Current status of HIV therapy: II. Opportunistic diseases

Infections and malignancies account for most deaths in patients with AIDS--and will continue to do so as long as HIV-induced immunosuppression is progressive and irreversible. Options available for prevention and improved management of such diseases are changing as new agents emerge, new combinations of agents are developed, and new indications for available agents are identified.     

The formal mental health care burden among recently deinstitutionalized patients

This article examines the extent to which the costs of formal health care are shifted from third-party payers to the patient and his or her family, especially during the transition to the community after discharge from a state hospital. Findings indicate that patients residing in the community are as likely to receive some care as their counterparts in institutions, but are at higher risk for uncovered care. Uncovered care is more likely to manifest as an unmet need for patients who have been recently discharged, especially for racial minorities, and as an out-of-pocket expense for patients who are established in the community.     

About optimized designs and circuits of autonomous electric stimulators for the gastrointestinal tract

Described in the paper are the key principles of designing of autonomous electrodes for the gastrointestinal tract (AE GT) as well as circuits of stimulating-pulse generators. A shape for the electric-stimulator frame, its geometric dimensions and choice of a material for electrodes are substantiated. The electric- and trauma-safety of AE GT is discussed. The main stimulating current parameters, as well as the flowchart and design of the electric stimulator are presented.     

Small colony variants (SCVs) of Staphylococcus aureus – A bacterial survival strategy

Small colony variants (SCVs) of Staphylococcus aureus have been implicated in chronic recurrent infections and have therefore gained renewed interest during the last decade. Moreover, SCVs have been shown to be part of the regular growth cycle, are highly dynamic or stable and can be selected during various harsh conditions. As such, the emergence of SCVs has been described not only in human, but also in veterinary medicine as well as in food microbiology. SCVs are characterized by impaired growth, down-regulation of genes for metabolism and virulence, while sigB and genes important for persistence and biofilm formation are up-regulated. Furthermore, SCVs are resistant to various antibiotics such as aminoglycosides, trimethoprim-sulfamethoxazole, fluorquinolones, fusidic acid or even to antiseptics such as triclosan. An underlying mechanism has been determined for hemin-, menadione- and thymidine-dependent SCVs as well as for SCVs which are impaired in their stress response. SCVs are optimized for persistence in the host. They are able to reverse and thereby constitute a highly dynamic subpopulation of S. aureus. Such phenotype switching constitutes an integral part of the infection process enabling the bacteria to hide inside the host cell without eliciting a strong host response.     

运用直接优先加权定序法测算医院床位需求

选取病床使用率等5项指标,运用直接优先加权定序法和预先设定的规则对26个科室的病床需求情况进行了综合评判,筛选出14个符合条件的科室,作为床位分配的参考。     

Views and preferences of low-literate Hispanics regarding diabetes education: results of formative research.

Hispanics are twice as likely as non-Hispanic Whites to have diabetes and are also at higher risk for diabetes-related complications and poorer outcomes. The prevalence of diabetes is inversely related to educational status. Low literacy is common, especially among older Hispanics. Little literature exists on formative research to create diabetes education materials for this audience. Two focus groups assessed views and preferences for diabetes education of low-literate, low-income, non-English-speaking urban Caribbean and Central American Hispanics with diabetes, as well as utility of materials developed specifically for this population, as part of the preliminary work for a pilot study of a diabetes intervention. Implications for practitioners and researchers are discussed.     

Seduction and the self: movements through precarity,race and sexuality in Japanese host clubs

In this article, I build on the notion of precarity to argue that Japanese host clubs are sites in which a particular kind of intimacy and sense of ‘belonging’ are produced. The analysis highlights host clubs as necessary spaces among many in the precarious economy and as important venues for the production of subjectivity for the male hosts (both migrant and Japanese) as well as for the migrant women who frequent these establishments. In particular, host clubs provide a lucrative employment opportunity for young men – particularly young men who are migrants from the rural parts of Japan or the Philippines (and often Japanese-Filipino young men) who are trying to make a living in the context of what has been characterised as ‘precarious Japan’. I draw on extended ethnographic fieldwork to show how the host clubs, though a part of the precarious economy, provide sites of home and belonging for both hosts and their clients.     

