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Robert J. Motzer MD David F. McDermott MD Bernard Escudier MD Mauricio Burotto MD Toni K. Choueiri MD Hans J. Hammers MD PhD Philippe Barthélémy MD PhD Elizabeth R. Plimack MD Camillo Porta MD Saby George MD Thomas Powles MD Frede Donskov MD PhD Howard Gurney MD Christian K. Kollmannsberger MD Marc-Oliver Grimm MD Carlos Barrios MD Yoshihiko Tomita MD PhD Daniel Castellano MD Viktor Grünwald MD PhD Brian I. Rini MD M. Brent McHenry PhD Chung-Wei Lee MD PhD Jennifer McCarthy MA Flavia Ejzykowicz PhD Nizar M. Tannir MD 《Cancer》2022,128(11):2085-2097
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Perinatal hypoxic-ischemic encephalopathy is a leading cause of neonatal death and disability.Therapeutic hypothermia significantly reduces death and major disability associated with hypoxic-ischemic encephalopathy;however,many infants still experience lifelong disabilities to movement,sensation and cognition.Clinical guidelines,based on strong clinical and preclinical evidence,recommend therapeutic hypothermia should be started within 6 hours of birth and continued for a period of 72 hours,with a target brain temperature of 33.5 ±0.5℃ for infants with moderate to severe hypoxic-ischemic encephalopathy.The clinical guidelines also recommend that infants be re warmed at a rate of 0.5℃ per hour,but this is not based on strong evidence.There are no randomized controlled trials investigating the optimal rate of rewarming after therapeutic hypothermia for infants with hypoxic-ischemic encephalopathy.Preclinical studies of rewarming are conflicting and results were confounded by treatment with sub-optimal durations of hypothermia.In this review,we evaluate the evidence for the optimal start time,duration and depth of hypothermia,and whether the rate of rewarming after treatment affects brain injury and neurological outcomes. 相似文献
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Mohamed F. Jalloh Sarah D. Bennett Didarul Alam Paryss Kouta Dalia Lourenço Mohammad Alamgir Leora R. Feldstein Daniel C. Ehlman Neetu Abad Neha Kapil Maya Vandenent Laura Conklin Brent Wolff 《Vaccine》2019,37(6):833-838
Background
In November 2017, the World Health Organization received initial reports of suspected diphtheria cases in camps established for displaced Rohingyas in Cox’s Bazar district, Bangladesh. By January 11, 2018, over 4,000 suspected cases of diphtheria and 30 deaths were reported. The Bangladesh government and partners implemented a diphtheria vaccination campaign in December 2017. Outbreak response staff reported anecdotal evidence of vaccine hesitancy. Our assessment aimed to understand vaccination barriers and opportunities to enhance vaccine demand among displaced Rohingyas in Bangladesh.Methods
In January 2018, we conducted a qualitative assessment consisting of nine focus group discussions and 15 key informant interviews with displaced Rohingyas in three camps. Participants included mothers and fathers with under five-year-old children, community volunteers, majhis (camp leaders), Islamic religious leaders, traditional and spiritual healers, and teachers. We recruited participants using purposive sampling, and analyzed the data thematically.Results
Across focus groups and in-depth interviews, trusted information sources cited by participants included religious leaders, elders, village doctors, pharmacists, majhis, and mothers trained by non-governmental organizations to educate caregivers. Treatment of diphtheria and measles was usually sought from multiple sources including traditional and spiritual healers, village doctors, pharmacies, and health clinics. Major barriers to vaccination included: various beliefs about vaccination causing people to become Christian; concerns about multiple vaccines being received on the same day; worries about vaccination side effects; and, lack of sensitivity to cultural gender norms at the vaccination sites.Conclusion
Although vaccination was understood as an important intervention to prevent childhood diseases, participants reported numerous barriers to vaccination. Strengthening vaccine demand and acceptance among displaced Rohingyas can be enhanced by improving vaccination delivery practices and engaging trusted leaders to address religious and cultural barriers using community-based channels. 相似文献7.
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Nagesh Adluru Cole H. Korponay Derek L. Norton Robin I. Goldman Richard J. Davidson 《Neurocase》2020,26(2):79-90
ABSTRACTYongey Mingyur Rinpoche (YMR) is a Tibetan Buddhist monk, and renowned meditation practitioner and teacher who has spent an extraordinary number of hours of his life meditating. The brain-aging profile of this expert meditator in comparison to a control population was examined using a machine learning framework, which estimates “brain-age” from brain imaging. YMR’s brain-aging rate appeared slower than that of controls suggesting early maturation and delayed aging. At 41 years, his brain resembled that of a 33-year-old. Specific regional changes did not differentiate YMR from controls, suggesting that the brain-aging differences may arise from coordinated changes spread throughout the gray matter. 相似文献