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Prevalence, risk factors and outcomes of labor induction among women delivered at Maternity Hospitals of Mongolia 蒙古妇产医院分娩妇女引产的流行率、风险因素和结果
Narantungalag Lkhagvasuren, Batjargal Enkh-Amgalan, Khaliun Bayar, Myagmartseren Bandi, J. Badarch
Introduction: Induction of labor is the stimulation of uterine contractions during pregnancy before labor begins on its own to achieve a vaginal birth. It is a common obstetric procedure that is indicated when the benefits to either mother or fetus outweigh those of pregnancy continuation. We aimed to determine the overall rate, outcomes, and associated factors of labor induction. Methods: A retrospective cross-sectional study was conducted among 5852 mothers delivered in "Urguu" First Maternity Hospital and National Center for Maternal and Child Health (NCMCH) between January 1st, 2019 and May 31st, 2019. SPSS version 25 was used for statistical analysis. Descriptive and binary logistic regression analyses were used to determine study variables and the association between dependent variables and independent variables. Comparison of proportions was performed by chi-square (χ2) for categorical variables to determine associations between selected covariates and induction. Results: A total of (5852) women were delivered at the research area, out of which (1079) were induced resulting in a prevalence of induction of (18.43%). Of the 1079 induced women, the most common indications for labor induction were 659 (61.1%) prolonged labor, 188 (17.4%) premature rupture of membranes, 139(12.9%) pre-eclampsia, and 87 (8.1%) oligohydramnios. Among the induced labor, 1031 (95.6%) were delivered by vaginal and 48 (4.4%) by Cesarean section. Conclusions: The prevalence of inducted labor was 18.43%. Factors associated with labor induction were maternal age, employment, residential type, and an abortion. The most common indications were premature rupture of membrane, prolonged labor, and pre-eclampsia. The successful rate was considerably higher and the frequency of cesarean sections was lower than the result of other studies.
导言:引产是在怀孕期间,在分娩开始前刺激子宫收缩,以实现阴道分娩。这是一种常见的产科手术,当对母亲或胎儿的好处超过继续妊娠的好处时,才会进行手术。我们的目的是确定引产的总体发生率、结果和相关因素。方法:对2019年1月1日至2019年5月31日在乌尔古乌第一妇产医院和国家妇幼保健中心分娩的5852名产妇进行回顾性横断面研究。采用SPSS 25版本进行统计分析。使用描述性和二元逻辑回归分析来确定研究变量以及因变量和自变量之间的关联。采用χ2对分类变量进行比例比较,以确定所选协变量与归纳法之间的关联。结果:研究区共分娩妇女5852例,其中引产1079例,引产率为18.43%。在1079例引产妇女中,最常见的引产指征为:延长分娩659例(61.1%),胎膜早破188例(17.4%),先兆子痫139例(12.9%),羊水过少87例(8.1%)。顺产1031例(95.6%),剖宫产48例(4.4%)。结论:引产率为18.43%。与引产相关的因素有产妇年龄、就业、居住类型和流产。最常见的适应症是胎膜早破、产程延长和先兆子痫。与其他研究结果相比,剖宫产成功率高,剖宫产率低。
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引用次数: 0
Thyroid Dland Disorders Associated with Combination of Antiangiogenic Agents and Immune Checkpoint Inhibitors: A Pharmacovigilance Study 甲状腺疾病与联合使用抗血管生成药物和免疫检查点抑制剂相关:一项药物警戒研究
L. Zhuge
Purpose: Immune checkpoint inhibitors (ICIs), including anti-PD-1/L1 therapy and anti-CTLA-4 therapy, were reported with thyroid gland disorders adverse events. Recently, the FDA announced a warning that the combination of navolumab and cabozantinib can cause adrenal insufficiency. We performed a pharmacovigilance study to analyze the association between thyroid gland disorders and the use of ICI, anti-angiogenic agents or the combination treatment by mining the FDA adverse events reporting system (FAERS) database. Methods: Data were searched and analyzed in the US Food and Drug Administration Adverse Event Reporting System (FAERS) database. Thyroid gland disorders, including hypothyroidism, hyperthyroidism, autoimmune thyroiditis, were