上海和苏州两地男男性行为者HIV自我检测行为、检测模式及影响因素研究

  目的  评估上海和苏州两地MSM的HIV自我检测行为、检测模式及影响因素。  方法  2021年2-5月间通过社交软件招募上海市、苏州市两地≥18岁且未被诊断为HIV/AIDS的MSM开展网络问卷现况调查,用频率描述自检行为及检测模式,用χ2检验和Logistic回归分析模型分析影响因素。  结果  759名研究对象中,542例有HIV自检史,占比71.4%。其中148例报告既往自检出现过阳性结果,140人经复测确认为假阳性。检测模式包括不检测、传统检测和自检/自检+传统检测三种,各占20.6%、10.0%、69.4%。与含自检模式相比,长居苏州(OR=1.85, 95% CI:1.08~3.17)、性角色插入方(OR=0.34, 95% CI:0.14~0.80)、近1年性伴数2~4人(OR=0.51, 95% CI:0.32~0.81)或5~9人(OR=0.31, 95% CI:0.14~0.68)、线下(OR=0.44, 95% CI:0.23~0.86)或“线下+线上”(OR=0.51, 95% CI:0.31~0.84)寻找性伴、近1年使用毒品/兴奋剂(OR=0.54, 95% CI:0.36~0.83)、有性病史(OR=0.41, 95% CI:0.24~0.69)、试剂获取困难(OR=2.52, 95% CI:1.53~4.15)、试剂使用困难(OR=1.93, 95% CI:1.22~3.07)是MSM选择未检测模式的影响因素;年龄18~＜25岁(OR=0.26, 95% CI:0.10~0.71)或25~＜45岁(OR=0.38, 95% CI:0.15~0.95)、近1年性伴数2~4人(OR=0.42, 95% CI:0.23~0.78)、试剂获取困难(OR=2.58, 95% CI:1.33~4.99)是MSM选择传统检测模式的影响因素(均有P < 0.05)。  结论  上海和苏州两地的MSM具有较高的自检使用率和支持服务需求,年龄、居住地、性行为特征、药物滥用、自检试剂可及性和可操作性影响MSM对检测模式的选择。     

Dietary Intakes of Selected Nutrients and Food Groups and Risk of Cervical Cancer

We investigated the relationships between intakes of selected dietary nutrients and food groups and risk of cervical cancer in a hospital-based, case-control study including 239 cases diagnosed with squamous cell carcinoma of the cervix and 979 hospital patients with nonneoplastic diagnoses who completed a self-administered questionnaire between 1982 and 1998 at Roswell Park Cancer Institute. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression adjusting for age, education, smoking status, use of oral contraceptives, barrier contraceptives and spermicides, family history of cervical cancer, year questionnaire completed, and energy intake. Significant reductions in risk of approximately 40–60% were observed for women in the highest vs. lowest tertiles of dietary fiber (OR = 0.59, 95% CI = 0.37–0.94), vitamin C (OR = 0.52, 95% CI = 0.33–0.80), vitamin E (OR = 0.44, 95% CI = 0.27–0.72), vitamin A (OR = 0.47, 95% CI = 0.30–0.73), α -carotene (OR = 0.41, 95% CI = 0.27–0.63), β -carotene (OR = 0.44, 95% CI = 0.29–0.68), lutein (OR = 0.51, 95% CI = 0.33–0.79), folate (OR = 0.55, 95% CI = 0.34–0.88), and total fruit and vegetable intake (OR = 0.52, 95% CI = 0.34–0.77). Our findings suggest that a diet rich in plant-based nutrients may be important in reducing the risk of cervical cancer.     

The Association Between Socio-Ecological Factors and Having an After-School Physical Activity Program

