PRA

PRA
  • 文章类型: Journal Article
    基于2018年世界结核病(TB)日的主题-“希望无结核病世界的领导人,“各种研究和国家一级的项目见证了结核病培训领导人如何帮助提高社区对结核病的认识。本研究旨在通过主要社区领导人评估倡导沟通和社会动员(ACSM)干预策略的有效性。使用Reach,有效性,收养,实施,维护(RE-AIM)框架。
    本研究由社区医学部进行,SriManakulaVinayagar医学院和医院(SMVMCH),Puducherry,在初级保健中心(PHC)的实地实践领域,Thirubuvanai.STOPTB,ENGAGE-TB,和国家结核病消除计划(NTEP)指南用于干预措施。主要社区领导人(KCL)列表(N=117)是从Mannadipet公社panchayat和PHC获得的。该研究分四个阶段进行:第一阶段(基线):定量数据:来自通知登记册的推定结核病病例比例;第二阶段(干预):员工护士培训计划,辅助护士助产士(ANM),认可的社会健康活动家(ASHA),和Anganwadi工人(小组活动),自助小组(SHG)领导人参与式农村评估(PRA)活动,为宗教领袖和前panchayat领袖举行的健康教育会议;第3阶段:加强正在进行的活动:健康教育会议和结核病的积极病例发现;第4阶段:终点线:干预的结果,使用RE-AIM框架进行评估。
    作为干预的结果,与干预前(2018年)和干预后(2019年)相比,结核病推定病例比例略有增加(21例).KCL确定和转介的推定结核病病例比例为312。通过基于社区的主动病例发现(ACF),总共确定了77例推定结核病病例。收集两个痰样本(在清晨)并送去进行基于Cartridge的核酸扩增测试(CBNAAT),其中三例为阳性。
    这项研究是由社区领导的,涉及来自不同背景的领导者,优化成功的机会。为了可持续性,我们已经启动了结核病支持小组。
    UNASSIGNED: Based on the theme of World Tuberculosis (TB) Day 2018-\"Wanted Leaders for TB free world,\" various studies and country-level project have witnessed how training leaders on TB has helped enhance TB awareness in the community. This study was conducted to evaluate the effectiveness of Advocacy Communication and Social Mobilization (ACSM) intervention strategy through key community leaders, using Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.
    UNASSIGNED: This study was undertaken by the Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), Puducherry, in the field practice area of Primary Health Centre (PHC), Thirubuvanai. The STOP TB, ENGAGE-TB, and National TB Elimination Program (NTEP) guidelines were used for interventions. Key community leaders (KCL) list (N = 117) was obtained from Mannadipet commune panchayat and PHC. The study was conducted in four phases: phase 1 (baseline): quantitative data: proportion of presumptive TB cases from notification register; phase 2 (intervention): training program for staff nurses, auxiliary nurse midwife (ANM), Accredited Social Health Activist (ASHA), and Anganwadi workers (group activity), participatory rural appraisal (PRA) activity for self-help group (SHG) leaders, and health education session for religious leaders and ex-panchayat leaders; phase 3: strengthening of ongoing activity: health education session and active case finding for TB; and phase 4: end line: outcome of the intervention, evaluated using the RE-AIM framework.
    UNASSIGNED: As an outcome of the intervention, there was a marginal increase (21 cases) in the proportion of presumptive TB cases when comparing before (2018) and after (2019) intervention. The proportion of presumptive TB cases identified and referred by KCL was 312. A total of 77 presumptive TB cases were identified through community-based active case finding (ACF). Two sputum samples (on the spot early morning) were collected and sent for Cartridge-based nucleic acid amplification testing (CBNAAT), of which three cases were positive.
    UNASSIGNED: This study was community led and involved leaders from diverse backgrounds, optimizing the chance of success. For sustainability, we have initiated TB support group.
