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1.
PurposeAccording to the social determinants of health framework, income inequality is a potential risk factor for adverse mental health. However, few studies have explored the mechanisms suspected to mediate this relationship. The current study addresses this gap through a mediation analysis to determine if social support and community engagement act as mediators linking neighbourhood income inequality to maternal anxiety and depressive symptoms within a cohort of new mothers living in the City of Calgary, Canada.MethodsData collected at three years postpartum from mothers belonging to the All Our Families (AOF) cohort were used in the current study. Maternal data were collected between 2012 and 2015 and linked to neighbourhood socioeconomic data from the 2006 Canadian Census. Income inequality was measured using Gini coefficients derived from 2006 after-tax census data. Generalized structural equation models were used to quantify the associations between income inequality and mental health symptoms, and to assess the potential direct and indirect mediating effects of maternal social support and community engagement.ResultsIncome inequality was not significantly associated with higher depressive symptoms (β = 0.32, 95%CI = −0.067, 0.70), anxiety symptoms (β = 0.11, 95%CI = −0.39, 0.60), or lower social support. Income inequality was not associated with community engagement. For the depression models, higher social support was significantly associated with lower depressive symptoms (β = −0.13, 95%CI = −0.15, −0.097), while community engagement was not significantly associated with depressive symptoms (β = 0.059, 95%CI = −0.15, 0.27). Similarly, for the anxiety models, lower anxiety symptoms were significantly associated with higher levels of social support (β = −0.17, 95%CI = −0.20, −0.13) but not with higher levels of community engagement (β = 0.14, 95%CI = −0.14, 0.41).ConclusionThe current study did not find clear evidence for social support or community engagement mediating the relationship between neighbourhood income inequality and maternal mental health. Future investigations should employ a broader longitudinal approach to capture changes in income inequality, potential mediators, and mental health symptomatology over time.  相似文献   
2.
《Cancer cell》2022,40(8):835-849.e8
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3.
《Digestive and liver disease》2022,54(11):1486-1493
BackgroundCold snare polypectomy (CSP) is a promising technique for the removal of sessile serrated polyps (SSPs) ≥ 10 mm. However, the efficacy and safety of this technique remain undetermined.AimsWe aimed to comprehensively evaluate the efficacy and safety of CSP for SSPs ≥ 10 mm.MethodsPubMed, EMBASE, Web of Science and Cochrane Library were searched up to January 2021.ResultsA total of 10 studies consisting of 1727 SSPs (range, 10–40 mm) from 1021 patients were included. The overall rates of technical success, adverse events (AEs) and residual SSPs were 100%, 0.7% and 2.9%, respectively. Subgroup analysis showed that the rates of technical success and AEs were comparable between CSP and cold endoscopic mucosal resection (EMR) (99.9% vs. 100% and 1.3% vs. 0.5%, respectively), between the proximal and distal colon (100% vs. 99.9% and 0.3% vs. 0, respectively), and between polyps of 10–19 mm and ≥20 mm (99.8% vs. 100% and 0.9% vs. 0, respectively). However, subgroup analysis showed that the rate of residual SSPs was slightly lower in CSP compared with cold EMR (1.3% vs. 3.9%), as well as in polyps of 10–19 mm compared with those ≥20 mm (3.1% vs. 4.7%).ConclusionCSP was an effective and safe technique for removing SSPs ≥ 10 mm.  相似文献   
4.
In this paper, we argue that understanding and addressing the problem of poor-quality medical products requires a more interdisciplinary approach than has been evident to date. While prospective studies based on rigorous standardized methodologies are the gold standard for measuring the prevalence of poor-quality medical products and understanding their distribution nationally and internationally, they should be complemented by social science research to unpack the complex set of social, economic, and governance factors that underlie these patterns. In the following sections, we discuss specific examples of prospective quality surveys and of social science studies, highlighting the value of cross-sector partnerships in driving high-quality, policy-relevant research in this area.  相似文献   
5.