defined by the Medical Dictionary for Regulatory Activities (MedDRA). We conducted disproportionality analysis using reporting odds ratio (ROR). The result was defined as a signal if the lower limit of the 95% confidence interval for ROR is over 2, the number of cases ≥3. And additive and multiplicative models were applied to analyze drug interactions. Results: In the FAERS database, we identified 2862 cases of thyroid gland disorders, and the cases number for hyperthyroidism, hypothyroidism and thyroiditis were 767 and 1579 and 556. In the disproportionality analysis, for ICI drugs group, our study detected moderate to strong signals between ICIs and thyroid gland disorders. Among these subgroups, ICI-related thyroiditis was associated with the strongest signal (ROR 23.09 [95% CI 21.08-25.28]). As for anti-angiogenic drugs group, however, very weak signals were found between anti-angiogenic drugs and thyroid gland disorders, only hypothyroidism was found with a significant signal (ROR 4.87 [95% CI 4.60-5.16]). As for combined regimen groups, we didn't identify significantly increased signals of thyroid gland disorders than monotherapy treatment. And we didn't find interactions between ICI and anti-angiogenic drugs according to additive/multiplicative models. Conclusion: In our study, we confirmed the increased risk of thyroid gland disorders of ICIs and anti-angiogenic agents monotherapy, however, there were no increased signals when the combination therapy was used. In order to prevent serious outcomes, we should be aware of thyroid gland disorders' risk when using ICIs or anti-angiogenic agents.
目的:免疫检查点抑制剂(ICIs),包括抗pd -1/L1治疗和抗ctla -4治疗,被报道与甲状腺疾病不良事件。最近,FDA宣布了一项警告,navolumab和cabozantinib联合使用可能导致肾上腺功能不全。我们进行了一项药物警戒研究,通过挖掘FDA不良事件报告系统(FAERS)数据库,分析甲状腺疾病与使用ICI、抗血管生成药物或联合治疗之间的关系。方法:对美国食品药品监督管理局不良事件报告系统(FAERS)数据库中的数据进行检索和分析。甲状腺疾病,包括甲状腺功能减退、甲状腺功能亢进、自身免疫性甲状腺炎,由调节活动医学词典(MedDRA)定义。我们使用报告优势比(ROR)进行歧化分析。若ROR的95%置信区间下限大于2,病例数≥3,则该结果为信号。采用加性和乘法模型分析药物相互作用。结果:在FAERS数据库中,我们发现2862例甲状腺疾病,其中甲状腺功能亢进、甲状腺功能减退和甲状腺炎分别为767例、1579例和556例。在歧化分析中,对于ICI药物组,我们的研究发现了ICI与甲状腺疾病之间中度至强烈的信号。在这些亚组中,ici相关性甲状腺炎与最强信号相关(ROR 23.09 [95% CI 21.08-25.28])。而在抗血管生成药物组,抗血管生成药物与甲状腺疾病之间的信号非常弱,只有甲状腺功能减退有显著信号(ROR 4.87 [95% CI 4.60-5.16])。至于联合治疗组,我们没有发现甲状腺疾病的信号比单药治疗明显增加。根据加法/乘法模型,我们没有发现ICI和抗血管生成药物之间的相互作用。结论:在我们的研究中,我们证实了ICIs和抗血管生成药物单独治疗会增加甲状腺疾病的风险,然而,联合治疗时没有增加信号。为了防止严重的后果,在使用ICIs或抗血管生成药物时,我们应该意识到甲状腺疾病的风险。
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引用次数: 0
Doplor Sleep: Monitoring Hospital Soundscapes for Better Sleep Hygiene 多普勒睡眠:监测医院声景以改善睡眠卫生
E. Özcan, Yiling Liu, J. Vroon, Daan Kamphuis, Simone Spagnol
Good sleep is conducive to the recovery process of hospital patients – and yet, in many wards, sleep duration and quality can often be suboptimal, in part due to modifiable hospital-related sounds and noises. At the neurological ward of the Reinier de Graaf hospital in Delft, the Netherlands, we developed and evaluated a prototype information exchange system to raise awareness of specific sounds as disturbing patients’ sleep. The system both classifies different relevant sound events and tracks sleep quality (using a Fitbit device). This information is then visualized for patients and staff to present the influence of the soundscape on patients’ sleep hygiene in a friendly and comprehensive way. We discuss the design process, including a context study and various evaluations of the technology, interface, and created affordances. Our initial findings indicate that visualizing hospital soundscapes may, indeed, support both patients and staff in their efforts towards better sleep hygiene.
