technical guidelines

技术准则
  • 文章类型: Journal Article
    人类神经元活动,从微电极体内记录,可以为人类认知的生理机制和脑部疾病的病理生理机制提供有价值的见解,特别是癫痫。连续和长期的记录是必要的,以监测不可预测的病理和生理活动,如癫痫发作或睡眠。由于它们的高阻抗,微电极比宏电极对噪声更敏感。低噪声水平对于从背景噪声中检测动作电位至关重要,并进一步隔离单个神经元的活动。因此,多单位活动的长期记录仍然是一个挑战。我们在这里分享了我们在微电极记录方面的经验,以及我们为降低噪声水平以提高信号质量所做的努力。我们还提供了详细的连接技术指南,录音,微电极记录的成像和信号分析。
    在过去的10年里,我们植入了122束Behnke-Fried混合宏微电极,56例药物耐药局灶性癫痫患者。微束植入颞叶(74%),以及额叶(15%),顶叶(6%)和枕叶(5%)。低噪声水平取决于我们的技术设置。降噪主要是在患者的录音室电绝缘和使用增强的微电极模型后获得的,达到5.8µV的中值均方根值。70%的捆绑包可以记录多单位活动(MUA),每束8根线中大约有3根,平均12天。91%的患者通过微电极记录癫痫发作,当连续记录时,在房间保温后,有75%的患者在癫痫发作期间记录了MUA。提出了技术准则,用于(i)手术绷带和连接到临床和研究放大器期间的电极尾巴操纵和保护,(ii)病人记录室的电绝缘和屏蔽,(iii)数据采集和存储,和(四)单一单位活动分析。
    我们逐步改进了我们的记录设置,现在能够以低噪声水平记录(i)微电极信号,持续时间长达3周,和(ii)来自增加数量的导线的MUA。我们建立了从电极轨迹规划到记录的逐步程序。所有这些微妙的步骤对于连续长期记录单位至关重要,以促进我们对发生的病理生理学以及认知和生理功能的神经元编码的理解。
    Human neuronal activity, recorded in vivo from microelectrodes, may offer valuable insights into physiological mechanisms underlying human cognition and pathophysiological mechanisms of brain diseases, in particular epilepsy. Continuous and long-term recordings are necessary to monitor non predictable pathological and physiological activities like seizures or sleep. Because of their high impedance, microelectrodes are more sensitive to noise than macroelectrodes. Low noise levels are crucial to detect action potentials from background noise, and to further isolate single neuron activities. Therefore, long-term recordings of multi-unit activity remains a challenge. We shared here our experience with microelectrode recordings and our efforts to reduce noise levels in order to improve signal quality. We also provided detailed technical guidelines for the connection, recording, imaging and signal analysis of microelectrode recordings.
    During the last 10 years, we implanted 122 bundles of Behnke-Fried hybrid macro-microelectrodes, in 56 patients with pharmacoresistant focal epilepsy. Microbundles were implanted in the temporal lobe (74%), as well as frontal (15%), parietal (6%) and occipital (5%) lobes. Low noise levels depended on our technical setup. The noise reduction was mainly obtained after electrical insulation of the patient\'s recording room and the use of a reinforced microelectrode model, reaching median root mean square values of 5.8 µV. Seventy percent of the bundles could record multi-units activities (MUA), on around 3 out of 8 wires per bundle and for an average of 12 days. Seizures were recorded by microelectrodes in 91% of patients, when recorded continuously, and MUA were recorded during seizures for 75 % of the patients after the insulation of the room. Technical guidelines are proposed for (i) electrode tails manipulation and protection during surgical bandage and connection to both clinical and research amplifiers, (ii) electrical insulation of the patient\'s recording room and shielding, (iii) data acquisition and storage, and (iv) single-units activities analysis.
    We progressively improved our recording setup and are now able to record (i) microelectrode signals with low noise level up to 3 weeks duration, and (ii) MUA from an increased number of wires . We built a step by step procedure from electrode trajectory planning to recordings. All these delicate steps are essential for continuous long-term recording of units in order to advance in our understanding of both the pathophysiology of ictogenesis and the neuronal coding of cognitive and physiological functions.
