Background: Delay in Tuberculosis (TB) diagnosis can contribute to late presentation, severe disease, and continued transmission. KNCV TB Foundation Nigeria through the United States Agency for International Developme...Background: Delay in Tuberculosis (TB) diagnosis can contribute to late presentation, severe disease, and continued transmission. KNCV TB Foundation Nigeria through the United States Agency for International Development (USAID) funded the TB Local Organization Network (LON) 1 and 2 projects that explored the availability of Tuberculosis services based on sector and levels of care. Methods: TB Patient Pathway Analysis was carried out in 14 states comprising 92 facilities. It involved primary, secondary, and tertiary levels of health care in both the public and private sectors. This was a cross-sectional study under program implementation. Proforma was used to collect data on the available TB diagnostic services. Results: In public health facilities, GeneXpert was available at 100% in tertiary facilities in 8 (57%) states;up to 82% in 4 (33%) states, 50% available at secondary facilities in 2 states, and There is none at the primary facilities. Smear microscopy was available at 100% in tertiary facilities in 9 (64%) states and 3 (25%) states have 50% to 82%;secondary -10 (71%) states have > 70% at facilities;primary 1 (7%) state has it in 61% of facilities. Loop-mediated isothermal amplification (TB-LAMP) in tertiary 2 (17%) states have 20% and 100% respectively;secondary 4 (<30%) states have in 1 or 2 facilities;none for primary facilities. In private health facilities, 79% of states have Smear microscopy at both primary and secondary facilities, and only 2 states (14%) at tertiary facilities. Only 1 (7%) state has GeneXpert in all tertiary facilities, 2 (14%) states have secondary facilities, and 4 states in about 1% of facilities. TB LAMP was not available in any tertiary facility, one (7%) state at secondary with coverage of 1%, and 2 (14%) states at primary both with 4% overall facility coverage. Conclusions: There is an inequitable distribution of TB diagnostic services in both sectors and levels of care in Nigeria. TB care and control will improve with enhanced equitable distribution of TB diagnostic service展开更多
对杭州湾北岸3处现代潮滩沉积物进行高精度粒度分析,查找研究区潮滩不同微相的粒度特征和差异,提取基于粒度分析的潮滩微相识别敏感指标,并将其应用到该区域的全新世钻孔潮滩沉积物中,识别钻孔潮滩沉积微相,据此建立研究区全新世早期的...对杭州湾北岸3处现代潮滩沉积物进行高精度粒度分析,查找研究区潮滩不同微相的粒度特征和差异,提取基于粒度分析的潮滩微相识别敏感指标,并将其应用到该区域的全新世钻孔潮滩沉积物中,识别钻孔潮滩沉积微相,据此建立研究区全新世早期的海平面曲线。研究表明:杭州湾北岸现代高潮滩盐沼沉积物粘土含量明显高于高潮滩下部和中潮滩,而砂含量与之相反;高潮滩盐沼平均粒径等粒度参数明显小于中、高潮滩的粒度参数;盐沼沉积物粒度频率曲线峰态宽缓,明显区别于高潮滩下部和中潮滩。上述现代潮滩微相粒度敏感指标可成功应用到钻孔潮滩沉积微相划分中,并建立了该区域全新世早期海平面曲线。曲线显示,9700~8700 cal a BP期间海平面上升约11.6 m,海平面上升速率可达1.2 cm/a。现代潮滩不同位置沉积物粒度参数的规律性差异可作为潮滩微相识别的有效指标,为古潮滩沉积微相识别和古海平面重建提供参考依据。展开更多
Objective:To analyze the current situation of diagnostic radiology equipment in Chinese mainland and to understand changes in the past 20 years,including gaps with other countries,in order to provide a scientific basi...Objective:To analyze the current situation of diagnostic radiology equipment in Chinese mainland and to understand changes in the past 20 years,including gaps with other countries,in order to provide a scientific basis for the government to formulate relevant policies and regulations,and supplement Chinese data for international organizations.Methods:This survey adopted a uniformly designed questionnaire,which was completed by the investigators or the respondents.The survey was distributed to all medical institutions that provided diagnostic radiology services in 31 provinces,autonomous regions,and municipalities,excluding Hong Kong,Macao,Taiwan,and military,China.Results:The survey showed that in the past 20 years,the number of medical institutions and diagnostic radiology equipment per million population in China has increased substantially.Dental radiology equipment increased nine-fold,and mammography equipment and computed tomography scanners showed a nearly five-fold increase.The four types of diagnostic radiology equipment,general diagnostic,fluoroscopic,mammography,and computed tomography,were associated with the population.Dental radiology equipment and bone mineral densitometers were related only to the gross domestic product(GDP).A large gap remains in the diagnostic radiology equipment per million population between China and the equipment of health-care level(HCL)I countries.Conclusions:An imbalance in the number of units of diagnostic radiology equipment per million population was observed in the different regions,China.Various types of diagnostic radiology equipment,especially mammography equipment and computed tomography scanners,need to be deployed to meet the medical needs of different populations.展开更多