BACKGROUND: After-school physical activity (PA) programs promote PA among youth. Few studies have used socio-ecological health models to identify barriers and facilitators of after-school PA programs. This study examined which socio-ecological factors are associated with having an after-school PA program. METHODS: A questionnaire was administered to key representatives of 114 elementary and 129 secondary schools. The association between socio-ecological factors and having an after-school PA program was analyzed at school level. RESULTS: In both types of schools more knowledge about community schools was positively associated with having an after-school PA program (odds ratio [OR] = 1.96; 95% confidence interval [CI] = 1.18-3.27; OR = 1.88; 95% CI = 1.27-2.80, respectively). In elementary schools, environmental factors associated with having an after-school PA program included PA facilities (OR = 4.98; 95% CI = 1.08-23.05), a PA working group (OR = 3.37; 95% CI = 1.02-11.10), agreements with the community (OR = 1.60; 95% CI = 1.05-2.43), shortage of human resources (OR = 0.57; 95% CI = 0.37-0.89) and lack of support from teachers (OR = 0.51; 95% CI = 0.33-0.80). In secondary schools, environmental factors included the presence of a remunerated coordinator (OR = 5.12; 95% CI = 1.38-19.10) and partnerships with "sport and PA leaders" (OR = 3.54; 95% CI = 1.01-12.41). CONCLUSION: Having an after-school PA program was associated with personal and environmental factors, which supports the use of socio-ecological frameworks for explorative and intervention studies aiming to increase after-school PA programs.     

Physical activity and colorectal cancer

Physical activity has been inconsistently associated with rectal cancer despite the consistent association between physical activity and colon cancer. In this study, the authors evaluated the association between physical activity and rectal cancer using the same questionnaire used to evaluate the previously reported association with colon cancer. A population-based study of 952 incident cases of cancer in the rectum and rectosigmoid junction and 1,205 age- and sex-matched controls was conducted in Utah and northern California at the Kaiser Permanente Medical Care Program between 1997 and 2002. Vigorous physical activity was associated with reduced risk of rectal cancer in both men and women (odds ratio (OR) = 0.60, 95% confidence interval (CI): 0.44, 0.81 for men; OR = 0.59, 95% CI: 0.40, 0.86 for women). Among men, moderate levels of physical activity also were associated with reduced risk of rectal cancer (OR = 0.70, 95% CI: 0.51, 0.97). Participation in vigorous activity over the past 20 years conferred the greatest protection for both men and women (OR = 0.55, 95% CI: 0.39, 0.78 for men; OR = 0.44, 95% CI: 0.30, 0.67 for women). In summary, physical activity was associated with reduced risk of rectal cancer in these data. The reduced risk was similar to that previously observed for colon cancer.     

安徽地区儿童暴露于农村生活环境对过敏性哮喘的影响

目的 研究暴露于农村生活环境对预防儿童哮喘及致敏的保护作用.方法 向2986名在校儿童父母发放哮喘标准调查表,采用放射性变应原荧光酶免疫吸附实验(RAST-FEIA)检测儿童血清中特异性IgE(sIgE)含量.结果 与在城镇生活的儿童相比,暴露于农村生活环境儿童的过敏性哮喘与非过敏性哮喘、过敏性哮鸣及特应性哮呜危险度显著性降低(OR=0.45,95%CI:0.13～0.96:OR=0.41,95%CI:0.15～0.95;OR=0.32,95% CI:0.11～0.62;OR=0.44,95% CI:0.13～0.91).1周岁内暴露与农村生活环境的儿童过敏性哮喘及特应性致敏危险度较低(OR=0.23,95% CI:0.04～0.91;OR=0.32,95%CI:0.17～0.78);若暴露持续至6周岁,过敏性哮喘及特应性致敏危险度更低(OR=0.21,95%CI:0.03～0.87;OR=0.31,95%CI:0.15～0.78).结论 暴露于农村环境对预防儿童过敏性哮喘及致敏的发生可能有保护作用,持续的暴露能加强此作用.     

School milk and risk of colorectal cancer: a national case-control study

To determine whether school milk consumption in childhood decreased the risk of adult colorectal cancer, the authors conducted a national population-based, case-control study of 562 cases and 571 controls. The authors identified new cases of colorectal cancer in 2007 among people aged 30-69 years from the New Zealand Cancer Registry. Controls were randomly selected from the electoral rolls and frequency matched to cases in 5-year age groups. Participation in school milk programs was associated with a reduced odds ratio for colorectal cancer (odds ratio (OR) = 0.70, 95% confidence interval (CI): 0.51, 0.96). Odds ratios decreased with increasing numbers of bottles of milk drunk compared with no school milk (for 1-799 bottles, OR = 1.04, 95% CI: 0.66, 1.67; for 800-1,199 bottles, OR = 0.81, 95% CI: 0.51, 1.29; for 1,200-1,599 bottles, OR = 0.62, 95% CI: 0.41, 0.93; for 1,600-1,799 bottles, OR = 0.57, 95% CI: 0.37, 0.90; and for 1,800 or more bottles, OR = 0.62, 95% CI: 0.41, 0.96). Participation in school milk programs in New Zealand was associated with a 2.1% reduction (95% CI: 0.7, 3.5) in the odds ratio for colorectal cancer for every 100 half-pint bottles drunk (1 half-pint bottle = 284 mL).     