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  • 文章类型: Journal Article
    磁共振引导聚焦超声(MRgFUS)是一种完全非侵入性的技术,已被FDA批准用于治疗多种疾病。这份报告,由美国医学物理学家协会(AAPM)任务组241编写,提供了MRgFUS技术的背景,重点是临床机构MRgFUS系统。该报告解决了医学物理学界感兴趣的问题,特定于车身MRgFUS系统配置,并就如何成功实施和维持临床MRgFUS计划提供建议.以下部分描述了典型MRgFUS系统和临床工作流程的关键特征,并为医学物理学家提供了关键点和最佳实践。常用的术语,定义了度量和物理学,并描述了影响MRgFUS程序的不确定性来源。最后,说明了安全和质量保证程序,描述了医学物理学家在MRgFUS程序中的推荐角色,和规划临床试验的监管要求是详细的。尽管本报告的范围仅限于在美国批准或目前正在进行临床试验的临床机构MRgFUS系统,提供的许多材料也适用于为其他应用设计的系统。
    Magnetic resonance-guided focused ultrasound (MRgFUS) is a completely non-invasive technology that has been approved by FDA to treat several diseases. This report, prepared by the American Association of Physicist in Medicine (AAPM) Task Group 241, provides background on MRgFUS technology with a focus on clinical body MRgFUS systems. The report addresses the issues of interest to the medical physics community, specific to the body MRgFUS system configuration, and provides recommendations on how to successfully implement and maintain a clinical MRgFUS program. The following sections describe the key features of typical MRgFUS systems and clinical workflow and provide key points and best practices for the medical physicist. Commonly used terms, metrics and physics are defined and sources of uncertainty that affect MRgFUS procedures are described. Finally, safety and quality assurance procedures are explained, the recommended role of the medical physicist in MRgFUS procedures is described, and regulatory requirements for planning clinical trials are detailed. Although this report is limited in scope to clinical body MRgFUS systems that are approved or currently undergoing clinical trials in the United States, much of the material presented is also applicable to systems designed for other applications.
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  • 文章类型: Journal Article
    Influenza virus infection is a respiratory infectious disease that can seriously affect human health. Influenza viruses can have frequent antigenic variation and changes, which can result in rapid and widespread transmission resulting in annual epidemics and outbreaks in places of public gathering such as schools, kindergartens and nursing homes. According to WHO estimation, seasonal influenza epidemics have caused an annually 3 to 5 million severe cases and 290 000 to 650 000 deaths globally. Pregnant women, young children, the elderly, and persons with chronic illnesses are at high risk for severe illness and death associated with influenza virus infection. Especially, COVID-19 pandemic might co-circulate with other respiratory infectious diseases such as influenza in the coming winter-spring season. Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) which includes split-virus influenza vaccine and subunit vaccine, quadrivalent inactivated influenza vaccine (IIV4) which is split, and trivalent live attenuated influenza vaccine (LAIV3) which was newly licensed. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. In 2018 and 2019, the China CDC issued the \"Technical Guidelines for Seasonal Influenza Vaccination in China\" . In the past year, new research evidences home and abroad have been published, and new seasonal influenza vaccine has been licensed in China. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccination Technical Working Group (TWG), updated the 2019-2020 technical guidelines and compiled the \"Technical guidelines for seasonal influenza vaccination in China (2020-2021)\" . The main updates in this version include the following: First, new research evidences especially studies of China, including disease burden, effectiveness, Vaccine-avoidable disease burden, vaccine safety monitoring, and cost-effectiveness and cost-benefit. Second, policies and measures for influenza prevention and control issued by National Health Commission (PRC) in the past year. Thirdly, new type seasonal influenza vaccine licensed and issued in 2020-2021 in China. Fourth, northern hemisphere influenza vaccination composition for the 2020-2021 season which included trivalent and quadrivalent influenza vaccine. Fifth, Influenza vaccination recommendations for 2020-2021 influenza season. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. Considering the situation of globally pandemic of COVID-19, to decrease the risk of influenza virus infection and minimize the impact on COVID-19 prevention and control, we recommend the following priority for seasonal influenza vaccination: healthcare workers, including clinical doctors and nurses, public health professionals, quarantine professionals; vulnerable groups living in nursing homes or welfare homes and staffs who take care those vulnerable groups; people work or stay in high population density places, such as teachers and students in kindergartens, primary and secondary school, prisoners and staffs of prisons; other high risk group of influenza, including adults ≥60 years of age, children aged 6-59 months, persons with specific chronic diseases, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. People whoever get IIV or LAIV all apply to the principle. If they were vaccinated in 2019-2020 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the CDCs at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels. These guidelines will be updated periodically as new evidence becomes available.