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  • 文章类型: Journal Article
    背景:赛迪绵羊是上埃及最丰富的反刍动物,尤其是在阿西特省。绵羊是埃及最丰富的动物之一。除了生产纤维和皮革外,他们还可以将低质量的粗粮转化为肉和牛奶。存在增强其繁殖的巨大机会。赛迪品种在繁殖方面鲜为人知。所以这项工作是为了提供更多关于荷尔蒙的信息,氧化,和血液代谢物参数,除了组织学,动情周期卵泡期卵巢的组织化学和免疫组织化学研究。本研究对25只健康的赛迪母羊进行血清分析,10只健康的母羊进行组织学评估,年龄为2至5岁,体重为38.5±2.03kg。
    结果:赛迪绵羊发情周期的卵泡期除了黄体退化外,还存在不同发育阶段的卵巢卵泡和闭锁。有趣的是,细胞凋亡和组织氧化标记在卵泡和黄体消退中起着至关重要的作用。卵泡期最突出的特征是存在成熟的窦(Graafian)和排卵前卵泡,以及某些血液代谢物和氧化标记物的水平升高。在这里,我们给出了赛迪绵羊卵巢卵泡的新示意图序列,并描述了不同类型的特征。我们还澄清了这些卵巢的组织学图片受荷尔蒙的影响,氧化和血液代谢因子表征赛迪绵羊发情周期的卵泡期。
    结论:这项工作有助于了解赛迪绵羊的繁殖,这有助于改善该绵羊品种的繁殖结果。这些发现对于实施遗传改良计划和利用先进的生殖技术作为发情同步越来越重要,人工授精和胚胎移植。
    BACKGROUND: Saidi sheep are the most abundant ruminant livestock species in Upper Egypt, especially in the Assiut governorate. Sheep are one of the most abundant animals raised for food in Egypt. They can convert low-quality roughages into meat and milk in addition to producing fiber and hides therefore; great opportunity exists to enhance their reproduction. Saidi breed is poorly known in terms of reproduction. So this work was done to give more information on some hormonal, oxidative, and blood metabolites parameters in addition to histological, histochemical and immunohistochemical investigations of the ovary during follicular phase of estrous cycle. The present study was conducted on 25 healthy Saidi ewes for serum analysis and 10 healthy ewes for histological assessment aged 2 to 5 years and weighted (38.5 ± 2.03 kg).
    RESULTS: The follicular phase of estrous cycle in Saidi sheep was characterized by the presence of ovarian follicles in different stages of development and atresia in addition to regressed corpus luteum. Interestingly, apoptosis and tissue oxidative markers play a crucial role in follicular and corpus luteum regression. The most prominent features of the follicular phase were the presence of mature antral (Graafian) and preovulatory follicles as well as increased level of some blood metabolites and oxidative markers. Here we give a new schematic sequence of ovarian follicles in Saidi sheep and describing the features of different types. We also clarified that these histological pictures of the ovary was influenced by hormonal, oxidative and blood metabolites factors that characterizes the follicular phase of estrous cycle in Saidi sheep.
    CONCLUSIONS: This work helps to understanding the reproduction in Saidi sheep which assist in improving the reproductive outcome of this breed of sheep. These findings are increasingly important for implementation of a genetic improvement program and utilizing the advanced reproductive techniques as estrous synchronization, artificial insemination and embryo transfer.