Dietary intakes of selected nutrients and food groups and risk of cervical cancer

We investigated the relationships between intakes of selected dietary nutrients and food groups and risk of cervical cancer in a hospital-based, case-control study including 239 cases diagnosed with squamous cell carcinoma of the cervix and 979 hospital patients with nonneoplastic diagnoses who completed a self-administered questionnaire between 1982 and 1998 at Roswell Park Cancer Institute. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression adjusting for age, education, smoking status, use of oral contraceptives, barrier contraceptives and spermicides, family history of cervical cancer, year questionnaire completed, and energy intake. Significant reductions in risk of approximately 40-60% were observed for women in the highest vs. lowest tertiles of dietary fiber (OR=0.59, 95% CI=0.37-0.94), vitamin C (OR=0.52, 95% CI=0.33-0.80), vitamin E (OR=0.44, 95% CI=0.27-0.72), vitamin A (OR=0.47, 95% CI=0.30-0.73), alpha-carotene (OR=0.41, 95% CI=0.27-0.63), beta-carotene (OR=0.44, 95% CI=0.29-0.68), lutein (OR=0.51, 95% CI=0.33-0.79), folate (OR=0.55, 95% CI=0.34-0.88), and total fruit and vegetable intake (OR=0.52, 95% CI=0.34-0.77). Our findings suggest that a diet rich in plant-based nutrients may be important in reducing the risk of cervical cancer.     

Raw and cooked vegetables, fruits, selected micronutrients, and breast cancer risk: a case-control study in Germany

In 1998-2000, a case-control study of breast cancer was conducted in Heidelberg, Germany. Three hundred ten consecutively recruited cases with primary breast cancer were matched according to 10-yr age groups to 353 controls with conditions unrelated to diet or endocrine disorders. Intake of raw vegetables, total vegetables, and whole-grain products was inversely associated with breast cancer risk (highest vs. lowest quartile adjusted odds ratio [OR] 0.51, 95% confidence interval [CI] 0.31-0.84; OR = 0.62, 95% CI = 0.38-1.02; and OR = 0.57; 95% CI = 0.34-0.95, respectively). Also, high intake of some selected vitamins and minerals possessing putative DNA-stabilizing properties displayed significant inverse risk associations. Adjusted ORs were as follows: vitamin C (OR = 0.49, 95% CI = 0.2-0.88), folate equivalents (OR = 0.47, 95% CI = 0.25-0.88), b-carotene (OR = 0.46, 95% CI = 0.27-0.80), zinc (OR = 0.35, 95% CI = 0.15-0.78), and copper (OR = 0.51, 95% CI = 0.31-1.03). In contrast, no significant association with risk was seen for an increased intake of fruits, cooked vegetables, fiber, calcium, manganese, or iron. In this population of German women, components of raw vegetables and some micronutrients appear to decrease breast cancer risk.     

Short peripheral venous catheters: effect of evidence-based guidelines on insertion, maintenance and outcomes in a university hospital

This study was designed to evaluate the impact of hospital-wide guidelines for short peripheral venous catheters (SPVC) insertion on the frequency of local catheter-related complications. In a 1051-bed Parisian university hospital, two observational, point prevalence surveys were undertaken in 1996 and in 1998, separated by implementation of written guidelines for SPVC insertion. The outcomes of SPVC insertion were defined as the presence or absence of local catheter-related complications (erythema, purulence around the insertion point, tenderness or induration along the cannulated vein). The proportion of polyurethane catheter materials used (56% vs. 81%, P<0.001), correct and sterile fixation (80% vs. 92%, P<0.05), non-movable catheters (92% vs. 98%, P=0.03) and insertion record (58% vs. 76%, P<0.01) increased between 1996 and 1998. The frequency of local catheter-related complications decreased (15% vs. 4%, P<0.01). Age >73 years [odds ratio (OR) 6.0, 95% confidence interval (CI) 1.28-28.05] was positively associated with local catheter-related complications, whereas duration of insertion (until 72 h) (OR 0.29, 95% CI 0.09-0.89) and the implementation of guidelines (OR 0.26, 95% CI 0.09-0.67) were negatively associated with local catheter-related complications. The implementation of guidelines was independently negatively associated with local catheter-related complications (OR 0.31, 95% CI 0.09-0.97). The results suggest that hospital guidelines for SPVC insertion can improve catheter care and significantly reduce local catheter-related complications.     