    流感是由流感病毒引起的一种急性呼吸道传染病,严重危害人群健康。流感病毒其抗原性易变,传播迅速,每年可引起季节性流行,在学校、托幼机构和养老院等人群聚集的场所可发生暴发疫情。每年流感季节性流行在全球可导致300万~500万重症病例,29万~65万呼吸道疾病相关死亡。孕妇、婴幼儿、老年人和慢性基础疾病患者等高危人群,患流感后出现严重疾病和死亡的风险较高。尤其是2020年全球新型冠状病毒(新冠)肺炎疫情严重流行态势仍将持续,今冬明春可能会出现新冠肺炎疫情与流感等呼吸道传染病叠加流行的情况。而接种流感疫苗是预防流感的最有效手段,可以减少流感相关疾病带来的危害及对医疗资源的占用。我国现已批准上市的流感疫苗有三价灭活流感疫苗(IIV3)、四价灭活流感疫苗(IIV4)和三价减毒活流感疫苗(LAIV3),IIV3包括裂解疫苗和亚单位疫苗,IIV4为裂解疫苗,LAIV为减毒疫苗。除个别地区外,流感疫苗在我国大多数地区属于非免疫规划类疫苗,实行自愿、自费接种。2018年和2019年,中国CDC均印发了当年度的《中国流感疫苗预防接种技术指南》。一年来,新的研究证据在国内外发表,新的疫苗产品在我国上市,为更好地指导我国流感预防控制和疫苗应用工作,国家免疫规划技术工作组流感疫苗工作组综合国内外最新研究进展,在2019年版指南的基础上进行了更新和修订,形成了《中国流感疫苗预防接种技术指南(2020-2021)》。本指南更新的内容主要包括以下几个方面:第一,增加了新的研究证据,尤其是我国的研究结果,包括流感疾病负担、疫苗效果、疫苗安全性监测、疫苗预防接种成本效果等;第二,更新了一年来国家卫生健康委员会流感防控有关政策和措施;第三,更新了我国2020-2021年度国内批准上市及批签发的流感疫苗种类;第四,更新了本年度IIV3、LAIV3和IIV4流感疫苗组份;第五,更新了2020-2021年度的流感疫苗接种建议。本指南建议:原则上,接种服务单位应为≥6月龄所有愿意接种流感疫苗且无禁忌证的人提供接种服务。对可接种不同类型、厂家疫苗产品的人群,可由受种者自愿选择接种任一种流感疫苗,无优先推荐。结合今年新冠肺炎疫情形势,为尽可能降低流感的危害和对新冠肺炎疫情防控的影响,推荐按照优先顺序对重点和高风险人群进行接种:医务人员,包括临床救治人员、公共卫生人员、卫生检疫人员等;养老机构、长期护理机构、福利院等人群聚集场所脆弱人群及员工;重点场所人群,如托幼机构、中小学校的教师和学生,监所机构的在押人员及工作人员等;其他流感高风险人群,包括≥60岁的居家老年人、6月龄~5岁儿童、慢性病患者、<6月龄婴儿的家庭成员和看护人员以及孕妇或在流感流行季节备孕的女性。首次接种或既往接种<2剂次流感疫苗的6月龄~8岁儿童应接种2剂次,间隔≥4周,对IIV或LAIV均建议上述原则;2019-2020年度或以前接种过≥2剂次流感疫苗的儿童,建议接种1剂次;≥9岁儿童和成人仅需接种1剂次。建议各地在疫苗供应到位后尽快安排接种工作,最好在10月底前完成免疫接种;对10月底前未接种的对象,接种单位在整个流行季节都可以提供接种服务。孕妇在孕期的任一阶段均可接种IIV。本指南适用于从事流感防控相关的各级疾病预防控制机构工作人员,预防接种点的接种人员,各级医疗机构儿科、内科、感染科等医务人员,以及各级妇幼保健机构的专业人员。根据国内外研究进展,本指南今后亦将定期更新、完善。.