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  • 文章类型: Journal Article
    这项研究的目的是评估在他克莫司和基于霉酚酸酯衍生物的维持治疗时代,轻度至中度免疫风险肾脏移植中不同诱导疗法的结果。
    这是一项回顾性队列研究,使用来自美国器官采购和移植网络的数据,在轻度至中度免疫风险的活体供者中,定义为首次移植和小组反应性抗体低于20%,但具有两个HLA-DR错配。根据胸腺球蛋白或巴利昔单抗的诱导治疗,将KTRs分为两组。仪器变量回归模型用于评估诱导治疗对急性排斥反应的影响。血清肌酐水平和移植物存活。
    在整个队列中,788例患者接受了巴利昔单抗,而1727例患者接受了胸腺球蛋白诱导。在移植后一年的急性排斥反应中,巴利昔单抗与胸腺球蛋白诱导之间没有显着差异(系数=-0.229,p值=0.106),移植后一年的血清肌酐水平(系数=-0.024,p值=.128)或死亡审查的移植物存活率(系数:-<0.001,p值=.201)。
    这项研究表明,在轻度至中度免疫风险活体供者KTRs中使用胸腺球蛋白或巴利昔单抗时,急性排斥反应发作或移植物存活没有显着差异,维持他克莫司和霉酚酸酯为基础的免疫抑制方案。
    The aim of this study is to assess the outcomes of different induction therapies among mild to moderate immunological risk kidney transplants in the era tacrolimus and mycophenolate-derivate based maintenance.
    This was a retrospective cohort study using data from the United States Organ Procurement and Transplantation Network among mild to moderate immunological risk living-donor KTRs, defined as having first transplant and panel reactive antibodies less than 20% but with two HLA-DR mismatches. KTRs were divided into two groups based on induction therapy with either thymoglobulin or basiliximab. Instrumental variable regression models were used to assess the effect of induction therapy on acute rejection episodes, serum creatinine levels and graft survival.
    Of the entire cohort, 788 patients received basiliximab while 1727 patients received thymoglobulin induction. There were no significant differences between basiliximab versus thymoglobulin induction in acute rejection episodes at one-year post-transplant (coefficient= -0.229, p value = .106), serum creatinine levels at one-year post-transplant (coefficient= -0.024, p value = .128) or death-censored graft survival (coefficient: - <0.001, p value = .201).
    This study showed no significant difference in acute rejection episodes or graft survival when using thymoglobulin or basiliximab in mild to moderate immunological risk living donor KTRs, maintained on tacrolimus and mycophenolate-based immunosuppressive regimen.
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  • 文章类型: Journal Article
    2003年和2004年,Aotearoa新西兰颁布了两项关键法律,规范了两种截然不同的女性身体商品化方式。2003年《卖淫改革法》(PRA)将卖淫合法化,消除买卖商业性服务的法律障碍。2004年人类辅助生殖技术法案(HART法案)另一方面,禁止商业代孕协议。本文对新西兰针对卖淫和商业代孕的立法解决方案所依据的伦理论点进行了比较分析。虽然以马克思主义女权主义的视角对待卖淫的监管,目的是确保性工作者的健康和安全,商业代孕被禁止,因为担心对现在和未来的人产生负面影响。我将每个法案的原则都建立在其道德基础上,并将两者相互比较。我得出的结论是,新西兰规范女性身体商品化的立法方法在道德上是不一致的。
    In 2003 and 2004, Aotearoa New Zealand enacted two key laws that regulate two very different ways in which the female body may be commodified. The Prostitution Reform Act 2003 (PRA) decriminalized prostitution, removing legal barriers to the buying and selling of commercial sexual services. The Human Assisted Reproductive Technology Act 2004 (HART Act), on the other hand, put a prohibition on commercial surrogacy agreements. This paper undertakes a comparative analysis of the ethical arguments underlying New Zealand\'s legislative solutions to prostitution and commercial surrogacy. While the regulation of prostitution is approached with a Marxist feminist lens with the aim to ensure the health and safety of sex workers, commercial surrogacy is prohibited outright for concerns of negative impacts on present and future persons. I ground the principles of each Act in their ethical foundations and compare these two against one another. I conclude that New Zealand\'s legislative approach to regulating the commodification of the female body is ethically inconsistent.