目的总结近年来股�9aa8;转子�95f4;�9aa8;b98;在稳[9a;性�91cd;建ٛ9;�9762;的982;念演化与研究进展。ٛ9;法查�9605;国内916;相关文献并结合自身经�9a8c;,从股�9aa8;转子�95f4;�9aa8;b98;的9e3;剖ܧ99;、稳[9a;型�9aa8;b98;与不稳[9a;型�9aa8;b98;分类、稳[9a;性90d;位与不稳[9a;性90d;位、术中加压初9cb;稳[9a;与术后滑动二次稳[9a;、内固[9a;术后稳[9a;性评估、ٞ9;期下地ޭ9;立负�91cd;޴99;�9762;进行总结分g90;。结g9c;股�9aa8;转子�95f4;�9aa8;b98;发生于股�9aa8;�9888;干�9aba;端转换区,具ٰ9;929;然的内翻不稳[9a;倾向。�9aa8;b98;90d;位质�91cf;是影响后续内固[9a;ܦ99;放的最�91cd;981;前提因素。判断�9aa8;b98;90d;位质�91cf;ٰ9;ֿ9;线和ֿ9;位两ٛ9;�9762;,ֿ9;线�91c7;用 Garden 指数;在ֿ9;位ٛ9;�9762;,�968f;着皮质ֿ9;位理念(正性、中性、负性࿰9;的提出,ܧ9;别强调前内侧皮质的相N92;砥住支d91;(9e3;剖、正性࿰9;,是获_97;�9aa8;b98;稳[9a;性90d;位的关�952e;,而不再强调后内侧小转子�9aa8;块的作用。术后影像学的稳[9a;性评分为ٞ9;期下地ޭ9;立负�91cd;提O9b;了�91cf;化指标。但术中的前内侧皮质支d91;90d;位,在术后934;�9888;�9aa8;块滑动获_97;二次稳[9a;的过程中,仍ٰ9;皮质ֿ9;位丢931;现象,�9700;研究其危�9669;因素和�9632;范措施。结论股�9aa8;转子�95f4;�9aa8;b98;在取_97;良97d;ֿ9;线的基础上,只981;获_97;了前内侧皮质的相N92;砥住和支d91;,并用内固[9a;器械维持住,就获_97;了术后稳[9a;性。术后稳[9a;性评分优良者,可以ָ9;全地ٞ9;期下地负�91cd;、ޭ9;立行走活动。  相似文献   
6.
BackgroundDual antiplatelet therapy (DAPT) is the cornerstone treatment of acute myocardial infarction (AMI).ObjectiveThe present study aimed to investigate the efficacy and safety of triple antiplatelet therapy (TAPT) in elderly female patients with diabetes and ST segment elevation myocardial infarction (STEMI), who had undergone percutaneous coronary intervention (PCI).MethodsWe designed a randomized, single-blind study. Control group A (97 elderly male patients with diabetes and STEMI, whose CRUSADE scores were < 30) received aspirin, ticagrelor, and tirofiban. A total of 162 elderly female patients with diabetes and STEMI were randomly divided into two groups according to CRUSADE score. Group B (69 patients with CRUSADE score > 31) received aspirin and ticagrelor. Group C (93 patients with CRUSADE score < 30) received aspirin, ticagrelor and tirofiban. P values < 0.05 were considered statistically significant.ResultsCompared to the findings in group A, post-PCI Thrombolysis in Myocardial Infarction (TIMI) grade 3 blood flow and TIMI myocardial perfusion grade 3 were significantly less prevalent in group B (p < 0.05). When compared to groups A and C, the incidence of major adverse complications was significantly higher in group B (p < 0.05).ConclusionTAPT could effectively reduce the incidence of major complications in elderly female patients with diabetes and STEMI. However, close attention should be paid to hemorrhage in patients receiving TAPT. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)  相似文献   
7.