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  • 文章类型: Journal Article
    Influenza virus infection is a respiratory infectious disease that can seriously affect human health. Influenza viruses can have frequent antigenic variation and changes, which can result in rapid and widespread transmission resulting in annual epidemics and outbreaks in places of public gathering such as schools, kindergartens and nursing homes. The World Health Organization (WHO) estimated that seasonal influenza epidemics have caused an annual 3 to 5 million severe cases, and 290000 to 650000 deaths globally. Pregnant women, young children, the elderly, and persons with chronic illnesses are at high risk for severe illness and death associated with influenza virus infection. Especially, COVID-19 pandemic might co-circulate with other respiratory infectious diseases such as influenza in the coming winter-spring season. Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) which includes split-virus influenza vaccine and subunit vaccine, quadrivalent inactivated influenza vaccine (IIV4) which is split, and trivalent live attenuated influenza vaccine(LAIV3) which was newly licensed. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. In 2018 and 2019, the Chinese Center for Disease Control and Prevention issued the\"Technical Guidelines for Seasonal Influenza Vaccination in China\". In the past year, new research evidences home and abroad have been published, and new seasonal influenza vaccine has been licensed in China. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccination Technical Working Group (TWG), updated the 2019-2020 technical guidelines and compiled the \"Technical guidelines for seasonal influenza vaccination in China (2020-2021)\". The main updates in this version include the following: First, new research evidences especially studies of China, including disease burden, effectiveness, Vaccine-avoidable disease burden, vaccine safety monitoring, and cost-effectiveness and cost-benefit. Second, policies and measures for influenza prevention and control issued by National Health Commission(PRC)in the past year. Thirdly, new type seasonal influenza vaccine licensed and issued in 2020-2021 in China. Fourth, northern hemisphere influenza vaccination composition for the 2020-2021 season which included trivalent and quadrivalent influenza vaccine. Fifth, Influenza vaccination recommendations for 2020-2021 influenza season. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. Considering the situation of globally pandemic of COVID-19, to decrease the risk of influenza virus infection and minimize the impact on COVID-19 prevention and control, we recommend the following priority for seasonal influenza vaccination: (1) healthcare workers, including clinical doctors and nurses, public health professionals, quarantine professionals; (2) Vulnerable groups living in nursing homes or welfare homes and staffs who take care those vulnerable groups; (3) People in some key places, such as teachers and students in kindergartens, primary and secondary school, prisoners and staffs of prisons; (4) Other high risk group of influenza, including adults ≥60 years of age, children aged 6-59 months, persons with specific chronic diseases, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. People whoever get IIV or LAIV all apply to the principle. If they were vaccinated in 2019-2020 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels. These guidelines will be updated periodically as new evidence becomes available.