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  • 文章类型: Journal Article
    背景和目的:移植前后检测抗人白细胞抗原(HLA)抗体对肺移植的成功具有重要意义。这项研究的目的是评估接受资格鉴定和移植的肺移植前后患者的抗HLA免疫。材料和方法:移植前,检查患者是否存在IgG类抗HLA抗体(抗人白细胞抗原),所谓的群体反应性抗体(PRA),使用流式细胞术方法。移植后,使用Luminex测定抗HLA抗体(也称为IgG)的类别和特异性.结果:在被检查的组中,PRA结果范围为0.1%至66.4%.在所检查的组中,只有9.7%的人发现了低(30%)和平均(30-80%)的免疫接种。在42.7%的患者中发现MFI(平均荧光强度)大于1000的I类抗HLA抗体。而发现II类抗HLA抗体的比例为38.4%。比较移植前后的免疫水平。在10.87%的患者中,发现了MFI超过1000的DSA抗体(供体特异性抗体)。结论:通过增加研究组的规模并进行长期观察,使用两种提出的确定IgG类抗HLA抗体的方法,似乎有可能证实移植前和移植后免疫之间的相关性。
    Background and Objectives: Testing for anti-human leukocyte antigen (HLA) antibodies both before and after transplantation is of fundamental significance for the success of lung transplantation. The aim of this study was the evaluation of anti-HLA immunization of patients before and after lung transplant who were subjected to qualification and transplantation. Materials and Methods: Prior to the transplantation, patients were examined for the presence of IgG class anti-HLA antibodies (anti-human leukocyte antigen), the so-called panel-reactive antibodies (PRA), using the flow cytometry method. After the transplantation, the class and specificity of anti-HLA antibodies (also IgG) were determined using Luminex. Results: In the group examined, the PRA results ranged from 0.1% to 66.4%. Low (30%) and average (30-80%) immunization was found in only 9.7% of the group examined. Presence of class I anti-HLA antibodies with MFI (mean fluorescence intensity) greater than 1000 was found in 42.7% of the patients examined, while class II anti-HLA antibodies were found in 38.4%. Immunization levels before and after the transplantation were compared. In 10.87% of patients, DSA antibodies (donor-specific antibodies) with MFI of over 1000 were found. Conclusions: It seems that it is possible to confirm the correlation between pre- and post-transplantation immunization with the use of the two presented methods of determining IgG class anti-HLA antibodies by increasing the size of the group studied and conducting a long-term observation thereof.
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  • 文章类型: Journal Article
    未经评估:在医疗管理和外科思维方面的机动性将患者作为一个整体是重点,而不仅仅是疾病。为了优化我们机构对儿科移植患者的治疗,我们在2013年改变了移植计划的设置,治疗,并在儿科环境中操作所有儿科移植患者。这项研究的目的是分析这种变化是否对患者安全有影响。患者群体,以及患者和移植结果。
    未经评估:在回顾性分析中,我们比较了两个时期的移植结果。Era1(2008-2012)仅包括在成人设施接受治疗的患者,第2时代(2013-2017年)患者仅在儿科环境中接受治疗.
    未经授权:有53例肾移植患者,1时代(28例)和2时代(25例)。总死亡率为5.6%。移植时的中位受体年龄在1时代为13.2岁,在2时代为8.59岁,移植时的中位受体体重在1时代为41.7kg。26kg,2时代中位数大小149。5厘米(1时代)与123厘米在era2(p=0.05)。直接接受者/供体重量比在两个时期保持稳定,对于20公斤以下的接受者,我们在1时代看到了更大的体重不匹配(0.84vs.0.66)。在患有先天性肾脏和泌尿道异常(CAKUT)的患者亚组中,透析开始时(p<0.001)和移植时(p<0.001)明显年轻,他们的体重也较少(p<0.01),和体型(p<0.001),这个亚组在2时代更大。HLA不匹配数据,血清肌酐,和GFR在两组中产生相当的结果。DSA检测的中位时间为46.2个月(3.8年)。
    UNASSIGNED:由于在移植时患有ESRD的儿童有更年轻和更小的趋势,确保医疗环境能够应对他们的特殊挑战至关重要。即使在这个接受者群体中,我们的数据概述了肾移植可以安全地进行.