Gender differences in adolescent smoking: mediator and moderator effects of self-generated expected smoking outcomes

PURPOSE: To examine relations among gender, self-generated smoking-outcome expectancies, and smoking in adolescents. METHODS: Students from one all-girls' (n=350; 53%) and one all-boys' (n=315; 47%) Catholic high school participated. Analyses included binary and ordinal logistic regression. RESULTS: For boys, smoking behavior was associated with buzz (odds radio [OR] = 1.92, 95% confidence interval [CI]: 1.31-2.83, p < .001), pleasure (OR = 1.47, 95% CI: 1.01-2.16, p = .044), taste/smell (OR = 2.17, 95% CI: 1.12-4.19, p = .022), stimulation (OR = 3.69, 95% CI: 1.32-10.28, p = .013), and exercise/sport impairment (OR = 2.84, 95% CI: 1.68-4.81, p < .001). Among girls, weight control (OR = 0.22, 95% CI: 0.13-0.36, p < .001), negative aesthetics (OR = 0.42, 95% CI: 0.28-0.64, p < .001), addiction (OR = 0.39, 95% CI: 0.28-0.55, p < .001), and negative mood (OR = 0.44, 95% CI 0.20-0.97, p = .041) predicted smoking. Buzz (beta = 2.88, p = .004) mediated the gender-smoking relationship. Moderators included negative social (beta = -0.45, p = .021) and enhance self-esteem (beta = -1.07, p = .024). CONCLUSION: Interventions might benefit from tailoring on gender differences in smoking-outcome expectancies.     

Balance and mobility performance as treatable risk factors for recurrent falling in older persons

BACKGROUND AND OBJECTIVES: The purpose of this study was to examine whether easily measurable measures for balance and muscle strength predicted recurrent falling as well as sophisticated measurements, and to examine which of the modifiable risk factors were strongest associated with recurrent falling. METHODS: The study was performed in a subsample (n=439, aged 69-92 years) of the Longitudinal Aging Study Amsterdam (LASA). Balance, muscle strength, physical activity, and performance tests were assessed. Falls were recorded during 1 year. The outcome measure was recurrent falls (>/=2 falls within 1 year). RESULTS: The area under the curve (AUC) of mediolateral sway (AUC=0.67; 95% CI:0.57-0.77), tandem stand (AUC=0.61; 95% CI:0.49-0.73), leg extension strength (AUC=0.58; 95% CI:0.51-0.64), and handgrip strength (AUC=0.57; 95% CI:0.51-0.64) for recurrent falling were not significantly different. In a multivariate model, mediolateral sway (OR=2.8; 95% CI:1.1-6.9), tandem stand (OR=2.1; 95% CI:1.1-3.8), and walking test (OR=2.2; 95% CI:1.1-4.1) were significantly associated with recurrent falling. CONCLUSIONS: The easily measurable tandem stand and handgrip strength predicted recurrent falling as well as the sophisticated measures. Mediolateral sway was strongest associated with recurrent falling.     

Racial and ethnic disparities in the prevalence and management of cardiovascular risk factors in the United States workforce

