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1.
目的:探究基于剪切波弹性成像(SWE)和多参数磁共振成像(mpMRI)对临床显著性前列腺癌(csPCa)的诊断价值。方法:回顾性选取2020年10月至2022年1月在延安大学附属医院泌尿外科疑诊为前列腺癌(PCa)并行超声引导下前列腺穿刺活检的患者为研究对象,共纳入患者74例。根据穿刺活检病理结果将患者分为PCa组与非PCa组,csPCa组与非PCa+临床不显著前列腺癌组(cisPCa),其中PCa组24例,csPCa组17例。采用单因素及多因素logistic逐步回归分析筛选csPCa的独立预测因子,并通过ROC曲线比较预测概率值与各独立预测因子的诊断效能。结果:tPSA、fPSA、PSAD、PV、PIRADS、Emax差、Emean差和Emin差在PCa组与非PCa组,以及非PCa+cisPCa组与csPCa组之间的差异有统计学意义(P<0.05)。logistic回归结果显示tPSA、PV、Emax差及PIRADS是csPCa的独立预测因子,ROC曲线结果显示logistic回归模型曲线下面积(AUC)为0.954,灵敏度为0.882,特异度为0.947,结果均优于各独立预测因子。结论:Emax差及PIRADS是csPCa的独立预测因子,与tPSA、PV联合具有较好的诊断效能。  相似文献   
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It has been widely demonstrated that there are a broad range of individual responses to all weight management regimens, often masked by reports of the mean. Identifying features of responders and non-responders to weight loss regimens enables a more tailored approach to the provision of weight management advice. Low-carbohydrate diets are currently popular, and anecdote suggests that males are more successful at losing weight using this approach. This is feasible given the physiological and socio-psychological differences between the genders. We analysed the extent and variation in weight change for males and females separately through a systematic search for all low-carbohydrate diet trials published since 1985. Very few studies compared weight loss outcomes by gender and, of those that did, most lacked supporting data. The majority of studies reported no gender difference but when a gender difference was found, males were more frequently reported as losing more weight than females on a low-carbohydrate diet. The lack of gender stratification in weight loss trials is concerning, as there are a range of gender-based factors that affect weight loss outcomes. This study highlights the importance of examining weight change for males and females separately, since as failure to do so may mask any potential differences, which, if detected, could assist with better weight loss outcomes.  相似文献   
3.
背景 儿科医生经常面临父母和教师对孩子行为问题报告不一致的情况,但既往关于父母和教师对学龄前儿童行为问题评估的研究较少。 目的 调查重庆市主城区学龄前儿童行为问题的现状,探讨父母及教师对学龄前儿童行为问题评估的一致性及差异。 方法 于2018年6月,采用分层整群抽样法,在重庆市主城区幼儿园抽取学龄前儿童2 698例。儿童家长填写Conners父母用症状问卷(PSQ),教师填写Conners教师量表(TRS),比较基于PSQ和TRS的行为问题检出情况。 结果 最终纳入问卷被有效回收的学龄前儿童2 660例(98.59%)。基于PSQ的儿童行为问题检出率为14.47%(385/2 660),男童高于女童〔17.91%(245/1 368)比10.84%(140/1 292),P<0.001〕;基于TRS的儿童行为问题检出率为4.44%(118/2 660),男童亦高于女童〔6.29%(86/1 368)比2.48%(32/1 292),P<0.001〕。PSQ中,男童在学习问题、心身问题、多动指数上的检出率高于女童(P<0.05);TRS中,男童在品行问题、多动指数上的检出率高于女童(P<0.05)。PSQ中,男童在品行问题、学习问题、冲动-多动问题、多动指数4个因子上的得分高于女童(P<0.05);TRS中,男童在品行问题、多动问题、注意力不集中-被动问题、多动指数4个因子上的得分高于女童(P<0.05)。Spearman秩相关分析结果显示:在男童中,TRS中品行问题、注意力不集中-被动问题、多动指数得分与PSQ中品行问题、学习问题、冲动-多动问题、多动指数得分呈正相关,TRS中多动问题得分与PSQ中品行问题、冲动-多动问题、多动指数得分呈正相关(rs值为0.056~0.113,P<0.05),TRS中多动问题得分与PSQ中焦虑问题得分呈负相关(rs=-0.059,P<0.05);在女童中,TRS中各因子得分与PSQ中各因子得分无相关关系(P>0.05)。 结论 家长反映的学龄前儿童行为问题检出率较教师高,家长及教师对学龄前儿童行为问题的评估虽然存在一定差异,但在品行问题、多动方面的评估一致性较好。  相似文献   
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AimThis clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients.MethodsA comprehensive literature search was conducted from November 11, 2017, to May 1, 2020, encompassing randomized and nonrandomized trials, observational studies, registries, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, Agency for Healthcare Research and Quality reports, and other relevant databases. Additional relevant studies, published through April 2021, were also considered.StructureChest pain is a frequent cause for emergency department visits in the United States. The “2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain” provides recommendations based on contemporary evidence on the assessment and evaluation of chest pain. This guideline presents an evidence-based approach to risk stratification and the diagnostic workup for the evaluation of chest pain. Cost-value considerations in diagnostic testing have been incorporated, and shared decision-making with patients is recommended.  相似文献   
6.