    UNASSIGNED: Frameshift in medical management as well as in surgical thinking is putting the patient as a whole is the focus, rather than just the disease. To optimize the treatment of our pediatric transplant patients in our institution, we changed in 2013 the transplant program setting, treating, and operating all patients with pediatric transplant exclusively in a pediatric environment. The aim of this study was to analyze whether or not this change had an impact on patients safety, patient population, and patients and transplant outcome.
    UNASSIGNED: In the retrospective analysis, we compared transplant outcome of two eras. Era1 (2008-2012) solely included patients treated in the adult facilities, era 2 (2013-2017) patients were exclusively treated in the pediatric environment.
    UNASSIGNED: There were 53 patients with renal transplant, with era 1 (28 patients) and era 2 (25 patients). Overall mortality was 5.6%. Median recipient age at transplantation was 13.2 years in era 1 and 8.59 years in era 2, median recipient weight at transplantation was 41.7 kg in era 1 vs. 26 kg in era 2, median size 149. 5 cm (era 1) vs. 123 cm in era2 (p = 0.05). The direct recipient/donor weight ratio remained stable in both eras, for recipients below 20 kg we saw a larger weight mismatch in era 1 (0.84 vs. 0.66). In the subgroup of patients with congenital anomalies of the kidney and urinary tract (CAKUT) those were significantly younger at onset of dialysis (p < 0.001) and at time of transplantation (p < 0.001), also they were less in body weight (p < 0.01), and body size (p < 0.001), this subgroup was larger in era 2. HLA mismatch data, serum creatinine, and GFR yield comparable results in both groups. Median time to detection of DSA was 46.2 month (3.8 years).
    UNASSIGNED: Since children with ESRD at the time of transplant trend to be younger and smaller, it is crucial to ensure a medical environment that is able to address their particular challenges. Even in this recipient cohort, renal transplantation can be performed safely as outlined by our data.
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  • 文章类型: Journal Article
    本文报道了通过熔融淬火技术制备的1.0mol%Er3/2.0mol%Yb3掺杂/共掺杂玻璃的光吸收和上转换(UC)研究。已分别从XPS和XRF分析确认了所制备的玻璃的元素和组成。Judd-Ofelt强度参数已使用吸收光谱进行了计算,并进一步用于预测Er_O键的性质,过渡概率,分支比和辐射寿命。TheCIE研究显示了非颜色可调和高纯度的绿色发射(94.2%)。已在三种不同的泵浦功率密度下记录了2.0mol%Yb3敏化玻璃的温度依赖性UC发射光谱,以建立可靠的基于FIR的温度标度。此外,温度相关光谱的Arrhenius拟合揭示了共掺杂玻璃中绿色发光的低热猝灭。
    The present article reports the optical absorption and upconversion (UC) studies of 1.0 mol% Er3+/2.0 mol% Yb3+doped/codoped glasses prepared by melt-quenching technique. The elements present and the composition of the prepared glass have been confirmed from XPS and XRF analysis respectively. Judd-Ofelt intensity parameters have been calculated using the absorption spectrum which is further utilized to predict the nature of Er_O bond, the transition probabilities, branching ratios and radiative lifetimes. The CIE study shows non-colour tunable and highly pure green emission (94.2%). The temperature-dependent UC emission spectra of the 2.0 mol% Yb3+sensitized glass have been recorded at three different pump power densities to establish a reliable FIR based temperature scale. Furthermore, the Arrhenius fitting of the temperature-dependent spectra reveals low thermal quenching of green luminescence in the codoped glass.
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  • 文章类型: Journal Article
    Management of immunosuppression in a kidney transplant recipient with a failed allograft is complex; continuation carries infectious and metabolic risks, and discontinuation can lead to sensitization.
    We evaluated risk factors for sensitization in 89 kidney or simultaneous kidney-pancreas recipients, whose kidney transplant failed after January, 2013 and who were subsequently re-evaluated for kidney transplantation.
