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991.
BACKGROUND:: The study of human attitudes toward death has given rise to a substantial body of empirical research. Psychometric instruments have been developed to measure fear of death, or death anxiety, and its psychological consequences in people who continually come into contact with stimuli related to mortality. OBJECTIVES:: To analyze the 20-item Death Anxiety Inventory (DAI) within the framework of item response theory (IRT) and using the generalized partial credit model. METHODS:: The sample comprised 154 men and 550 women and was drawn from nurses, doctors, industrial workers, teachers, undergraduates, and retired persons. Subjects completed the DAI, a self-administered, Likert-type questionnaire of 20 items, each with six response options. RESULTS:: The DAI showed a relatively adequate fit to the generalized partial credit model. Thus, 4 of the 20 items presented a poor fit to the model. The analysis of item information and test information functions revealed that the 20-item test was appropriate for differentiating subjects with medium or high levels of death anxiety. The test information function was higher in this range of scores, indicating greater precision in the estimate of death anxiety for these subjects. DISCUSSION:: The generalized partial credit model can be used to obtain detailed information about a clinical test and its items, and there are advantages to this approach when working with polytomous tests. 相似文献
992.
Causes of nephrotic syndrome and nephrotic‐range proteinuria are different in adult Chinese patients: A single centre study over 33 years
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S. Larréché A. Bousquet C. Soler C. Mac Nab D. de Briel D. Delaune C. Bigaillon P. Pasquier C. Dubost T. Demoures B. Malgras S. Ausset S. de Rudnicki T. Leclerc B. de Loynes S. Bonnet N. Mocellin C. Ficko A. Mérens 《Médecine et maladies infectieuses》2018,48(6):403-409
Background
This study aimed to describe the microbiological epidemiology of repatriated French soldiers with an open traumatic injury, and to measure the proportion of multidrug-resistant bacteria (MDRB).Methods
Retrospective study including all French soldiers repatriated in 2011 and 2012 in Parisian military hospitals for open traumatic injury. Results of clinical samples and MDRB screening were collected. The antibiotic susceptibility was assessed using the agar disk diffusion method. Characterization of resistance mechanisms was performed using PCR. Genotyping of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) isolates was performed using rep-PCR.Results
A total of 139 patients were included; 70% of them were repatriated from Afghanistan. At admission, 24/88 were positive for MDRB (28%), mainly ESBL-E but no carbapenemase-producing Enterobacteriaceae and vancomycin-resistant Enterococcus faecium were identified. Forty-five patients had lesion sample collection, and 28/45 had a positive culture. The most frequently isolated pathogens were Enterobacter cloacae, Pseudomonas aeruginosa, and Escherichia coli. For eight patients, a MDRB was isolated from the wound, mainly ESBL-E (7/8) but also one methicillin-resistant Staphylococcus aureus and one imipenem-resistant Acinetobacter baumannii. Among ESBL-E, the PCR evidenced the high prevalence of CTX-M15 enzymes. Rep-PCR performed on the 23 ESBL-producing E. coli isolates highlighted numerous profiles.Conclusions
Controlling the spread of ESBL-E is currently challenging for French Armed Forces. Despite any evidence of an epidemic clone, a high-level compliance with hygiene precautions is required throughout the chain of care to avoid cross contamination. 相似文献997.
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Elena Larrieta-Carrasco Yvonne N. Flores Luis R. Macías-Kauffer Paula Ramírez-Palacios Manuel Quiterio Eric G. Ramírez-Salazar Paola León-Mimila Berenice Rivera-Paredez Guillermo Cabrera-Álvarez Samuel Canizales-Quinteros Zuo-Feng Zhang Tania V. López-Pérez Jorge Salmerón Rafael Velázquez-Cruz 《Experimental and molecular pathology》2018,104(1):50-58
Non-alcoholic fatty liver disease (NAFLD) is the accumulation of extra fat in liver cells not caused by alcohol. Elevated transaminase levels are common indicators of liver disease, including NAFLD. Previously, we demonstrated that PNPLA3 (rs738409), LYPLAL1 (rs12137855), PPP1R3B (rs4240624), and GCKR (rs780094) are associated with elevated transaminase levels in overweight/obese Mexican adults. We investigated the association between 288 SNPs identified in genome-wide association studies and risk of elevated transaminase levels in an admixed Mexican-Mestizo sample of 178 cases of NAFLD and 454 healthy controls. The rs2896019, rs12483959, and rs3810622 SNPs in PNPLA3 and rs1227756 in COL13A1 were associated with elevated alanine aminotransferase (ALT, ≥ 40 IU/L). A polygenic risk score (PRS) based on six SNPs in the ADIPOQ, COL13A1, PNPLA3, and SAMM50 genes was also associated with elevated ALT. Individuals carrying 9–12 risk alleles had 65.8% and 48.5% higher ALT and aspartate aminotransferase (AST) levels, respectively, than those with 1–4 risk alleles. The PRS showed the greatest risk of elevated ALT levels, with a higher level of significance than the individual variants. Our findings suggest a significant association between variants in COL13A1, ADIPOQ, SAMM50, and PNPLA3, and risk of NAFLD/elevated transaminase levels in Mexican adults with an admixed ancestry. This is the first study to examine high-density single nucleotide screening for genetic variations in a Mexican-Mestizo population. The extent of the effect of these variations on the development and progression of NAFLD in Latino populations requires further analysis. 相似文献
999.
