Correlates of county-level nonviral sexually transmitted infection hot spots in the US: application of hot spot analysis and spatial logistic regression

PurposeWe used a combination of hot spot analysis (HSA) and spatial regression to examine county-level hot spot correlates for the most commonly reported nonviral sexually transmitted infections (STIs) in the 48 contiguous states in the United States (US).MethodsWe obtained reported county-level total case rates of chlamydia, gonorrhea, and primary and secondary (P&S) syphilis in all counties in the 48 contiguous states from national surveillance data and computed temporally smoothed rates using 2008–2012 data. Covariates were obtained from county-level multiyear (2008–2012) American Community Surveys from the US census. We conducted HSA to identify hot spot counties for all three STIs. We then applied spatial logistic regression with the spatial error model to determine the association between the identified hot spots and the covariates.ResultsHSA indicated that ≥84% of hot spots for each STI were in the South. Spatial regression results indicated that, a 10-unit increase in the percentage of Black non-Hispanics was associated with ≈42% (P < 0.01) [≈22% (P < 0.01), for Hispanics] increase in the odds of being a hot spot county for chlamydia and gonorrhea, and ≈27% (P < 0.01) [≈11% (P < 0.01) for Hispanics] for P&S syphilis. Compared with the other regions (West, Midwest, and Northeast), counties in the South were 6.5 (P < 0.01; chlamydia), 9.6 (P < 0.01; gonorrhea), and 4.7 (P < 0.01; P&S syphilis) times more likely to be hot spots.ConclusionOur study provides important information on hot spot clusters of nonviral STIs in the entire United States, including associations between hot spot counties and sociodemographic factors.     

心肺复苏基础研究热点与展望

心肺复苏基础研究是现代心肺复苏学的重要组成部分,对于解析心肺复苏相关机制,改进现有心肺复苏策略和发现新的治疗靶点至关重要。本文对复苏时治疗措施(胸外心脏按压、药物治疗)和复苏后治疗措施(目标温度管理和药物治疗)、复苏后脑损伤机制及预后评估等当前心肺复苏基础研究热点做一述评,以期为心肺复苏基础和临床研究提供参考。     

温度和时间对10%葡萄糖注射液中5-羟甲基糠醛含量的影响

10% 葡萄糖注射液中5- 羟甲基糠醛含量随温度、时间而改变。初均速法加速实验,以ln Vol,代替InKi对热力学温度的倒数1/T1作Arrhenius图得直线,线性回归计算出反应活化能和不同温度下5一羟甲基糠醛含量的达限时间。结果提示;在制剂灭菌,药品使用和贮存过程中,应采用科学的,适宜的方法和措施,确保药品质量。     

Changes in blood-brain barrier permeability during hot water-induced seizures in rats

Abstract. Hot water epilepsy (HWE) was induced in freely moving Wistar rats by applying hot water jets over the head region. The status of the blood-brain barrier (BBB) during the seizures and during hot water-induced hyperthermia without seizures was examined using Evans blue dye. In order to investigate the contribution of concomitant factors to this process, synchronized body temperature and blood pressure recordings were also made. Tonic-clonic seizure activity was observed within an average of 3.9 min (SE=0.6 min) in the rats exposed to the hot water jets; this treatment induced BBB opening in the cortical and deep brain areas. Body temperature and blood pressure increased from 36.5°±0.3°C to 40.0°±0.2°C, and from 91±3 mmHg to 153±4 mmHg, respectively. In the group of animals exposed to hot water application without inducing seizures, there were significant increases both in blood pressure and body temperature; however, the extravasation of Evans blue was not pronounced in the brains. Hot water-induced seizures, increased cerebrovascular permeability. Although high blood pressure and hyperthermia contribute to this permeability, the seizure activity is the major factor in this change.     

Isoflavones--safe food additives or dangerous drugs?