BackgroundAn altered understanding of relationships, including friendship, is one of the hallmark features of autism. However, research concerning friendship understanding among autistic people is scarce. The existing literature is limited mostly to children and often disregards gender differences. Thus, the current study aimed to examine friendship understanding in adolescents and adults whilst taking into account both autism diagnosis and gender.MethodThe current study was a secondary analysis of data obtained in the Polish Autism Survey. Participants were 76 autistic individuals (44 males, ages 14−37 years) and 76 matched controls. Qualitative responses to an open-ended question concerning friendship understanding were coded into six non-exclusive categories, including motivational (intimacy, support, and companionship) and cognitive-developmental (reciprocity, unconditional responsiveness, and complexity) aspects of friendship. Chi-squared tests and Mann-Whitney U were used to examine group (autistic vs. typically developing) and gender differences in friendship understanding.ResultsAutistic people referred to intimacy and unconditional responsiveness less often and also provided less complex definitions of a ‘friend’ than their typically developing peers. Autistic and typically developing males endorsed unconditional responsiveness and complexity less often than females. Additionally, participants who included cognitive-developmental aspects in their definition of a ‘friend’ more often reported having casual friends and a best friend.ConclusionsThe findings shed light on rarely explored aspects of friendship understanding in autistic and typically developing adolescents and adults. The study identifies distinct profiles of friendship understanding in autistic males and females. Taken together, the results can foster the development of fine-grained assessment and support of friendship understanding for people on the autism spectrum.  相似文献   
7.
《Value in health》2022,25(5):677-684
ObjectivesHealthcare policy makers should ensure optimal patient access to medical nutrition (MN) as part of the management of nutrition-related disorders and conditions. Questions remain whether current healthcare policies reflect the clinical and economic benefits of MN. The objective of this article is to characterize coverage and reimbursement of MN, defined as food for special medical purposes/medical food for a diverse set of countries, including Australia, Belgium, Brazil, Canada, China, France, Germany, Hong Kong, Italy, Japan, The Netherlands, Singapore, Spain, United Kingdom, and United States.MethodsData sources included published literature and online sources. ISPOR’s Nutrition Economics Special Interest Group developed a data collection form to guide data extraction that included reimbursement coverage, years that reimbursement policies were established, and presence of a formal health technology assessment (HTA) for MN technologies.ResultsReimbursement coverage of MN technologies varied across the countries that were reviewed. All but 3 countries limited coverage to specific formulations of products, regardless of demonstrated clinical benefit. The year that reimbursement policies were established varied across countries (ranging from 1984 to 2017), and only 4 countries regularly update policies. France and Brazil are the only countries with a formal HTA process for MN technologies.ConclusionsMost countries have limited MN reimbursement, have not updated reimbursement policies, and lack HTA for MN technologies. These limitations may lead to suboptimal access to MN technologies where they are indicated to manage nutrition-related disorders and conditions, with the potential of negatively affecting patient and healthcare system outcomes.  相似文献   
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9.
BackgroundThe purpose of this study was to identify sex differences in lower limb kinematics, kinetics, and muscle activation patterns between individuals with osteoarthritis and healthy controls during a two-legged squat.MethodThirty OA (15 females) and 30 healthy (15 females) participants performed three 2-legged squats. Sagittal and frontal plane hip, knee, and ankle kinematics and kinetics were calculated. Two-way ANOVAs (Sex X OA Status) were used to characterize differences in squatting strategies between sexes and between those with and without knee OA.ResultsA greater decrease in sagittal hip, knee, and ankle range of motion and knee joint power was observed in the OA participants compared to the healthy controls. Females with OA had significantly reduced hip and knee adduction angles compared to the healthy females and males with OA. Females also had decreased hip power, hip flexion, and hip adduction moments and knee adduction moments compared to their male counterparts, with the greatest deficits observed in the females with OA. Females with OA also had the highest magnitude of muscle activation for the quadriceps, hamstrings, and gastrocnemius throughout the squat, while males with OA showed increased activation of the vastus lateralis and medial gastrocnemius compared to the healthy males.ConclusionsOA significantly altered biomechanics and neuromuscular control during the squat, with males employing a hip-dominant strategy, allowing them to achieve a greater lower limb range of motion.  相似文献   
10.
Background and aimsThe associations between dyslipidemia and coronary artery calcium (CAC) are controversial. We investigated their cross-sectional relationships and developed a predictive scoring system for prognostically significant coronary calcification (PSCC).Methods and resultsThis study evaluated the lipid profiles and the CAC score (CACS) measured through multidetector computed tomography (MDCT) among Taiwanese adult patients in a tertiary hospital between 2011 and 2016. Patients with CACS higher than 100 were classified as having PSCC. Dyslipidemia for each lipid component was defined based on the clinical cutoffs or the use of the lipid-lowering agents. Multivariable logistic regression was used to assess the association between dyslipidemia and PSCC and the model performance was assessed using calibration plot, discrimination, and a decision curve analysis.Of the 3586 eligible patients, 364 (10.2%) had PSCC. Increased age, male sex, higher body mass index (BMI), and higher level of triglyceride (TG) were associated with PSCC. The adjusted odds ratios (95% confidence intervals) of PSCC was 1.15 (0.90–1.47) for dyslipidemia defined by total cholesterol (TC) ≥200 mg/dL, 1.06 (0.83–1.35) for low-density-lipoprotein-cholesterol (LDL-C) ≥130 mg/dL, and 1.36 (1.06–1.75) for TG ≥ 200 mg/dL. The positive association between TG ≥ 200 mg/dL and PSCC was not modified by sex. Incorporating hypertriglyceridemia did not significantly improve the predictive performance of the base model comprising of age, sex, BMI, smoking, hypertension, diabetes, estimated glomerular filtration rate, and fasting glucose.ConclusionsHypertriglyceridemia was significantly associated with the prevalent odds of PSCC. Our proposed predictive model may be a useful screening tool for PSCC.  相似文献   
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