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1.
IntroductionThe purpose of this study was to explore factors influencing meropenem pharmacokinetics (PKs) in critically ill patients by developing a population PK model and to determine the optimal dosing strategy.MethodsThis prospective observational study involved 12 critically ill patients admitted to the intensive care unit and treated with meropenem 1 g infused over 1 h every 8 h. Blood samples were collected on days 1, 2, and 5 immediately prior to dosing, and at 1, 2, 4, and 6 h after the start of infusion. Population PK parameters were estimated using nonlinear mixed-effects model software.ResultsMeropenem PK was adequately described using a two-compartment model. Typical values of total and inter-compartmental clearance were 9.30 L/h and 9.70 L/h, respectively, and the central and peripheral compartment volumes of distribution were 12.61 L and 7.80 L, respectively. C-reactive protein (CRP) was identified as significant covariate affecting total meropenem clearance. The probability of target attainment (PTA) predicted by Monte Carlo simulations varied according to the patients’ CRP. The PTA of 100% time above the minimum inhibitory concentration ≤2 mg/L for bacteria was achieved after a dose of 1 and 2 g infused over 4 h every 8 h in patients with CRP of 30 and 5 mg/dL, respectively.ConclusionThe findings of this study suggest that CRP might be helpful in managing meropenem dosing in critically ill patients. Higher doses and extended infusion may be required to achieve optimal pharmacodynamic targets.  相似文献   
2.
BackgroundBefore the COVID-19 pandemic, people with mobility, vision, hearing, and cognitive disabilities were at a higher risk of lower psychosocial well-being than people without disabilities. It is, therefore, of great importance to investigate whether the pandemic has exacerbated this difference.ObjectiveThis study examines whether people with disabilities (categorized as mobility, vision, hearing, cognitive, and any disabilities) report more COVID-19-related negative effects on psychosocial well-being (loneliness, decreased social contact, decreased hope for the future, concerns about being infected) than people without disabilities.MethodsWe analyzed population-based data from the Finnish Health, Welfare, and Services (FinSote) survey carried out in 2020–2021 (N = 22 165, age 20+). Logistic regression models were applied, controlling for the effects of age, sex, partnership, living alone, and education.ResultsAll disability groups, except those with vision disabilities, reported significantly more often that the pandemic increased loneliness than people without disabilities. There were no significant differences between the disability groups and people without disabilities in decreased social contacts. People with only mobility and cognitive disabilities reported significantly more often that the pandemic decreased their hope for the future than those without disabilities. All disability groups were more often concerned about being infected than people without disabilities, but this effect was not significant among people 75 or older.ConclusionThe psychosocial well-being of people with specific types of disabilities should receive special attention during crises like the COVID-19 pandemic.  相似文献   
3.
目的分析中国不同地区糖代谢状态的归因死亡风险和疾病负担。方法本研究数据基于2012—2015年中国高血压调查和2013年中国居民死因监测数据。共纳入22702名35岁及以上无心血管疾病史的中国高血压调查对象,并于2018—2019年对其随访心血管死亡结局。利用Cox比例风险模型,对糖代谢状态与死亡的风险比进行估计。采用人群归因百分比(PAF)评估不同糖代谢状态造成的心血管疾病负担。结果在随访时间内,共有479例心血管病死亡。与正常血糖人群相比,糖尿病前期和糖尿病人群的心血管病死亡风险[HRs(95%CI)]分别为1.37(1.04~1.80)和1.36(1.06~1.75)。2013年我国心血管死亡归因于糖尿病前期和糖尿病的PAF分别为2.48%(95%CI:2.31%~2.66%)和2.96%(95%CI:2.79%~3.13%),归因于糖尿病前期和糖尿病的心血管病死亡人数分别为11.99万和13.97万。此外,不同糖代谢状态的PAF存在地区和省级差异,心血管病死亡归因于糖尿病的PAF最高为东部地区[3.73%(95%CI:3.44%~4.04%)],其次为西部地区[2.62%(95%CI:2.24%~3.01%)],最低为中部地区[2.42%(95%CI:2.16%~2.68%)]。结论我国糖尿病前期和糖尿病带来的心血管疾病负担较重,且存在地区和省份差异,应当采取相应措施,减少糖尿病前期和糖尿病造成的疾病负担。  相似文献   
4.