The sales volume of products containing isoflavone has increased since the publication of the Women's Health Initiative. The many apparently contradictory results published on the effects of isoflavones on a variety of estrogen-regulated organs point to both beneficial as well as adverse effects on human health. It is of particular importance that psychovegetative climacteric complaints such as hot flushes are, if at all, only slightly influenced by isoflavones. The substances appear to have weak anti-osteoporotic effect. Their anti-atherosclerotic action is debatable, as not all authors find any beneficial effect on lipids. Most importantly, there is dispute as to whether isoflavones derived from soy or red clover have negative, positive or any effect at all on the mammary gland or endometrium. It is beyond any doubt that soy products may have cancer preventing properties in a variety of organs including the mammary gland. However, these properties may only be exerted if the developing organ was under the influence of isoflavones during childhood and puberty. This may also explain the often quoted "Japanese Phenomenon", the fact that breast cancer occurs to a lesser extent in Japanese women. When administered to isoflavone "inexperienced" women at the time of menopause, the phytoestrogens appear to share the same effects as estrogen used in classical preparations for hormone replacement therapy, i.e. they may stimulate the proliferation of endometrial and mammary gland tissue with at present unknown and unpredictable risk to these organs. Therefore, the following question arises for the clinician: Why should soy or red clover products containing isoflavone be recommended, if the positive effects are only negligible but the adverse effects serious?     

Do hot spots of deprivation predict the rates of suicide within London boroughs?

INTRODUCTION: The ecological associations between suicide rates and different indices of deprivation within London have been investigated at least for half a century. In the present study, the association between rates of suicide with newly developed hot spots of deprivation index within London boroughs have been studied taking into account the results of the spatial dependency between suicide rates in nearby boroughs. METHODS: Suicide data were provided by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. The hot spots index of deprivation and the population counts were provided by the Department of the Environment, Transport and the Region (DETR) and Office for the National Statistics (ONS), respectively. RESULTS: The results show that there is no strong spatial dependency between suicide rates in the London boroughs, the 'hot spots' index of deprivation predicts the rates of suicide in males 30-49, better than other age and sex groups. The rate of suicide decreases with decreasing deprivation as indicated by the 'hot spots' index. CONCLUSION: These findings suggest that at the London boroughs the 'hot spots' index of deprivation (together with other socio-economic and social fragmentation indices) should be considered as a potential explanatory variable to explain the effects of age on rates of suicide in men and women.     

Prediction and monitoring of treatment effect using T1-weighted dynamic contrast-enhanced magnetic resonance imaging in colorectal liver metastases: Potential of whole tumour ROI and selective ROI analysis

Purpose

To evaluate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for prediction and early monitoring of treatment in colorectal liver metastases.

Materials and methods

Ten patients were included. Baseline and follow-up DCE-MRI examinations were evaluated by whole tumour and selected ROI placements calculating Kep-values. Selective ROIs, concentric-like and hot spot, were drawn on early arterial phase images. Monitoring of treatment was performed comparing RECIST1.1 criteria with whole tumour and selected ROI placement. To evaluate treatment effect between responders and non-responders, independent samples t-test was used on Kep-values.

Results

In each patient largest lesion was evaluated totalling 10 target lesions. At baseline, for whole tumour ROI placements mean Kep-values in responders were significantly higher than mean Kep-values in non-responders (t = 7.481, p < 0.001). Selective ROI placement comparison of mean Kep-values at baseline and after 6 weeks of treatment (first follow-up measurement) showed significant decrease in responding patients (t = 4.706, p = 0.003) whereas increase in Kep-values in non-responding patients was not statistically significant.

Conclusion

This preliminary study shows that baseline Kep for whole tumour ROI is a predictor for treatment outcome. Decrease of Kep using selective ROIs allows early identification of response after 6 weeks of treatment.     

人窦房结胶原纤维网架的构筑

目的：观察人窦房结胶原纤维网架的构筑及其与窦房结中央动脉的关系。方法：用NaOH消蚀法扫描电镜观察成人窦房结。结果：人窦房结中央动脉管壁的纤维网架分为内膜、中膜和外膜3层;在窦房结中央动脉周围,形成厚约50～80μm的致密的动脉周围层;再向外是中央层,窦房结实质细胞就位于其胶原纤维隔围成的直径约8～16μm的孔洞中;中央层与普通心肌胶原纤维网架间的界限明显。结论：人窦房结胶原纤维网架的构筑,有利于消除中央动脉博动的影响,并为窦房结实质细胞构筑一个相对稳定的微环境。