OBJECTIVE: To assess racial or ethnic differences in workers with respect to awareness, treatment, and control of hypertension, diabetes, and dyslipidemia, and to identify factors associated with these disparities. METHODS: Analysis of nationally representative data collected from employed persons participating in the National Health and Nutrition Examination Survey 1999 to 2002, with sub-analyses by race and ethnicity. RESULTS: Mexican-American workers are less likely than non-Hispanic whites to be aware of their hypertension (odds ratio [OR] = 0.60; 95% confidence interval [CI] = 0.39-0.94) and less likely to be treated (OR = 0.45; 95% CI = 0.23-0.85); less likely to be aware (OR = 0.56; 95% CI = 0.33-0.93) and treated (OR = 0.33; 95% CI = 0.14-0.78) for dyslipidemia; and more likely to be aware of diabetes (OR = 3.01; 95% CI = 1.14-7.95). Non-Hispanic blacks treated for hypertension are less likely than whites to reach blood pressure goal (OR = 0.47; 95% CI = 0.33-0.66). Having a usual place of care is independently associated with awareness and treatment for hypertension, and treatment for dyslipidemia. CONCLUSION: Understanding cardiovascular health disparities in the workforce can help employers structure appropriate workplace screening and prevention programs.     

Workplace accommodations for people with disabilities: National Health Interview Survey Disability Supplement, 1994-1995

As American workers age, workers with impairments and functional limitations make up a larger percentage of our workforce. This investigation presents data from the National Health Interview Survey Disability Supplement 1994-1995 (NHIS-D) describing the nature of workplace accommodations in the American workforce and factors associated with the provision of such accommodations. Of a nationally representative sample of workers aged 18 to 69 years with a wide range of impairments, 12% reported receiving workplace accommodations. Males (odds ratio (OR) 0.64: 95% confidence interval (CI) 0.53-0.78) and Southerners (OR 0.57; 95% CI = 0.47-0.70) were less likely than others to receive workplace accommodations. Those with mental health conditions were less likely than others to receive accommodations (OR 0.56; 95% CI = 0.44-0.70). College graduates (OR 1.53; 95% CI = 1.22-1.91), older workers, full time workers (OR 3.99; 95% CI = 2.63-3.87), and the self-employed (OR 1.76; 95% CI = 1.28-2.41) were more likely than others to receive accommodations.     

海南省已育二孩职业女性三孩生育意愿现状及影响因素

目的 随着国家全面三孩政策的实施,育龄女性的生育意愿成为社会关注的焦点。为了解海南省育龄女性三孩生育意愿水平及影响因素,特开展本调查。方法 本文以海南省已育二孩的职业女性为研究对象,于2021年10月1日至11月1日采用自行设计的问卷进行线上和线下调查。本次调查共发放问卷900份,剔除无效问卷后,对868份有效问卷分别进行单因素和多因素统计分析。结果 75.3%的调查对象明确没有三孩生育意愿;年龄越小（OR（95%CI）=0.33（0.12~0.64）,P=0.008）,是农村户籍（OR（95%CI）=0.44（0.23~0.67）,P=0.004）,月收入在2000~4000元（OR（95%CI）=0.55（0.27~0.85）,P=0.033）,已有孩子性别非全是男孩（OR（95%CI）=1.67（1.10~1.89）,P=0.040）的职业女性,生育三孩的意愿越强。结论 鼓励实行弹性工作制、提供福利性托育服务、完善陪产假或者育儿假制度;依法履行监督职能;对雇用女职工的企业予以减税;提高参保率、推进长期护理保险;营造现代的生育文化。     

Hormone replacement therapy and acute myocardial infarction: a large observational study exploring the influence of age

BACKGROUND: We examined whether the discrepancy between observational studies and randomized clinical trials (RCTs) on the effect of hormone replacement therapy (HRT) on myocardial infarction (MI) could be explained by differences in age of participants at the time of either HRT initiation or the MI event. METHODS: A matched case-control study was performed using the General Practice Research Database. Cases (n = 22 225) had a first diagnosis of MI between 1987 and 2001; up to six controls (n = 144 085) were matched to each case based on age, sex, and practice. Conditional logistic regression was performed adjusting for traditional cardiovascular risk factors, as well as, cardiovascular drug use and consultation rate. RESULTS: HRT users had a lower overall risk of MI compared with never users [odds ratio (OR): 0.76; 95% confidence interval (95% CI) 0.68-0.86); results were similar for opposed (OR: 0.73; 95% CI 0.68-0.86) and unopposed (OR: 0.79; 95% CI 0.66-0.96) therapy. This apparent benefit increased with older age at HRT initiation(18-44 years: OR = 0.99; 95% CI 0.74-1.33; 45-54 years: OR = 0.84; 95% CI 0.71-1.00; 55-64 years: OR = 0.67; 95% CI 0.54-0.82; 65-74 years: OR = 0.50; 95% CI 0.34-0.74; >75 years: OR = 0.55; 95% CI 0.23-1.32). Moreover, the cardioprotective effect was greater for MIs occurring at older ages (P-value for interaction = 0.003). CONCLUSION: The effect of HRT on MI becomes more pronounced with older age at initiation and at older ages at the time of an MI event. These findings contradict the hypothesis that the apparent protection seen in observational studies was due to the inclusion of younger participants.     