Objective:To survey and analyze the radiation doses of pediatric CT in some provinces(autonomous region)or municipalities in China,and compare them with the data released by the relevant domestic and international org...Objective:To survey and analyze the radiation doses of pediatric CT in some provinces(autonomous region)or municipalities in China,and compare them with the data released by the relevant domestic and international organizations,so as to identify the current status of Chinese pediatric CT radiation doses.Methods:Radiation doses of pediatric CT were collected during August and December 2016 from 40 hospitals(including 18 children’s hospitals)in 15 provinces,municipalities or autonomous regions across the China.The procedures of head CT,chest CT and abdomen CT were selected in these hospitals,and 10 patients in each group of 0-<1 y,1-<5 y,5-<10 y and 10-<15 y were collected at random for every procedure.Weighted CT dose index(CTDI_(w)),volumetric CT dose index(CTDI_(vol))and dose length product(DLP)were used as survey quantities.An independent sample Kruskal-Wallis rank sum test was performed for CTDI and DLP for each procedure for different age groups,and pairwise comparisons were performed for intra-group data.The same statistical method was also conducted for CTDI and DLP of the same procedure and age group in different provinces or municipalities.Results:The 75th percentiles of the distribution of CTDI and DLP in different age groups of 0-<1 y,1-<5 y,5-<10 y and 10-<15 y were as follows:36.5,43.4,49.1,51.1 mGy and 488,635,723,852 mGy.cm for head,6.1,6.4,6.8,9.6 mGy and 108,136,187,293 mGy.cm for chest,10.5,10.3,11.4,13.0 mGy and 251,284,353,523 mGy.cm for abdomen.The 50th percentiles of the distribution of the radiation doses for the same procedure varied with the ages(head,CTDI_(w):H=155.66,DLP:H=212.35,P<0.05;chest,CTDI_(vol):H=85.43,DLP:H=197.36,P<0.05;abdomen:H=62.29,DLP:H=173.22,P<0.05)and with lower dose at lower age.Radiation doses were close for head between 5-<10 y and 10-<15 y groups,for chest between 1-<5 y and 5-<10 y groups and between 5-<10 y and 10-<15 y groups,and for abdomen between 0-<1 y and 1-<5 y groups,with no statistically significant difference(the adjusted P>0.05).The dose levels of di展开更多
文摘Background: Delay in Tuberculosis (TB) diagnosis can contribute to late presentation, severe disease, and continued transmission. KNCV TB Foundation Nigeria through the United States Agency for International Development (USAID) funded the TB Local Organization Network (LON) 1 and 2 projects that explored the availability of Tuberculosis services based on sector and levels of care. Methods: TB Patient Pathway Analysis was carried out in 14 states comprising 92 facilities. It involved primary, secondary, and tertiary levels of health care in both the public and private sectors. This was a cross-sectional study under program implementation. Proforma was used to collect data on the available TB diagnostic services. Results: In public health facilities, GeneXpert was available at 100% in tertiary facilities in 8 (57%) states;up to 82% in 4 (33%) states, 50% available at secondary facilities in 2 states, and There is none at the primary facilities. Smear microscopy was available at 100% in tertiary facilities in 9 (64%) states and 3 (25%) states have 50% to 82%;secondary -10 (71%) states have > 70% at facilities;primary 1 (7%) state has it in 61% of facilities. Loop-mediated isothermal amplification (TB-LAMP) in tertiary 2 (17%) states have 20% and 100% respectively;secondary 4 (<30%) states have in 1 or 2 facilities;none for primary facilities. In private health facilities, 79% of states have Smear microscopy at both primary and secondary facilities, and only 2 states (14%) at tertiary facilities. Only 1 (7%) state has GeneXpert in all tertiary facilities, 2 (14%) states have secondary facilities, and 4 states in about 1% of facilities. TB LAMP was not available in any tertiary facility, one (7%) state at secondary with coverage of 1%, and 2 (14%) states at primary both with 4% overall facility coverage. Conclusions: There is an inequitable distribution of TB diagnostic services in both sectors and levels of care in Nigeria. TB care and control will improve with enhanced equitable distribution of TB diagnostic service