    流感是由流感病毒引起的一种急性呼吸道传染病,严重危害人群健康。流感病毒其抗原性易变,传播迅速,每年可引起季节性流行,在学校、托幼机构和养老院等人群聚集的场所可发生暴发疫情。每年流感季节性流行在全球可导致300万~500万重症病例,29万~65万呼吸道疾病相关死亡。孕妇、婴幼儿、老年人和慢性基础疾病患者等高危人群,患流感后出现严重疾病和死亡的风险较高。尤其是今年全球新冠疫情严重流行态势仍将持续,今冬明春可能会出现新冠疫情与流感等呼吸道传染病叠加流行的情况。而接种流感疫苗是预防流感的最有效手段,可以减少流感相关疾病带来的危害及对医疗资源的占用。我国现已批准上市的流感疫苗有三价灭活流感疫苗(IIV3)、四价灭活流感疫苗(IIV4)和三价减毒活流感疫苗(LAIV3),IIV3包括裂解疫苗和亚单位疫苗,IIV4为裂解疫苗,LAIV为减毒疫苗。除个别地区外,流感疫苗在我国大多数地区属于非免疫规划类疫苗,实行自愿、自费接种。2018年和2019年,中国疾病预防控制中心均印发了当年度的《中国流感疫苗预防接种技术指南》。一年来,新的研究证据在国内外发表,新的疫苗产品在我国上市,为更好地指导我国流感预防控制和疫苗应用工作,国家免疫规划技术工作组流感疫苗工作组综合国内外最新研究进展,在2019年版指南的基础上进行了更新和修订,形成了《中国流感疫苗预防接种技术指南(2020—2021)》。本指南更新的内容主要包括以下几个方面:第一,增加了新的研究证据,尤其是我国的研究结果,包括流感疾病负担、疫苗效果、疫苗安全性监测、疫苗预防接种成本效果等;第二,更新了一年来国家卫生健康委员会流感防控有关政策和措施;第三,更新了我国2020—2021年度国内批准上市及批签发的流感疫苗种类;第四,更新了本年度三价和四价流感疫苗组份;第五,更新了2020—2021年度的流感疫苗接种建议。本指南建议:原则上,接种服务单位应为≥6月龄所有愿意接种流感疫苗且无禁忌证的人提供接种服务。对可接种不同类型、厂家疫苗产品的人群,可由受种者自愿选择接种任一种流感疫苗,无优先推荐。结合今年新冠疫情形势,为尽可能降低流感的危害和对新冠疫情防控的影响,推荐按照优先顺序对重点和高风险人群进行接种:(1) 医务人员, 包括临床救治人员、公共卫生人员、卫生检疫人员等;(2) 养老机构、长期护理机构、福利院等人群聚集场所脆弱人群及员工; (3)重点场所人群,如托幼机构、中小学校的教师和学生,监所机构的在押人员及工作人员等; (4)其他流感高风险人群,包括60岁及以上的居家老年人、6月龄~5岁儿童、慢性病患者、6月龄以下婴儿的家庭成员和看护人员以及孕妇或准备在流感流行季节怀孕的女性。首次接种或既往接种2剂次以下流感疫苗的6月龄~8岁儿童应接种2剂次,间隔≥4周,对IIV或LAIV均建议上述原则;2019—2020年度或以前接种过2剂次或以上流感疫苗的儿童,建议接种1剂次;9岁及以上儿童和成人仅需接种1剂次。建议各地在疫苗供应到位后尽快安排接种工作,最好在10月底前完成免疫接种;对10月底前未接种的对象,接种单位在整个流行季节都可以提供接种服务。孕妇在孕期的任一阶段均可接种IIV。本指南适用于从事流感防控相关的各级疾病预防控制机构工作人员,预防接种点的接种人员,各级医疗机构儿科、内科、感染科等医务人员,以及各级妇幼保健机构的专业人员。根据国内外研究进展,本指南今后亦将定期更新、完善。.
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  • 文章类型: Journal Article
    Influenza virus infection is a respiratory infectious disease. The World Health Organization (WHO) estimated that seasonal influenza epidemics have caused an annual 3 to 5 million severe cases, and 290 000 to 650 000 deaths globally. Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4). In 2018, the Chinese Center for Disease Control and Prevention issued the \"Technical Guidelines for Seasonal Influenza Vaccination in China (2018-2019)\" ( \"Guide 2018\" for short). To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccination Technical Working Group (TWG), updated the 2018 technical guidelines and compiled the \"Technical guidelines for seasonal influenza vaccination in China (2019-2020)\" . The main updates in this version include the following: First, new research evidences especially studies of China, including disease burden, effectiveness, Vaccine-avoidable disease burden, vaccine safety monitoring, and cost-effectiveness and cost-benefit. Second, policies and measures for influenza prevention and control issued by National Health Commission (PRC) in the past year. Thirdly, new type seasonal influenza vaccine licensed and issued in 2019-2020 in China. Fourth, northern hemisphere influenza vaccination composition for the 2019-2020 season which included trivalent and quadrivalent influenza vaccine. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2018-2019 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels. These guidelines will be updated periodically as new evidence becomes available.