Use of exogenous hormones by women and lung cancer: evidence from the Royal College of General Practitioners' Oral Contraception Study

OBJECTIVE: The objective of this study was to assess the risk of lung cancer among women who have used oral contraception or hormone replacement therapy (HRT), especially those exposed to both classes of exogenous hormones. DESIGN: This study is a nested case-control one using prospectively collected data from the Royal College of General Practitioners' Oral Contraception Study (OCS). The 162 case patients were women with a diagnosis of lung cancer recorded on the OCS database by August 2004. Each case patient was matched with 3 control subjects who were free of the disease at the time of the case patient's diagnosis, of similar age and with similar length of follow-up in the OCS. RESULTS: Compared with never use, current use of oral contraception was associated with a statistically nonsignificant reduced risk of lung cancer, with an adjusted odds ratio (OR) of 0.47 and a 95% confidence interval (CI) of 0.08-2.95 (OR=0.86 and 95% CI=0.50-1.48 for former use; OR=0.84 and 95% CI=0.49-1.43 for ever use). Similar comparisons for HRT were current use (OR=1.21, 95% CI=0.23-6.37), former use (OR=0.62, 95% CI=0.23-1.68) and ever use (OR=0.71, 95% CI=0.28-1.78). The OR among women who had used both classes of hormones was 0.53 (95% CI=0.16-1.72), as compared with those who had used neither. CONCLUSIONS: Our results are compatible with findings from other studies that suggest that oral contraceptives may reduce the risk of lung cancer. Evidence for a beneficial effect of HRT is less convincing. Further study is needed to determine how long any benefit lasts and whether it is stronger in women exposed to both classes of exogenous hormones. The small number of events occurring in this very large cohort, however, shows that any public health benefit is likely to be marginal.     

Risk factors for early infant mortality in Sarlahi district, Nepal

OBJECTIVES: Early infant mortality has not declined as rapidly as child mortality in many countries. Identification of risk factors for early infant mortality may help inform the design of intervention strategies. METHODS: Over the period 1994-97, 15,469 live-born, singleton infants in rural Nepal were followed to 24 weeks of age to identify risk factors for mortality within 0-7 days, 8-28 days, and 4-24 weeks after the birth. FINDINGS: In multivariate models, maternal and paternal education reduced mortality between 4 and 24 weeks only: odds ratios (OR) 0.28 (95% confidence interval (CI) = 0.12-0.66) and 0.63 (95% CI = 0.44-0.88), respectively. Miscarriage in the previous pregnancy predicted mortality in the first week of life (OR = 1.98, 95% CI = 1.37-2.87), whereas prior child deaths increased the risk of post-neonatal death (OR = 1.85, 95% CI 1.24-2.75). A larger maternal mid-upper arm circumference reduced the risk of infant death during the first week of life (OR = 0.88, 95% CI = 0.81-0.95). Infants of women who did not receive any tetanus vaccinations during pregnancy or who had severe illness during the third trimester were more likely to die in the neonatal period. Maternal mortality was strongly associated with infant mortality (OR = 6.43, 95% CI = 2.35-17.56 at 0-7 days; OR = 11.73, 95% CI = 3.82-36.00 at 8-28 days; and OR = 51.68, 95% CI = 20.26-131.80 at 4-24 weeks). CONCLUSION: Risk factors for early infant mortality varied with the age of the infant. Factors amenable to intervention included efforts aimed at maternal morbidity and mortality and increased arm circumference during pregnancy.     

