新疆煤中天然放射性和铀伴生煤矿潜在职业照射

目的 分析新疆煤中天然放射性水平和铀伴生煤矿的潜在职业照射。方法 根据近年来新疆煤中天然放射性水平调查的论文报道中的数据,分析比较新疆煤中天然放射性水平。结果 通过分析发现,新疆煤中²³⁸U活度浓度与世界、美国和俄罗斯相近,²³²Th活度浓度低于世界、美国和俄罗斯,²³⁸U和²³²Th活度浓度均低于我国平均浓度,在正常自然本底变化范围内。结论 从放射卫生学角度考虑,合理开发利用新疆的煤炭资源不会对矿工和居民的健康带来额外影响。     

四川省三个核设施地区水源水总α、总β放射性水平调查

目的 调查四川省三个核设施地区水源水总α、总β放射性水平,为本省核设施地区水源水放射性水平提供基线数据库。方法 根据国家标准《生活饮用水标准检验方法放射性指标》（GB/T 5750.13-2006）的方法要求,调查四川省三个核设施地区水源水总α、总β放射性水平。结果 三个核设施地区水源水总α比活度范围为（0.016~0.188）Bq/L;总β比活度范围为（0.028~0.229）Bq/L,处于全国平均中下水平,属于正常的本底水平。结论 三个核设施地区水源水总α、总β放射性水平均低于《生活饮用水卫生标准》（GB 5749-2006）中的国家标准限值。     

福州市透视受检者入射体表剂量率现况与控制措施研究

目的 了解福州市医用常规X射线机透视受检者入射体表空气比释动能率典型值水平,并研究控制措施,保障受检者健康权益。方法 参照《医用常规X射线诊断设备影像质量控制检测规范》（WS 76-2011）对透视受检者入射体表空气比释动能率典型值水平进行调查与评价,并对控制措施结果开展追踪调查。结果 共调查87台X射线影像增强器透视设备,透视受检者入射体表空气比释动能率典型值>25 mGy/min为22台,对其中（市级及以下卫计委管理）17台开展干预。5台经过设备维修,5台采用"高电压、低电流、厚滤过"操作方法,透视受检者入射体表空气比释动能率典型值降为≤ 25 mGy/min。停机4台。待置换新机3台。结论 加强监督管理,开展放射工作人员培训,提高放射卫生防护意识;强化质量控制检测,及时维修或更换透视机;采用"高电压、低电流、厚滤过"等合理操作方法,是控制透视受检者入射体表空气比释动能率典型值的主要措施。     

丁苯酞软联合胞磷胆碱钠注射液治疗血管性痴呆的疗效及对CysC、IFN-γ、Hcy水平的影响

目的探究丁苯酞软联合胞磷胆碱钠注射液治疗血管性痴呆(VD)的疗效及对血清胱抑素C(CysC)、干扰素-γ(IFN-γ)、同型半胱氨酸(Hcy)水平的影响。方法选取2015年3月至2020年3月本院收治的VD患者120例作为研究对象,随机分为对照组和实验组,各60例。对照组接受常规内科治疗和胞磷胆碱钠注射液治疗,实验组在对照组的基础上接受丁苯酞软治疗,6个月后比较两组总有效率、简易精神状态检查(MMSE)量表、日常生活能力(ADL)量表和CysC、IFN-γ、Hcy水平。结果实验组总有效率、MMSE、ADL评分均高于对照组(P<0.05),CysC、IFN-γ、Hcy水平均低于对照组(P<0.05)。结论苯酞软联合胞磷胆碱钠注射液治疗VD,能降低CysC、IFN-γ、Hcy水平,疗效显著。     

Distance traveled to undergo revision shoulder arthroplasty is impacted by patient demographics and exceeds that of primary shoulder arthroplasty