    Among recipients with pre graft failure cPRA < 50%, calcineurin inhibitor (CNI) continuation (OR .11, P = .003) and steroid continuation (OR .17, P = .04) were associated with significantly lower odds of developing an absolute increase in cPRA of ≥50%. Each additional HLA mismatch was associated with OR of 2.16 (P = .02). CNI use was associated with OR of .09 (P = .001) for increase in cPRA to ≥80% if pre graft failure cPRA was <50%, and OR of .08 (P = .02) for increase in cPRA to ≥98% if pre graft cPRA was <80%. Anti-metabolites were continued more often among recipients who had a <50% increase (P = .006); however, the association was lost on multivariate analyses. Weaning off immunosuppression and higher number of HLA mismatches are associated with greater likelihood of sensitization.
    While both CNI and steroid continuation conferred some protection against increase in cPRA, CNI continuation was the only factor protecting against becoming highly sensitized.
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  • 文章类型: Journal Article
    Canine progressive retinal atrophy (PRA) describes a group of hereditary diseases characterized by photoreceptor cell death in the retina, leading to visual impairment. Despite the identification of multiple PRA-causing variants, extensive heterogeneity of PRA is observed across and within dog breeds, with many still genetically unsolved. This study sought to elucidate the causal variant for a distinct form of PRA in the Shetland sheepdog, using a whole-genome sequencing approach. Filtering variants from a single PRA-affected Shetland sheepdog genome compared to 176 genomes of other breeds identified a single nucleotide variant in exon 11 of the Bardet-Biedl syndrome-2 gene (BBS2) (c.1222G>C; p.Ala408Pro). Genotyping 1386 canids of 155 dog breeds, 15 cross breeds and 8 wolves indicated the c.1222G>C variant was only segregated within Shetland sheepdogs. Out of 505 Shetland sheepdogs, seven were homozygous for the variant. Clinical history and photographs for three homozygotes indicated the presence of a novel phenotype. In addition to PRA, additional clinical features in homozygous dogs support the discovery of a novel syndromic PRA in the breed. The development and utilization of a diagnostic DNA test aim to prevent the mutation from becoming more prevalent in the breed.
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  • 文章类型: Journal Article
    UNASSIGNED: Progressive retinal atrophy (PRA) is one of the main causes of blindness in dogs. Despite its clinical importance, there is limited epidemiological information available, particularly in South America.
    UNASSIGNED: The main objective of this study was to perform a retrospective, and prospective analysis of PRA in dogs admitted at the Veterinary Hospital of the Federal University of Paraná, Brazil.
    UNASSIGNED: Medical records of dogs admitted between 2014 and 2018 were selected through the archives of the Comparative Ophthalmology Laboratory. A total of 130 dogs with medical records indicating clinical signs suggestive of PRA, independent of the electroretinography confirmation, were selected. In order to investigate common characteristics, each patient\'s clinical history, ophthalmic examination, and visual status were reviewed (obstacle course, pupillary light reflex, dazzle reflex, visual tracking to a cotton ball, and menace responses). Additionally, a prospective study was performed, where flash electroretinography was performed on 30 animals with clinical signs suggestive of PRA, and 14 animals were selected for fundus photography. Data were assessed through descriptive and inferential statistics.
    UNASSIGNED: A total of 2,055 dogs were evaluated between January 2014 and December 2018. Of those, 130 animals were presumptively diagnosed with PRA (6.33%), consisting of 18 different breeds and 27 dogs with a mixed pedigree. Poodles were the most prevalent breed (n = 26; 20.00%), followed by Cocker Spaniels (n = 19; 14.62%). In the reported caseload, Pomeranians showed a considerably higher odds ratio for PRA development (15.36%).
    UNASSIGNED: Pomeranians presented a high odds ratio, suggesting that further studies may be performed with breeds with a high potential for developing this disease.
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