Preexposure Prophylaxis for HIV Prevention in the United States - 2013: A Clinical Practice Guideline provides comprehensive information for the use of daily oral antiretroviral preexposure prophylaxis (PrEP) to reduce the risk of acquiring HIV infection in adults.

关键词：人类免疫缺陷病毒；传染病；暴露前预防

查看摘要 索取原文[67页]

The past decade has seen explosive growth in digitized medical data. This trend offers medical practitioners an unparalleled opportunity to identify effectiveness of treatments for patients using summary statistics and to offer patients more personalized medical treatments based on predictive analytics. To exploit this opportunity, statisticians and computer scientists need to work and communicate effectively with medical practitioners to ensure proper measurement data, collection of sufficient volumes of heterogeneous data to ensure patient privacy, and understanding of probabilities and sources of errors associated with data sampling. Interdisciplinary collaborations between scientists are likely to lead to the development of more effective methods for explaining probabilities, possible errors, and risks associated with treatment options to patients. This chapter introduces some online resources to help medical practitioners with little or no background in summary and predictive statistics learn basic statistical concepts and implement data analysis on their personal computers using R, a high-level computer language that requires relatively little training. Readers who are only interested in understanding basic statistical concepts may want to skip the subsection on R.

关键词：大数据；数据挖掘；知识发现；医药

查看摘要 索取原文[13页]

During recent Medicaid audits, we determined that home blood-glucose test strips (test strips) are available to the Centers for Medicare & Medicaid Services (CMS) and certain State Medicaid agencies at a net cost well below that available to other State Medicaid agencies. This report summarizes the findings of those audits and discusses the potential application to other States. Our objective was to summarize the results of prior audits that identified opportunities for State Medicaid programs to achieve savings for test strips.

关键词：审计；血糖试纸；成本；糖尿病用品

查看摘要 索取原文[18页]

Cardiovascular disease outcomes have been associated with exposure to ambient particulate matter (PM) air pollution in many epidemiological studies. Experimental studies have revealed potential mechanisms behind the epidemiological results and many of these studies have revealed changes in the expression of important genes in key biological pathways with exposure to air pollution from fossil fuel combustion. Few epidemiological studies have examined this. We hypothesized that blood cell gene expression levels along biological pathways relevant to cardiovascular outcomes would be associated with traffic-related air pollutant exposures in elderly subjects with coronary artery disease. Available data were collected in a cohort panel study funded by the National Institutes of Health, National Institute of Environmental Health Sciences. Gene expression data were available for 43 subjects with up to 12 weekly repeated measures conducted in three of the four retirement communities in the Los Angeles Air basin where the exposure measurement work took place. Whole blood samples were collected weekly, RNA was isolated and then it was reversed transcribed into complementary DNA for subsequent gene expression analysis using the polymerase chain reaction method. Candidate genes (35) were selected a priori based on biological function and reported pollutant exposure effects. Exposure measurements were conducted in the indoor and outdoor environment of each community and included daily size-fractionated PM mass and PM organic chemical composition, including polycyclic aromatic hydrocarbons (PAH).

关键词：空气污染；血液；心血管疾病;冠状动脉疾病

查看摘要 索取原文[96页]

The ideal materials used for biomedical application are of high biocompatibility, acceptable strength, minimal tissue responses and low cytotoxicity. Polyhydroxyalkanoates (PHAs) represent a class of biopolymers composed of different types of hydroxyalkanoic acids monomers, which are produced by microorganisms under unbalanced growth conditions. With excellent biodegradability and biocompatibility, PHAs attract more and more attention of various areas especially medicine and health care, where they have already been used in lots of aspects, ranging from wound dressings, drug delivery applications, and surgical implants to other medical devices. However, it is a crucial issue should be taken into consideration that the potential cytotoxicity is caused by both the chemical compositions and the methods of processing and forming PHAs, such as the surface properties and the chemical purities of the materials. Therefore, systematic assessment of PHAs' cytotoxicity is very important for their biological and biomedical applications. In this chapter, we focus on the cytotoxicity caused by different types of PHAs and the mechanisms behind are also discussed.

关键词：聚羟基脂肪酸酯；细胞毒性；生物相容性；生物医学

查看摘要 索取原文[16页]

The broad objective of the proposed study is to empirically evaluate the efficacy of a cognitive behavioral intervention, titled, Post Admission Cognitive Therapy (PACT), for military personnel psychiatrically hospitalized due to a suicide-related event with either a recent or a lifetime suicide attempt. The primary outcomes will be incidence of repeat suicide attempt(s) and number of days until a repeat suicide attempt. Secondary outcomes include psychiatric symptoms, repeat number of psychiatric hospitalization(s), hope for one s future, and acceptability of treatment. A multi-site, single-blind, randomized controlled trial will be the research design. A total of 218 individuals will be recruited from the inpatient psychiatric and traumatic brain injury (TBI) units at the Walter Reed National Military Medical Center and Fort Belvoir Community Hospital. Participants will be randomized into one of two conditions: (1) PACT + Enhanced Usual Care (EUC) or (2) EUC. The PACT+EUC condition will consist of six 60-90 minute individual cognitive behavioral therapy sessions administered over preferably three days during the inpatient stay and up to four telephone booster sessions. The EUC condition will consist of usual psychiatric care patients receive during their hospitalization, the assessment services provided by MA and/or PhD level clinicians, and case management services provided for one year by Bachelor s level research personnel. Follow-up assessments will be conducted at 1, 3, 6, and 12-month post discharge by blind PhD level clinicians.