Approximate and exact tests of Hardy-Weinberg equilibrium using uncertain genotypes

Testing for Hardy-Weinberg equilibrium (HWE) is commonly used as a quality control filter in genome-wide scans for markers with experimentally determined genotypes. In contrast, for markers with imputed genotypes, there are post-imputation metrics of quality that can be used as screens but there are no formal tests of deviation from HWE. Similarly, there are no formal tests of deviation from HWE for probabilistic genotypes that are generated by sequencing projects. Here, I describe generalizations of the approximate χ(2) and exact tests of HWE for use with uncertain genotypes. The tests fully account for the probabilities of all possible genotypes at a marker for each individual. By computer simulation, the approximate and exact tests are shown to maintain valid control of the type I error rate. Calculations of the loss of power as the uncertainty in genotypes increases are illustrated. The tests are compatible with chip-based genotypes for single-nucleotide polymorphisms and copy number polymorphisms, imputed genotypes, and probabilistic assignments of genotype from variable-coverage sequence data.     

Voltaire's Best Seller

Thirty years of study have proved that these artificial organelles are versatile tools for learning about the cell membrane. Researchers are now actively investigating their potential for some interesting practical uses as vehicles for gene transfer, as artificial erythrocyte surrogates, as a lubricant for degenerated joint surfaces, and most imminently as “targeted carriers” of pharmacologic agents.     

Element speciation definitions,analytical methodology,and some examples

This paper gives definitions related to element speciation and the reasons for the need for speciation. The problems focused on, involve sampling, sample preparation and storage, as well as changes in species information that occur during the use of various separation technologies. However, the potential and advantages of the separation methods in element speciation are also discussed. In addition, problems arising during element detection that are attributable to analytes or mobile-phase composition are outlined, as well as the pronounced advantages of detection by inductively coupled plasma-mass spectrometry (ICP-MS). The combination of the various separation systems with element- or molecule-specific detectors creates problems especially in element speciation. These difficulties are described along with recent developments for overcoming them or for improving their coupling efficiency. Finally, several elements for which the issue of speciation is important are discussed, with examples from some recent publications on arsenic, selenium and iodine speciation.     

Outline of medical standards for divers

Information required for the medical examination of sport, commercial, and military divers is provided. The paper adheres to an outline format and covers the diver's medical history as well as specific points to look for in the physical and laboratory examination. Numerous disqualifying conditions are listed and they are divided into absolute contraindications and relative contraindications. Physical work capacity standards are also included as well as pressure and oxygen testing. References have been drawn from the international literature, and sources of additional medical information are provided.     

Diagnostic tools for preventing and managing maternal and congenital syphilis: an overview

Syphilis is a major cause of adverse outcomes in pregnancy in developing countries. Fetal death and morbidity due to congenital syphilis are preventable if infected mothers are identified and treated appropriately by the middle of the second trimester. Most pregnant women with syphilis are asymptomatic and can only be identified through serological screening. Non-treponemal tests, such as the rapid plasma reagin (RPR) test, are sensitive, simple to perform, and inexpensive. However, they have often not been available at primary health-care settings because they required cold storage for reagents and electricity to operate a rotator. Additionally, as many as 28% of positive RPR results in pregnant women are biological false positives. Confirmatory assays are usually available only in reference laboratories. Technological advances have resulted in improved serodiagnostic tools for syphilis. New enzyme immunoassays are available for surveillance and for large-scale screening programmes. Decentralized antenatal screening with on-site confirmation is now possible since new RPR reagents that are stable at room temperature have become commercially available, as have solar-powered rotators and simple, rapid point-of-care treponemal tests that use whole blood and do not require electricity or equipment. These will be valuable tools for preventing or eliminating congenital syphilis. The development of a non-invasive rapid treponemal test that distinguishes between active and past infections remains a high priority in areas where syphilis is endemic.     

Making a Visual Impression (or Not): Current Design Practices of Nutritional Websites

Understanding the influence of visual design, as the access point for online health communication, is key as Americans are increasingly sickened by an obesity epidemic. Nutritional websites that deliver critical health information should be considered as a potential strategy to fight against the grave consequences of obesity, as research indicates that consumers are consistently turning to the Internet as a resource for health information. Focusing on nutritional websites, this study analyzes the use of visual design principles that are known to greatly influence first impressions and appeal of the information from the user’s perspective. The results suggest there are opportunities for improvement to the online communication of nutritional information to increase the likelihood of users’ favorable first impressions, the critical first steps for nutritional information delivery goals.     

Sexual orientation and sex role conformity

Homosexuals are stereotypically viewed as deviating from the conventional sex role standards of our society. Homosexual males are regarded as effeminate, while homosexual females are seen as masculine. Some limited empirical support for these stereotypes has been reported in the literature. However, results remain inconclusive. In order to provide a further test of these stereotypes, 186 male and female homosexual, bisexual, and heterosexual subjects were administered the Bem Sex Role Inventory. Results showed no significant support for prevailing stereotypes. Possible reasons for the discrepancy between these findings and previous reports are explored and suggestions are offered for future research.     