目的探讨ٓ9;良内固[9a;融合术治u97;成人Ⅱ型痛性足副舟�9aa8;(painful accessory navicular,PAN࿰9;的u97;效。ٛ9;法2016 年 1 月—2017 年 12 月,�91c7;用ٓ9;良内固[9a;融合术治u97; 29 例(37 足࿰9;Ⅱ型 PAN。其中男 12 例,973; 17 例;年�9f84; 18~50 岁,平均 41.4 岁。扭伤 24 例,无明显诱因 5 例。患者均行 6 个月以上保守治u97;,症状无明显ٓ9;善。术前及末次�968f;访时�91c7;用美国矫形足踝协会(AOFAS࿰9;中足评分评估临床u97;效;X 线片测�91cf;跟�9aa8;倾e9c;9d2;、距�9aa8;第 1 跖�9aa8;9d2;、距舟关节包ֻ9;9d2;、距�9aa8;第 2 跖�9aa8;9d2;。结g9c;术后 1 例出现切口浅表感染,经加强换药后愈合;其ӵ9;患者切口均Ⅰ期愈合,无深�90e8;感染或�9aa8;�9ad3;炎发生。29 例均获�968f;访,�968f;访时�95f4; 12~33 个月,平均 25.1 个月。X 线片93a;关节�9762;均于术后 2~5 个月愈合,平均 3.4 个月。�968f;访期�95f4;未9c1;内固[9a;ܦ9;松动或断裂。末次�968f;访时,AOFAS 疼痛、R9f;能、R9b;线评分及总分以及距舟关节包ֻ9;9d2;、距�9aa8;第 1 跖�9aa8;9d2;和距�9aa8;第 2 跖�9aa8;9d2;均较术前显著ٓ9;善,差异ٰ9;统计学意Ӥ9;(P<0.05࿰9;;跟�9aa8;倾e9c;9d2;手术前后差异无统计学意Ӥ9;(t=1.097,P=0.276࿰9;。 结论91c7;用ٓ9;良内固[9a;融合术治u97;成人Ⅱ型 PAN 可ٰ9;效缓9e3;症状,患足R9f;能恢90d;良97d;,并发症少。  相似文献   
8.
9.
10.
目的探讨单纯 Ilizarov 环形916;固[9a;技术治u97;合并�9aa8;筋9c;室综合征的胫�9aa8;平台�9aa8;b98;的u97;效。ٛ9;法2013 年 9 月—2017 年 3 月,收治 30 例合并�9aa8;筋9c;室综合征的胫�9aa8;平台�9aa8;b98;患者,�91c7;用单纯 Ilizarov 环形916;固[9a;技术治u97;。男 23 例,973; 7 例;年�9f84; 23~43 岁,平均 34.4 岁。致伤S9f;因:交�901a;事故伤 12 例,�9ad8;904;坠落伤 4 例,摔伤 8 例,�91cd;ܦ9;砸伤 6 例。受伤至入�9662;时�95f4; 1~12 h,平均 4.8 h。�9aa8;b98; Schatzker 分型:Ⅱ型 1 例、Ⅲ型 3 例、Ⅳ型 10 例、Ⅴ型 7 例、Ⅵ型 9 例。30 例均因�9aa8;筋9c;室综合征行切开减压;切开减压至手术时�95f4;为 10~15 d,平均 12.5 d。治u97;后�91c7;用9d;关节学会评分系统(KSS࿰9;及 Ilizarov ٛ9;法研究与^94;用协会(ASAMI࿰9;协议评价9d;关节R9f;能。结g9c;手术时�95f4; 110~155 min,平均 123.1 min;术中出血�91cf; 100~500 mL,平均 245 mL;术后住�9662;时�95f4; 3~5 d,平均 3.8 d。患者均获�968f;访,�968f;访时�95f4; 20~24 周,平均 22.7 周。�9664; 2 例患者出现�9488;�9053;感染征象916;,无其他并发症发生。X 线片90d;查显93a;�9aa8;b98;均愈合,愈合时�95f4; 10~20 周,平均 14.6 周。末次�968f;访时,9d;关节 KSS 临床评分总分为 70~95 分,平均 87.5 分;R9f;能评分总分为 70~90 分,平均 79.0 分。参照 ASAMI 协议评价获优 24 例、良 3 例、可 2 例、差 1 例。结论ֿ9;于合并�9aa8;筋9c;室综合征的胫�9aa8;平台�9aa8;b98;,单纯 Ilizarov 环形916;固[9a;技术治u97;后患者关节R9f;能可以基本恢90d;且并发症少,是一�9879;相ֿ99;全、ٰ9;效的治u97;ٛ9;法。  相似文献   
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