    流感是由流感病毒引起的一种急性呼吸道传染病,每年流感季节性流行在全球可导致300万至500万重症病例,29万至65万呼吸道疾病相关死亡。接种流感疫苗是预防流感病毒感染及其严重并发症的最有效手段。我国现已批准上市的流感疫苗有三价灭活流感疫苗(IIV3)和四价灭活流感疫苗(IIV4)。2018年,中国疾病预防控制中心印发了《中国流感疫苗预防接种技术指南(2018—2019)》(简称\"2018年版指南\")。为更好地指导我国流感预防控制和疫苗应用工作,国家免疫规划技术工作组流感疫苗工作组综合国内外最新研究进展,在2018年版指南的基础上进行了更新和修订,形成了《中国流感疫苗预防接种技术指南(2019—2020)》。本指南更新的内容主要为:第一,增加了新的研究证据,尤其是我国的研究结果,包括流感疾病负担、疫苗效果、接种疫苗可避免的疾病负担、疫苗安全性监测、疫苗预防接种成本效果等;第二,增加了一年来国家卫生健康委员会流感防控有关政策和措施;第三,更新了我国2019—2020年度国内批准上市及批签发的流感疫苗种类;第四,更新了本年度IIV3和IIV4组分。本指南建议:原则上,接种服务单位应为≥6月龄所有愿意接种流感疫苗且无禁忌证的人提供接种服务。对可接种不同类型、厂家疫苗产品的人群,可由受种者自愿选择接种任一种流感疫苗,无优先推荐。为降低高危人群罹患流感及感染后发生严重临床结局的风险,指南推荐6月龄至5岁儿童,60岁及以上老人,慢性病患者,医务人员,6月龄以下婴儿的家庭成员和看护人员,以及孕妇或准备在流感季节怀孕的女性为优先接种对象。首次接种流感疫苗的6月龄至8岁儿童应接种两剂次,间隔≥4周;2018—2019年度或以前接种过1剂及以上流感疫苗的儿童,建议接种1剂。9岁及以上儿童和成人仅需接种1剂。建议各地在疫苗供应到位后尽快安排接种工作,最好在10月底前完成免疫接种;对10月底前未接种的对象,整个流行季节都可以提供接种服务。孕妇在孕期的任一阶段均可接种流感疫苗。本指南适用于从事流感防控相关的各级疾病预防控制机构工作人员,预防接种点的接种人员,各级医疗机构儿科、内科、感染科等医务人员,以及各级妇幼保健机构的专业人员。根据国内外研究进展,本指南今后亦将定期更新、完善。.
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  • 文章类型: Journal Article
    The main focus of the presented study is a multi-variant accuracy assessment of a photogrammetric 2D and 3D data collection, whose accuracy meets the appropriate technical requirements, based on the block of 858 digital images (4.6 cm ground sample distance) acquired by Trimble® UX5 unmanned aircraft system equipped with Sony NEX-5T compact system camera. All 1418 well-defined ground control and check points were a posteriori measured applying Global Navigation Satellite Systems (GNSS) using the real-time network method. High accuracy of photogrammetric products was obtained by the computations performed according to the proposed methodology, which assumes multi-variant images processing and extended error analysis. The detection of blurred images was preprocessed applying Laplacian operator and Fourier transform implemented in Python using the Open Source Computer Vision library. The data collection was performed in Pix4Dmapper suite supported by additional software: in the bundle block adjustment (results verified using RealityCapure and PhotoScan applications), on the digital surface model (CloudCompare), and georeferenced orthomosaic in GeoTIFF format (AutoCAD Civil 3D). The study proved the high accuracy and significant statistical reliability of unmanned aerial vehicle (UAV) imaging 2D and 3D surveys. The accuracy fulfills Polish and US technical requirements of planimetric and vertical accuracy (root mean square error less than or equal to 0.10 m and 0.05 m).