Patient-reported outcomes in rehabilitation research: instruments and current developments in Germany

Monitoring the health status of patients has become a major activity in rehabilitation research in recent years. As a result, various self-assessment instruments have been developed, adapted or improved with the aim of measuring patient-reported outcomes and predictors. Among these are international instruments, such as the NHP or the SF-36, as well as those developed in Germany, such as the IRES, the FREM-17 or the SPE-scale. Some of the widely used international instruments, such as the NHP and SF-36, have been translated into German for application in Germany. All of these instruments have been thoroughly tested and validated in several studies. Current trends in statistical methods (e.g. responsiveness, Rasch scaling) as well as classical test-theoretical standards were taken into consideration in the development of these instruments. In this article, we provide a comprehensive review of five important assessment fields of rehabilitation research in Germany: health-related quality of life (generic, disease-specific, children and adolescents, preference-based), evaluation of specific therapy and education programs, motivation, screening for vocational problems and screening for comorbid disorders. The questionnaires are critically discussed, and perspectives for further research are specified. Although assessment instruments as the IRES or the SF-36 are well-established in rehabilitation research studies, there is still a need for further research to determine the best choice of instruments for a given purpose. The limitations of the questionnaires with respect to health care studies are also discussed.     

创伤失血性休克液体复苏中的监测及临床意义

目的探讨限制性液体复苏中的监护治疗学问题。方法通过总结研究临床实践中实施的监护措施,比较有助于创伤失血性休克液体成功复苏的监护治疗技术,并为液体复苏过程中的液体选择方法、温度等实施策略提供依据。结果创伤失血性休克液体复苏过程中通过对全身及局部的灌注状况严密监测及其临床意义的了解,可以指导临床有效地实施液体复苏。结论监测结果对治疗过程起到指导作用。     

Statistical procedures for estimating the community probability of illness in family studies: rhinovirus and influenza

A statistical method is presented for determining acquisition rates of illness from community sources of infection and for distinguishing among viruses which are associated with different epidemic seasons. The new method consists of a computationally simple procedure for estimating the community transmission parameter and the standard error of the estimator. This method, as well as a previously developed maximum likelihood procedure, is applied to illness data as a means for distinguishing among broad patterns of illness acquisition. The periods evaluated are the rhinovirus, influenza A and influenza B seasons in Tecumseh, Michigan, for the years 1976-1980. Tecumseh households are stratified into exposure groups depending on age-group composition. Estimates are found for the risk differences of illness acquired from the community for households with different age-group distributions. Analysis of the Tecumseh data reveals that members of households with children are more apt than members of households without children to acquire illness associated with rhinovirus, influenza A and influenza B from the community. Members of households with just preschool children (and adults) are more apt than members of households with just school children (and adults) to acquire illness associated with rhinovirus and influenza B from the community. In contrast, members of households with just preschool children (and adults) are just as likely as members of households with just school children (and adults) to acquire illnesses associated with influenza A from the community.     

以益生菌为载体的基因工程疫苗研究进展

益生菌是被人体摄入后能产生除细菌本身具有的营养以外的益生作用的一种活菌。益生菌具有多种健康功效,且具有公认的安全性,随着益生菌蛋白表达技术的成熟,以益生菌为蛋白或抗原、抗体释放载体的研究成为了新的亮点。本文以乳酸杆菌为益生菌代表,对以益生菌为载体的基因工程疫苗的作用原理、相关技术及研究近况作一综述。     

Checking hazard regression models using pseudo-observations

Graphical methods for model diagnostics are an essential part of the model fitting procedure. However, in survival analysis, the plotting is always hampered by the presence of censoring. Although model specific solutions do exist and are commonly used, we present a more general approach that covers all the models using the same framework. The pseudo-observations enable us to calculate residuals for each individual at each time point regardless of censoring and provide methods for simultaneously checking all the assumptions of both the Cox and the additive model. We introduce methods for single as well as multiple covariate cases and complement them with corresponding goodness-of-fit tests. The methods are illustrated on simulated as well as real data examples.     

Sensation Seekers as a Healthcare Marketing Metasegment

This article discusses “sensation seekers” as a market segment for communication and prevention programs for various lifestyle and/or risk-related health problem areas such as alcohol abuse, drug abuse, suicide attempts, and sexually transmitted diseases. Although sensation seekers tend to be creative, artistic individuals, they are also prone to various negative health behaviors and many population-based prevention programs have over-looked these individuals as an important target. Various inputs to sensation-seeking causation are explored, including biological/chemical, psychological, and the impact of external characteristics. Using a combination for regulatory focus and risk homeostasis, propositions are provided for improving the effectiveness of the communications. Recommendations for prevention efforts focusing on reaching this subculture using television, along with other electronic media are proposed, including recommendations for message construction and presentation venues.