A nested case-control study of brain tumors among employees at a petroleum exploration and extraction research facility

Work-related exposures potentially associated with a cluster of brain tumors at a petroleum exploration and extraction research facility were evaluated in a nested case-control study. Fifteen cases were identified in the original cohort and 150 matched controls were selected. Odds ratios (ORs) for occupational exposure to petroleum, radiation, solvents, magnetic fields, and work activities were near or below 1.0. ORs near 1.5 were observed for: working with computers (OR = 1.47; 95% confidence interval [CI] = 0.30-9.35); work-related travel (OR = 1.48; 95% CI = 0.25-5.95), and travel immunizations (OR = 1.62; 95% CI = 0.23-9.45). Higher ORs were observed for work in administrative and marketing buildings and for achieving a master's or higher degree (OR = 2.0, 95% CI = 0.4-10.7). While some ORs above 1.5 were noted, no work-related chemical and physical exposures were significantly associated with the occurrence of brain tumors among employees at this facility.     

低预后人群拮抗剂方案中不同扳机时机对临床结局的影响北大核心CSCD

目的探讨在拮抗剂方案中,低预后人群选择不同扳机时机对临床结局产生的影响。方法筛选2017年1月至2019年6月期间在河南省人民医院生殖中心进行拮抗剂方案助孕的波塞冬标准下的低预后患者资料共1613个周期进行回顾性队列研究,根据不同扳机时机分为3组,按照常规标准扳机为正常组(961个周期),提前1 d扳机为提前组(359个周期),推迟1 d扳机为推迟组(293个周期)。通过单因素分析、多元logistics回归分析等方法比较不同扳机时机对累积妊娠率、累积活产率等临床结局的影响。结果三组患者鲜胚移植妊娠率分别为提前组35.77%(44/123)、正常组39.16%(150/383)、推迟组34.01%(50/147)。三组患者累积妊娠率和累积活产率由低到高依次为提前组、正常组、推迟组,组间比较差异均有统计学意义[累积妊娠率为33.18%(72/217)、42.33%(276/652)、45.27%(91/201),P=0.024;累积活产率为22.97%(48/209)、31.96%(201/629)、35.90%(70/159),P=0.012]。经过多元logistics回归调整混杂因素后,结果显示提前和推迟扳机与正常扳机相比,对临床结局的影响无统计学意义[推迟组的鲜胚移植妊娠率OR(95%CI)=0.69(0.44~1.09),P=0.114;累积妊娠率OR(95%CI)=0.77(0.51~1.16),P=0.214;累积活产率OR(95%CI)=0.83(0.54~1.29),P=0.418;提前组的鲜胚移植妊娠率OR(95%CI)=0.98(0.60~1.60),P=0.934;累积妊娠率OR(95%CI)=0.87(0.58~1.30),P=0.513;累积活产率OR(95%CI)=0.86(0.54~1.35),P=0.515]。结论波塞冬低预后人群在拮抗剂方案中按照常规标准进行扳机可获得理想的临床结局,可以综合考虑患者的个体情况进行扳机。     

Predisposing and Enabling Factors Associated with Mammography Use Among Hispanic and Non-Hispanic White Women Living in a Rural Area

ABSTRACT:  Context: Women who do not receive regular mammograms are more likely than others to have breast cancer diagnosed at an advanced stage. Purpose: To examine predisposing and enabling factors associated with mammography use among Hispanic and non-Hispanic White women. Methods: Baseline data were used from a larger study on cancer prevention in rural Washington state. In a sample of 20 communities, 537 women formed the sample for this study. The main outcomes were ever having had a mammogram and having had a mammogram within the past 2 years. Findings: Reporting ever having had a mammogram was inversely associated with lack of health insurance (OR = 0.37, 95% CI: 0.16-0.84), ages under 50 years (OR = 0.23, 95% CI: 0.12-0.45), high cost of exams (OR = 0.48, 95% CI: 0.27-0.87), and lack of mammography knowledge (OR = 0.16, 95% CI: 0.07-0.37), while increasing education levels were positively associated (OR = 1.72, 95% CI: 1.09-2.70). Reporting mammography use within the past 2 years was inversely associated with ages under 50 years (OR = 0.49, 95% CI: 0.27-0.88) and over 70 years (OR = 0.47, 95% CI: 0.24-0.94), lack of health insurance (OR = 0.23, 95% CI: 0.10-0.50), and high cost of exams (OR = 0.55, 95% CI: 0.35-0.87). Conclusions: Continued resources and programs for cancer screening are needed to improve mammography participation among women without health insurance or low levels of education.