关键词：急性护理；招聘；认知；认知行为治疗

查看摘要 索取原文[34页]

The objective of the project is to perform anatomically correlated high resolution DTI studies and quantitative immunohistochemical analyses of axonal injury in the human brain following traumatic brain injury. The specific aims are Aim (1) To optimize the resolution and signal quality of whole human brain ex vivo diffusion tensor imaging; Aim (2) To perform radiological- pathological correlations using whole human brains from civilian TBI fatalities and US military fatalities caused by blast-related injuries. Aim (3) To construct detailed atlases of the brain regions most frequently injured by blast-related TBI and non-blast-related TBI. During the third year of the project, we have made progress as follows: (A) We have performed DTI on 59 blocks of brain tissue: 2-3 regions from each of 22 cases (5 blast-TBI, 8 non- blast TBI, 9 controls); (B) We have performed blinded stereological analysis of axonal injury, microgliosis and astrogliosis in each of the 63 blocks of tissue; (C) We found essentially no correlation between any of the DTI parameters and the histopathological markers. Possible explanations for this lack of correlation include heterogenous brain white matter fiber orientation, high variability in injury to death interval, and inconsistent brain tissue fixation. Ongoing work will address these possibilities.

关键词：爆炸；脑；扩散；人类；在体内分析

查看摘要 索取原文[21页]

In public health, a key challenge is moving from accurate monitoring to effective intervention. Selected findings for health determinants and outcomes were reported in the CDC Health Disparities and Inequalities ReportUnited States, 2011 (1); a second report was released in 2013 (2). This supplement is a companion to the two earlier health disparity reports. It highlights health interventions included in those reports that are proven effective or show promise in reducing health disparities. Taken together, these three reports offer real-world examples of how public health programs can achieve their intended impact.

关键词：数据收集；健康差距；干预措施；预防医学

查看摘要 索取原文[52页]

Humans have intuitively understood the value of trees to their physical and mental health since the beginning of recorded time. A scientist with the Pacific Northwest Research Station wondered if such a link could be scientifically validated. His research team took advantage of an infestation of emerald ash borer, an invasive pest that kills ash trees, to conduct a study that gets closer to a definitive connection between the loss of trees and increased human mortality. Researchers analyzed data on demographics, tree loss from the emerald ash borer, and human mortality from lower respiratory disease and cardiovascular disease for 1990 through 2007. Results showed that the spread of the emerald ash borer across 15 states - first recorded in 2002 - was associated with an additional 15,000 deaths from cardiovascular disease and an additional 6,000 deaths from lower respiratory disease. Human mortality increased the longer emerald ash borer was present and killing trees. Deaths occurred at higher rates in wealthier counties, where more trees are typically found in urban areas. Although the study doesnt establish causation, it does suggest a link between trees and human health. This information can be applied to a range of fields including public health, urban forestry, and urban planning.

关键词：心脑血管疾病；死亡；人口

查看摘要 索取原文[6页]

Mild traumatic brain injury (MTBI) is a vulnerability factor for the development of pain-related conditions above and beyond those related to comorbid traumatic and emotional symptoms. We acquired functional magnetic resonance imaging (fMRI) on a validated pain anticipation task and tested the hypotheses that individuals with a reported history of MTBI, compared with healthy comparison subjects, would show increased brain response to pain anticipation and ineffective pain modulation after controlling for psychiatric symptoms. Eighteen male subjects with a reported history of blast-related MTBI related to combat, and eighteen healthy male subjects with no reported history of MTBI (healthy controls) underwent fMRI during an event-related experimental pain paradigm with cued high or low intensity painful heat stimuli. No subjects in either group met diagnostic criteria for current mood or anxiety disorder. We found that relative to healthy comparison subjects, after controlling for traumatic and depressive symptoms, participants with a reported history of MTBI showed significantly stronger activations within midbrain periaqueductual grey (PAG), right dorsolateral prefrontal cortex and cuneus during pain anticipation. Furthermore, we found that brain injury was a significant moderator of the relationship between anticipatory PAG activation and reported subjective pain. Our results suggest that a potentially disrupted neurocognitive anticipatory network may result from damage to the endogenous pain modulatory system and underlie difficulties with regulatory pain processing following MTBI. In other words, our findings are consistent with a notion that brain injury makes it more difficult to control acute pain. Understanding these mechanisms of dysfunctional acute pain processing following MTBI may help shed light on the underlying causes of increased vulnerability for the development of pain-related conditions in this population.

关键词：脑；脑震荡；损害；背外侧前额叶

查看摘要 索取原文[8页]