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  • 文章类型: Journal Article
    Human adenovirus (HAdV) is one of the common pathogens causing human respiratory infections and HAdV infection can result in a variety of diseases. In recent years, outbreaks of HAdV infection have been detected from time to time in China and clustered severe cases have been reported in some regions. This technical guideline has been timely developed to provide technical support on the control and prevention of HAdV respiratory infections. It provides an overview of etiology, epidemiology, clinical manifestations, and treatment principles of HAdV infection, determines the definitions of laboratory-confirmed cases, clinically diagnosed cases, severe and critically severe HAdV pneumonia cases. Then the workflow of case detecting and reporting, and the outbreak epidemic disposal has been formulated. Finally, the control and prevention measures in places at high risk for HAdV transmission and individual preventive measures also has been introduced.
    人腺病毒是人呼吸道感染常见的病原体之一,其感染可引起多种疾病。近年来,我国不断出现由人腺病毒引起的呼吸道感染暴发疫情,个别地区报告聚集性的重症病例。为指导各地做好人腺病毒呼吸道感染的预防控制工作,制定本指南供参照使用。本指南从病原学、流行病学、临床表现及治疗原则等方面对人腺病毒感染进行了概述,确定了实验室确诊病例、临床诊断病例、重症与危重症人腺病毒肺炎病例的定义,规范了病例发现与报告、暴发疫情处置工作流程,梳理了重点场所预防控制措施和个体预防措施。.
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  • 文章类型: Comparative Study
    The European Society of Gastrointestinal Endoscopy (ESGE) has recently issued a technical review focused on small bowel capsule endoscopy (SBCE).
    To compare SBCE current practice in Italy to ESGE technical recommendations.
    A dedicated per-centre semi-quantitative questionnaire was prepared by a group of SBCE experts. One-hundred-fifty Centres were invited to participate in the data collection concerning SBCEs performed between June 2016 and June 2017. Data were compared with ESGE recommendations.
    120 Centres participated in the data collection. Current practices agreed with ESGE recommendations in 56.3% (9/16) of the issues evaluated. Differences between ESGE recommendations and current practice concerned the management of patients with pacemakers or cardiac implantable defibrillators (which was in agreement with ESGE recommendations in 31.7% and 15.8% of Centres, respectively), the SBCE setting (only 51% of SBCEs were performed as outpatients procedures), the assessment of capsule excretion (timing and modality were in agreement with ESGE recommendation in 20.0% of Centres), and in the involvement of trained nurses or fellows in training as pre-readers (7/120; 5.8%).
    Although SBCE is widely used and largely available in Italy, there are still some technical, practical and organizational issues that can be modified to bridge the gap between current practice and ESGE guideline recommendations.
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  • 文章类型: Journal Article
    由于使用了许多具有可变性能的方法,弓形虫病的分子诊断缺乏标准化。这种方法的多样性也削弱了实验室之间稳健的性能比较。通过传播技术准则来协调实践是改善这些性能的有用方法。用于这种分子诊断的方法和实践的知识是提供弓形虫PCR指南的重要步骤。在本研究中,我们的目的是(i)描述法国临床微生物学实验室使用的弓形虫-PCR方法和实践;(ii)提出技术指南,以改善弓形虫病的分子诊断.要做到这一点,从2008年至2015年,我们在熟练的法国实验室进行了一项基于问卷调查的年度自我管理式调查,并根据这些调查和以前发表的研究结果提出了指南.这一时期逐渐放弃了传统的PCR方法,针对B1基因的弓形虫PCR以及使用两种伴随的分子方法进行诊断。在研究期间,实践的多样性仍然存在,尽管越来越多地使用商业试剂盒,如PCR试剂盒,DNA提取对照和PCR抑制对照。我们还观察到DNA提取自动化的趋势。实践的演变并不总是伴随着这些方面的改进,据报道,尿嘧啶-DNA糖基化酶的使用正在减少,以避免残留污染。我们在这里提出与调查期间探讨的项目相对应的技术建议,关于DNA提取,弓形虫PCR和良好的PCR实践。