The Qiang population mainly lived in Beichuan Qiang Autonomous County of Sichuan Province. It is one of the nomads in China, distributed along the Minjiang River. The Qiang population was assumed to have great affinity with the Han, the largest ethnic group in China, when it refers to the genetic origin. Whereas, it is deeply understudied, especially from the Y chromosome. Here in this study, we used validated high-resolution Y-chromosome single nucleotide polymorphisms (Y-SNPs) and short tandem repeats (Y-STRs) panels to study the Qiang ethnic group to unravel their paternal genetic, forensic and phylogenetic characteristics. A total of 422 male samples of the Qiang ethnic group were genotyped by 233 Y-SNPs and 29 Y-STRs. Haplogroup O-M175 (N = 312) was the most predominant haplogroup in the Qiang ethnic group, followed by D-M174 (N = 32) and C-M130 (N = 32), N-M231 (N = 27), and Q-M242 (N = 15). After further subdivision, O2a-M324 (N = 213) accounted for the majority of haplogroup O. Haplogroup C2b-Z1338 (N = 29), D1a-CTS11577 (N = 30). O2a2b1a1a1-F42 (N = 48), O2a1b1a1a1a-F11 (N = 35), and O2a2b1a1-M117 (N = 21) represented other large terminal haplogroups. The results unveiled that Qiang ethnic group was a population with a high percentage of haplogroup O2a2b1a1a1-F42 (48/422) and O2a1b1a1a1a-F11 (35/422), and O2a2b1a1-M117 (21/422), which has never been reported. Its haplogroup distribution pattern was different from any of the Han populations, implying that the Qiang ethnic group had its unique genetic pattern. Mismatch analysis indicated that the biggest mismatch number in haplogroup O2a2b1a1a1-F42 was 21, while that of haplogroup O2a1b1a1a1a-F11 was 20. The haplotype diversity of the Qiang ethnic group equaled 0.999788, with 392 haplotypes observed, of which 367 haplotypes were unique. The haplogroup diversity of the Qiang ethnic group reached 0.9767, and 53 terminal haplogroups were observed (The haplogroup diversity of the Qiang ethnic group was the highest among Qiang and all Han subgroups, indicating the larger genetic diversity of the Qiang ethnic group.). Haplogroup O2a2b1a1a1-F42 was the most predominant haplogroup, including 11.37 % of the Qiang individuals. Median-joining trees showed gene flow between the Qiang and Han individuals. Our results indicated that 1) the highest genetic diversity was observed in the Qiang ethnic group compared to any of the former studied Chinese population, suggesting that the Qiang might be an older paternal branch; 2) the haplogroup D-M174 individuals of Qiang, Tibetans and Japanese distributed in three different subclades, which was unable to identify through low-resolution Y-SNP panel; and 3) the Qiang had lower proportion of haplogroup D compared to Yi and Tibetan ethnic groups, showing that the Qiang had less genetic communication with them than with Han Chinese.  相似文献   
5.
6.
PurposeThe growing size of public variant repositories prompted us to test the accuracy of pathogenicity prediction of DNA variants using population data alone.MethodsUnder the a priori assumption that the ratio of the prevalence of variants in healthy population vs that in affected populations form 2 distinct distributions (pathogenic and benign), we used a Bayesian method to assign probability to a variant belonging to either distribution.ResultsThe approach, termed Bayesian prevalence ratio (BayPR), accurately parsed 300 of 313 expertly curated CFTR variants: 284 of 296 pathogenic/likely pathogenic variants in 1 distribution and 16 of 17 benign/likely benign variants in another. BayPR produced an area under the receiver operating characteristic curve of 0.99 for 103 functionally confirmed missense CFTR variants, which is equal to or exceeds 10 commonly used algorithms (area under the receiver operating characteristic curve range = 0.54-0.99). Application of BayPR to expertly curated variants in 8 genes associated with 7 Mendelian conditions led to the assignment of a disease-causing probability of ≥80% to 1350 of 1374 (98.3%) pathogenic/likely pathogenic variants and of ≤20% to 22 of 23 (95.7%) benign/likely benign variants.ConclusionIrrespective of the variant type or functional effect, the BayPR approach provides probabilities of pathogenicity for DNA variants responsible for Mendelian disorders using only the variant counts in affected and unaffected population samples.  相似文献   
7.