基金国家自然科学基金项目《杭州湾北岸全新世早期(10-9 cal ka BP)高精度海平面重建及沉积环境响应》(批准号:41706098)《基于微体化石识别全新世高海面阶段长江口外水团相互作用及调控机制》(批准号:42076081)。
文摘对杭州湾北岸3处现代潮滩沉积物进行高精度粒度分析,查找研究区潮滩不同微相的粒度特征和差异,提取基于粒度分析的潮滩微相识别敏感指标,并将其应用到该区域的全新世钻孔潮滩沉积物中,识别钻孔潮滩沉积微相,据此建立研究区全新世早期的海平面曲线。研究表明:杭州湾北岸现代高潮滩盐沼沉积物粘土含量明显高于高潮滩下部和中潮滩,而砂含量与之相反;高潮滩盐沼平均粒径等粒度参数明显小于中、高潮滩的粒度参数;盐沼沉积物粒度频率曲线峰态宽缓,明显区别于高潮滩下部和中潮滩。上述现代潮滩微相粒度敏感指标可成功应用到钻孔潮滩沉积微相划分中,并建立了该区域全新世早期海平面曲线。曲线显示,9700~8700 cal a BP期间海平面上升约11.6 m,海平面上升速率可达1.2 cm/a。现代潮滩不同位置沉积物粒度参数的规律性差异可作为潮滩微相识别的有效指标,为古潮滩沉积微相识别和古海平面重建提供参考依据。
文摘Objective:To analyze the current situation of diagnostic radiology equipment in Chinese mainland and to understand changes in the past 20 years,including gaps with other countries,in order to provide a scientific basis for the government to formulate relevant policies and regulations,and supplement Chinese data for international organizations.Methods:This survey adopted a uniformly designed questionnaire,which was completed by the investigators or the respondents.The survey was distributed to all medical institutions that provided diagnostic radiology services in 31 provinces,autonomous regions,and municipalities,excluding Hong Kong,Macao,Taiwan,and military,China.Results:The survey showed that in the past 20 years,the number of medical institutions and diagnostic radiology equipment per million population in China has increased substantially.Dental radiology equipment increased nine-fold,and mammography equipment and computed tomography scanners showed a nearly five-fold increase.The four types of diagnostic radiology equipment,general diagnostic,fluoroscopic,mammography,and computed tomography,were associated with the population.Dental radiology equipment and bone mineral densitometers were related only to the gross domestic product(GDP).A large gap remains in the diagnostic radiology equipment per million population between China and the equipment of health-care level(HCL)I countries.Conclusions:An imbalance in the number of units of diagnostic radiology equipment per million population was observed in the different regions,China.Various types of diagnostic radiology equipment,especially mammography equipment and computed tomography scanners,need to be deployed to meet the medical needs of different populations.
文摘Objective:To survey and analyze the radiation doses of pediatric CT in some provinces(autonomous region)or municipalities in China,and compare them with the data released by the relevant domestic and international organizations,so as to identify the current status of Chinese pediatric CT radiation doses.Methods:Radiation doses of pediatric CT were collected during August and December 2016 from 40 hospitals(including 18 children’s hospitals)in 15 provinces,municipalities or autonomous regions across the China.The procedures of head CT,chest CT and abdomen CT were selected in these hospitals,and 10 patients in each group of 0-<1 y,1-<5 y,5-<10 y and 10-<15 y were collected at random for every procedure.Weighted CT dose index(CTDI_(w)),volumetric CT dose index(CTDI_(vol))and dose length product(DLP)were used as survey quantities.An independent sample Kruskal-Wallis rank sum test was performed for CTDI and DLP for each procedure for different age groups,and pairwise comparisons were performed for intra-group data.The same statistical method was also conducted for CTDI and DLP of the same procedure and age group in different provinces or municipalities.Results:The 75th percentiles of the distribution of CTDI and DLP in different age groups of 0-<1 y,1-<5 y,5-<10 y and 10-<15 y were as follows:36.5,43.4,49.1,51.1 mGy and 488,635,723,852 mGy.cm for head,6.1,6.4,6.8,9.6 mGy and 108,136,187,293 mGy.cm for chest,10.5,10.3,11.4,13.0 mGy and 251,284,353,523 mGy.cm for abdomen.The 50th percentiles of the distribution of the radiation doses for the same procedure varied with the ages(head,CTDI_(w):H=155.66,DLP:H=212.35,P<0.05;chest,CTDI_(vol):H=85.43,DLP:H=197.36,P<0.05;abdomen:H=62.29,DLP:H=173.22,P<0.05)and with lower dose at lower age.Radiation doses were close for head between 5-<10 y and 10-<15 y groups,for chest between 1-<5 y and 5-<10 y groups and between 5-<10 y and 10-<15 y groups,and for abdomen between 0-<1 y and 1-<5 y groups,with no statistically significant difference(the adjusted P>0.05).The dose levels of di