    The molecular diagnosis of toxoplasmosis lacks standardisation due to the use of numerous methods with variable performance. This diversity of methods also impairs robust performance comparisons between laboratories. The harmonisation of practices by diffusion of technical guidelines is a useful way to improve these performances. The knowledge of methods and practices used for this molecular diagnosis is an essential step to provide guidelines for Toxoplasma-PCR. In the present study, we aimed (i) to describe the methods and practices of Toxoplasma-PCR used by clinical microbiology laboratories in France and (ii) to propose technical guidelines to improve molecular diagnosis of toxoplasmosis. To do so, a yearly self-administered questionnaire-based survey was undertaken in proficient French laboratories from 2008 to 2015, and guidelines were proposed based on the results of those as well as previously published work. This period saw the progressive abandonment of conventional PCR methods, of Toxoplasma-PCR targeting the B1 gene and of the use of two concomitant molecular methods for this diagnosis. The diversity of practices persisted during the study, in spite of the increasing use of commercial kits such as PCR kits, DNA extraction controls and PCR inhibition controls. We also observed a tendency towards the automation of DNA extraction. The evolution of practices did not always go together with an improvement in those, as reported notably by the declining use of Uracil-DNA Glycosylase to avoid carry-over contamination. We here propose technical recommendations which correspond to items explored during the survey, with respect to DNA extraction, Toxoplasma-PCR and good PCR practices.
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  • 文章类型: Journal Article
    这篇评论的重点是使病虫害综合管理(IPM)的原始概念适应欧洲实施的综合水果生产(IFP)的更广泛概念的过程。尽管大多数害虫管理策略仍然依赖于使用合成农药,现在有各种各样的创新和环保工具可以替代现代苹果生产系统中的农药。我们还强调了最近的虫害管理策略和工具如何为IPM改进研究创造了机会,包括使用生物杀虫剂,化学信息素和生物防治。预测模型,还开发了新的树木训练系统和创新的喷雾设备,以提高治疗覆盖率,减轻农药漂移和减少水果上的化学残留物。还审查了危害有效实施IPM的可能威胁,特别是与农药抗性的发展和新的入侵性害虫的引入有关的风险。根据第128/09号指令,欧洲立法将IPM视为可持续使用农药的战略方法。在此背景下,IPM和相关指南被称为满足与工人和旁观者安全有关的不同领域的关注。除了以市场为导向的农业的传统经济标准,可持续农业包括评估农艺实践在其发生的社会背景下对环境的影响。由于消费者对水果生产产生的环境影响的担忧,IFP认证超过产品标准,包括过程方面,是消费者和连锁超市经常需要的。
    This review focuses on the process of adapting the original concept of Integrated Pest Management (IPM) to the wider conception of the Integrated Fruit Production (IFP) implemented in Europe. Even though most of the pest management strategies still rely on the use of synthetic pesticides, a wide array of innovative and environmentally friendly tools are now available as possible alternative to the pesticides within the modern apple production system. We also highlight how recent pest management strategies and tools have created an opening for research towards IPM improvement, including the use of biorational pesticides, semiochemicals and biological control. Forecasting models, new tree training systems and innovative spray equipment have also been developed to improve treatment coverage, to mitigate pesticide drift and to reduce chemical residues on fruits. The possible threats that jeopardize the effective implementation of IPM and particularly the risks related to the development of the pesticide resistance and the introduction of new invasive pests are also reviewed. With the directive 128/09, the European legislation recognizes IPM as a strategic approach for the sustainable use of pesticides. Within this context, IPM and related guidelines is called to meet different areas of concern in relation to the worker and bystander safety. Beside the traditional economic criteria of the market-oriented agriculture, sustainable agriculture includes the assessment of the environmental impact of the agronomic practices within the societal context where they take place. As a consequence of the raising consumer concerns about environmental impacts generated by the fruit production, IFP certification over product standards, including process aspects, are frequently required by consumers and supermarket chains.
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