BackgroundPrevious research has highlighted disparities in access to and outcomes following shoulder arthroplasty. The purpose of this study is to compare travel distance for primary vs. revision surgery and to determine the relationships between travel distance to undergo revision shoulder arthroplasty and patient demographics and postoperative adverse outcomes. We hypothesized that older patients, those with increased medical comorbidities, and those with greater financial resources would travel farther for surgery.MethodsThe Healthcare Cost and Utilization Project, American Hospital Association, and UnitedStatesZipCodes.org Enterprise data sets were compiled to collect data on patient demographics, operation performed, and postoperative adverse outcomes. Population-weighted zip code centroid points of patients’ residences as well as hospital coordinates were used to approximate the distance traveled to undergo shoulder arthroplasty. Kruskal-Wallis tests and logistic regression analyses were used to analyze the relationship between travel distance and patients’ demographics and postoperative outcomes.ResultsPatients traveled farther to undergo revision shoulder arthroplasty than to undergo primary shoulder arthroplasty (P = .0001). Among patients who underwent revision operations, older age (P = .0001) and increased medical comorbidities (P = .003) were associated with decreased travel distance. White patients and those with commercial insurance traveled farther to receive care (P = .0001). There were no clinically significant associations between postoperative outcomes following revision surgery and travel distance.ConclusionPatients may travel farther to undergo revision surgery owing to patient preferences or because these complex operations are performed at fewer centers. Younger and healthier patients, white patients, and those with commercial insurance plans traveled farther to receive care. Future work is needed to determine the underlying causes of these disparities and whether it is patient preferences or systemic factors such as hospital density or access to high-quality health insurance that are influencing access to this specialized surgical care.     

YouTube is a poor-quality source for patient information on the rehabilitation following total shoulder arthroplasty

BackgroundDespite the ubiquity of health information on YouTube, the quality of the information as it pertains to total shoulder arthroplasty (TSA) rehabilitation is unknown. The purpose of this study is to investigate the quality of information available on YouTube as it pertains to rehabilitation following TSA, including anatomic and reverse TSA.MethodsUtilizing predefined search terms, 480 videos regarding rehabilitation following TSA were screened for study inclusion. A total of 143 videos were included in the final analysis. Of these, 99 (69.2%) videos were on rehabilitation of anatomical TSA and 44 (30.8%) videos reported on rehabilitation after reverse TSA. Each video was reviewed using 3 scoring systems: (1) Journal of the American Medical Association (JAMA) benchmark criteria, (2) Global Quality Score (GQS), and (3) DISCERN instrument.ResultsYouTube videos regarding TSA are of suboptimal educational quality with a mean JAMA score of 2.5 ± 0.7, mean GQS of 2.7 ± 0.9, and mean DISCERN score of 33.2 ± 5.5 overall. Upon evaluation of video metrics based on classification it was found that educational nonphysician videos had significantly more likes than all other categories (P = .01). Educational physician videos were found to be significantly longer than all other categories (educational physician: 10.0 ± 14.8 minutes, educational nonphysician: 6.2 ± 3.2 minutes, personal testimony: 3.5 ± 2.6 minutes, commercial: 5.8 ± 5.4 minutes; P < .01) and had significantly higher JAMA (P < .01), GQS (P < .01), and DISCERN (P < .01).ConclusionYouTube videos are a poor source of educational information for patients regarding TSA rehabilitation. Educational videos prepared by nonphysicians accrued more likes than other video categories. Although educational videos by physicians provided statistically higher quality educational content as noted by JAMA, GQS, and DISCREN scores, the average scores across all author categories were classified as low (JAMA), moderate to poor (GQS), or poor (DISCERN) quality educational content. Additionally, our findings suggest that physician educational videos that are shorter in duration are more likely to be well received and watched to completion by viewers compared to longer videos. Patients should be provided trusted resources to learn more about TSAs.     

Determinants of post-intensive care mortality in high-level treated critically ill patients

Objective To assess the predictive ability of preillness and illness variables, impact of care, and discharge variables on the post-intensive care mortality.Setting and patients 5,805 patients treated with high intensity of care in 89 ICUs in 12 European countries (EURICUS-I study) surviving ICU stay.Methods Case-mix was split in training sample (logistic regression model for post-ICU mortality: discrimination assessed by area under ROC curve) and in testing sample. Time to death was studied by Cox regression model validated with bootstrap sampling on the unsplit case-mix.Results There were 5,805 high-intensity patients discharged to ward and 423 who died in hospital. Significant odds ratios were observed for source of admission, medical/surgical unscheduled admission, each year age, each SAPSII point, each consecutive day in high-intensity treatment, and each NEMS point on the last ICU day. Time to death in ward was significantly shortened by different source of admission; age over 78 years, medical/unscheduled surgical admission; SAPSII score without age, comorbidity and type of admission over 16 points; more than 2 days in high-intensity treatment; all days spent in high treatment; respiratory, cardiovascular, and renal support at discharge; and last ICU day NEMS higher than 27 pointsConclusions Worse outcome is associated with the physiological reserve before admission in the ICU, type of illness, intensity of care required, and the clinical stability and/or the grade of nursing dependence at discharge.This study was supported in part, by the Foundation for Research on Intensive Care in Europe (FRICE) and by a grant from the Commission of the European communities (BMH1-CT93-1340)