F. Mateos C. Valero J. M. Olmos B. Casanueva J. Castillo J. Martínez J. L. Hernández J. González Macías 《Osteoporosis international》2014,25(2):525-533
Summary
No differences in either bone mineral density or serum 25OHD levels have been found between 205 women with fibromyalgia (both pre- and postmenopausal) and their controls. However, a lack of the expected 25OHD summer rise was observed in patients.Introduction
Contradictory data have been published regarding a possible association between fibromyalgia and osteoporosis or hypovitaminosis D. Most studies, however, have been performed in small size samples and have excluded postmenopausal women. We decided to study this association in a larger sample of fibromyalgia patients including both pre- and postmenopausal women.Methods
Two hundred five patients were recruited from a clinic specializing in fibromyalgia and 205 healthy controls were enrolled from the census of a Primary Care Center. Controls were matched with patients by age and the time of the year they were included in the study. Bone mineral density (BMD) was measured by DXA. Serum 25OHD, iPTH, P1NP, and CTX were also determined.Results
BMD was similar in both groups (lumbar spine, 0.971?±?0.146 g/cm2 in patients and 0.970?±?0.132 g/cm2 in controls; femoral neck, 0.780?±?0.122 g/cm2 and 0.785?±?0.117 g/cm2, respectively). 25OHD levels were also similar: 23.0?±?9.5 ng/ml and 24.1?±?9.6 ng/ml. However, while controls showed the usual summer rise in 25OHD, fibromyalgia patients did not. PTH did not show seasonal changes, but on average was higher in patients (51 pg/ml vs. 48 pg/ml; p?=?0.034). P1NP or CTX were similar in both groups.Conclusions
No differences in BMD were found between patients and controls. As for 25OHD, a lack of its expected summer rise was observed. It is doubtful whether this has any homeostatic consequence. We consider that the association reported in other studies is merely circumstantial, and not due to the intrinsic characteristics of these disorders. 相似文献1000.
Objective: Little is known about the nationwide patterns in the use of public
health informatics systems by local health departments (LHDs) and whether LHDs
tend to possess informatics capacity across a broad range of information
functionalities or for a narrower range. This study examined patterns and
correlates of the presence of public health informatics functionalities within
LHDs through the creation of a typology of LHD informatics capacities.Methods: Data were available for 459 LHDs from the 2013 National Association of
County and City Health Officials Profile survey. An empirical typology was
created through cluster analysis of six public health informatics
functionalities: immunization registry, electronic disease registry, electronic
lab reporting, electronic health records, health information exchange, and
electronic syndromic surveillance system. Three-categories of usage emerged
(Low, Mid, High). LHD financial, workforce, organization, governance, and
leadership characteristics, and types of services provided were explored across
categories.Results: Low-informatics capacity LHDs had lower levels of use of each
informatics functionality than high-informatics capacity LHDs. Mid-informatics
capacity LHDs had usage levels equivalent to high-capacity LHDs for the three
most common functionalities and equivalent to low-capacity LHDs for the three
least common functionalities. Informatics capacity was positively associated
with service provision, especially for population-focused services.Conclusion: Informatics capacity is clustered within LHDs. Increasing LHD
informatics capacity may require LHDs with low levels of informatics capacity to
expand capacity across a range of functionalities, taking into account their
narrower service portfolio. LHDs with mid-level informatics capacity may need
specialized support in enhancing capacity for less common technologies. 相似文献