目的 对东营区≥45岁常住居民进行结直肠癌筛查,并探讨初筛阳性者肠镜顺应性及其影响因素,为提高居民结直肠癌筛查工作提供科学依据。方法 采用方便抽样方法选择辖区内2个镇和3个街道的社区卫生服务中心作为结直肠癌筛查志愿者招募点招募≥45岁常住居民为研究对象开展结直肠癌筛查及问卷调查,对初筛阳性者进一步进行肠镜检查,采用描述性分析方法对居民结直肠筛查结果及肠镜顺应性进行分析,并对其影响因素进行单、多因素分析。结果 本研究共纳入1 201人进行分析,男662人,女539人,45~59岁372人,60~69岁495人,70~79岁334人。初筛阳性人数总计371例,其中危险因素初筛阳性154例,FOBT阳性298例,危险因素和FOBT阳性双阳性者81例,初筛阳性率为30.89%。男性(OR=3.177)、黏液血便史(OR=7.683)以及肠道息肉病史(OR=5.008)为结直肠癌初筛阳性的危险因素。371例初筛阳性者中121例完成结肠镜检查,结肠镜检查顺应率为32.61%。性别(OR=2.776)、年龄(OR=0.511、0.433)、婚姻状况(OR=4.267)、文化程度(OR=2.782、3.916)、医疗保险(OR=2.743)是结直肠癌初筛阳性者结肠镜检查顺应性的影响因素。结论 东营市东营区结直肠癌初筛阳性率较高,应加强对存在黏液血便史以及肠道息肉病史男性个体人群的结直肠癌筛查。居民结直肠镜检查顺应性较低,尤其是60岁及以上、非在婚、文化程度较低、无医保的女性个体,可特异性强化对该群体个体的健康教育,提高其结直肠镜顺应性。  相似文献   
8.
This study evaluated the genetic variation of 17 autosomal short tandem repeat (STR) loci included in the PowerPlex® 18D Kit. Samples of 562 unrelated healthy Lahu individuals living in Yunnan Province in southwestern China were investigated. The data were analyzed to provide information on allele frequencies and other statistical parameters relevant to the forensic population. Of the 17 loci, 16 reached the Hardy–Weinberg equilibrium after Bonferroni correction. A total of 176 alleles were identified in 17 STR loci, and allele frequencies ranged from 0.000 890 to 0.578 292. The combined discrimination power (CPD) and probability of excluding paternity (CPE) of the 17 STR loci were 0.999 999 999 999 999 999 489 and 0.999 998 301 753 122. The genetic relationships among 28 populations were also estimated.  相似文献   
9.
AimTo examine simulation-based education (SBE) strategies on situation awareness (SA) in nursing students including the strategies of SBE, the measurement tools of SA during SBE and the effectiveness of SBE on SA.BackgroundSA has been reported as an effective way to identify and manage deteriorating patients. Researchers have suggested that SBE is more effective than other instructional modalities in improving SA. However, SA among nursing students and studies regarding the effectiveness of SBE on SA are limited.DesignThe Arksey and O'Malley scoping review framework was used to guide the review process and the PRISMA-ScR checklist was used to report on this scoping review.MethodsThe databases searched were Medline, CINAHL, EMBASE, EBSCO and Google Scholar from December 2020 to November 2021. Thematic analysis was applied to identify the main findings in the literature.ResultsNine eligible articles were included. Five major themes were identified: SBE situations used to teach SA to nursing students, SBE strategies to improve SA in nursing, effectiveness of SBE on SA in nursing, measurements of SA used during the SBE and experimental studies examining the effectiveness of SBE on SA.ConclusionThis review reveals that SBE may be useful to cultivate SA in nursing students. Future studies that use randomized clinical trials to test the effects of combining different simulation strategies on SA are suggested. Developing more reliable and valid SA global assessment queries and standardizing the query process of SA measurement is also recommended.  相似文献   
10.
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