安人或阿拉斯加原住民,夏威夷或太平洋岛民,非洲,中东,多种族或多民族。其他社会人口统计学和社会经济变量包括性别,性取向,年龄组,家庭年收入,教育程度,和就业状况。
    结果:大多数样本,不管耶稣诞生,报告已接种疫苗(3639/5404,67.34%)。美国出生的参与者报告COVID-19疫苗接种比例最高,自我鉴定为白人(1431/2753,51.98%),而在外国出生的参与者中,自我鉴定为西班牙裔/拉丁美洲裔的参与者比例最高(310/886,34.99%)。比较没有接种COVID-19疫苗的美国出生和外国出生的参与者,自我报告的最高比例的社会人口统计学特征在群体之间相似,被确定为女性,异性恋或异性恋,18至35岁,家庭年收入<25000美元,失业或从事非传统工作。在报告没有接种疫苗的32.66%(1765/5404)的参与者中,这些参与者中有45.16%(797/1765)报告说他们根本不可能接种疫苗。当进一步检查未接种疫苗的参与者报告他们在美国出生时接种COVID-19疫苗的可能性时,在美国出生和外国出生的人中,他们根本不可能接种疫苗的比例最高。外国出生的,然而,与美国出生的个体(274/1409,19.45%)相比,他们报告“非常有可能”接种疫苗(112/356,31.46%)的可能性几乎成比例分布。
    结论:我们的研究结果表明,有必要进一步探索可能增加疫苗接种可能性的因素,这些因素可以针对服务不足而量身定制,代表性不足,和难以接触的团体。例如,外国出生的人与美国出生的人相比,在报告COVID-19未接种疫苗时,最有可能接种疫苗。我们的研究增加了不断增长的基础,这将进一步加深我们对因素的理解,这些因素可以帮助确定当前COVID-19大流行中疫苗犹豫和疫苗采用的干预点,以及未来的流行病。
    背景:
    BACKGROUND: Extended literature has demonstrated that COVID-19 vaccination is crucial for the health of all individuals, regardless of age. Research on vaccination status in the United States (US) among US-born and non-US-born residents is limited.
    OBJECTIVE: The objective of our study was to examine COVID-19 vaccination during the pandemic among US-born and non-US-born people, while accounting for sociodemographic and socioeconomic factors gathered through a nationally distributed survey.
    METHODS: A descriptive analysis was conducted on a comprehensive 116-item survey distributed between May 2021 and January 2022 across the US by self-reported COVID-19 vaccination and US/non-US birth status. For participants that responded that they were not vaccinated, we asked if they were \"not at all likely,\" \"slightly to moderately likely,\" or \"very to extremely likely\" to be vaccinated. Race and ethnicity were categorized as White, Black or African American, Asian, American Indian or Alaskan Native, Hawaiian or Pacific Islander, African, Middle Eastern, and multiracial or multiethnic. Additional sociodemographic and socioeconomic variables included gender, sexual orientation, age group, annual household income, educational attainment, and employment status.
    RESULTS: The majority of the sample, regardless of whether they were US-born or non-US-born, reported being vaccinated (3639/5404, 67.34%). The US-born participants with the highest proportion of COVID-19 vaccination self-identified as White (1431/2753, 51.98%), while the highest proportion of vaccination among non-US-born participants was found among participants who self-identified as Hispanic/Latino (310/886, 34.99%). Comparing US-born and non-US-born participants showed that among those who were not vaccinated, the highest self-reported sociodemographic characteristics by proportion were similar between the groups, and included identifying as a woman, being straight or heterosexual, being aged 18 to 35 years, having an annual household income <$25,000, and being unemployed or taking part in nontraditional work. Among the 32.66% (1765/5404) of participants that reported not being vaccinated, 45.16% (797/1765) stated that they were not at all likely to seek vaccination. Examining US/non-US birth status and the likelihood to be vaccinated for COVID-19 among nonvaccinated participants revealed that the highest proportions of both US-born and non-US-born participants reported being not at all likely to seek vaccination. Non-US-born participants, however, were almost proportionally distributed in their likelihood to seek vaccination; they reported to be \"very to extremely likely\" to vaccinate (112/356, 31.46%); compared to 19.45% (274/1409) of US-born individuals reporting the same.
    CONCLUSIONS: Our study highlights the need to further explore factors that can increase the likelihood of seeking vaccination among underrepresented and hard-to-reach populations, with a particular focus on tailoring interventions for US-born individuals. For instance, non-US-born individuals were most likely to vaccinate when reporting COVID-19 nonvaccination than US-born individuals. These findings will aid in identifying points of intervention for vaccine hesitancy and promoting vaccine adoption during current and future pandemics.
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