良好的睡眠有助于医院病人的康复过程——然而,在许多病房里,睡眠时间和质量往往不是最佳的,部分原因是与医院有关的声音和噪音可以改变。在荷兰代尔夫特Reinier de Graaf医院的神经病房,我们开发并评估了一个原型信息交换系统,以提高对干扰患者睡眠的特定声音的认识。该系统对不同的相关声音事件进行分类,并跟踪睡眠质量(使用Fitbit设备)。然后将这些信息可视化给患者和工作人员,以友好和全面的方式呈现声景对患者睡眠卫生的影响。我们讨论了设计过程,包括上下文研究和对技术、界面和创建的功能的各种评估。我们的初步研究结果表明,可视化医院的声景可能确实有助于患者和工作人员改善睡眠卫生。
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引用次数: 3
A qualitative approach for the Health Technology Assessment of IT supported Type 2 Diabetes management tools 对信息技术支持的2型糖尿病管理工具进行卫生技术评估的定性方法
G. Improta, M. Illario, V. Luca, G. Annuzzi, G. Iaccarino, M. Triassi
The health technology assessment is fundamental in the acquisition of novel technologies and it is an important tool for the decision makers. With the development of novel emerging mobile-health apps, devices, software and In-formation and Communication Technologies (ICT), the evaluation over a wide range of available products is a critical issue. Here we propose a questionnaire-based approach to assess ICT tools able to facilitate the lives of people with Type 2 Diabetes Mellitus (T2DM). We used a 5-point Likert scale as a psychometric scale to assess experts’ opinions regarding novel tools for the T2DM self-management. Preliminary data collected through the administration of the questionnaire show the relative importance of the functionalities and features of the examined technologies, giving opportunities for future improvements.
卫生技术评估是获取新技术的基础,是决策者的重要工具。随着新型移动健康应用程序、设备、软件和信息通信技术(ICT)的发展,对各种可用产品的评估是一个关键问题。在这里,我们提出了一种基于问卷的方法来评估ICT工具能够促进2型糖尿病(T2DM)患者的生活。我们使用5点李克特量表作为心理测量量表来评估专家对T2DM自我管理新工具的意见。通过管理调查表收集的初步数据显示了所审查技术的功能和特性的相对重要性,为今后的改进提供了机会。
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引用次数: 1
Mode of discharge in CoViD-19 era: the case of the C.O.U. Oncology of “San Giovanni di Dio e Ruggi d'Aragona” University Hospital 新型冠状病毒肺炎时代的出院方式——以“圣乔凡尼·迪奥·鲁吉·阿拉戈纳”大学医院c.o.u肿瘤科为例
R. Alfano, I. Loperto, A. Scala, Teresa Angela Trunfio, A. Lombardi, A. Borrelli, M. Triassi, G. Improta
Background. The Covid-19 pandemic has deeply impacted the oncology community. The European Society for Medical Oncology (ESMO) suggests strengthening telemedicine services, reducing clinic visits and switching to subcutaneous or oral, rather than intravenous, therapies whenever possible. Methods. This study was conducted at the Oncology Complex Operating Unit by collecting data on all patients who accessed in 2019-2020. The aim was to understand how Covid-19 affected hospital admissions. Statistical tests and Logistic Regression were implemented. Results. The statistical analysis carried out showed that between 2019 and 2020 there was less use of emergency admission and voluntary discharge, while highlighting the increase in the "Protected with integrated home care" discharge mode. Conclusion. The results show how the European guidelines have improved the health process, from admission with the reduction of emergencies to discharge.
背景。新冠肺炎疫情对肿瘤学界产生了深刻影响。欧洲肿瘤医学学会(ESMO)建议加强远程医疗服务,减少诊所就诊,并尽可能改用皮下或口服治疗,而不是静脉注射治疗。方法。这项研究是在肿瘤综合手术单元进行的,收集了2019-2020年所有就诊患者的数据。目的是了解Covid-19是如何影响住院的。采用统计检验和Logistic回归。结果。统计分析显示,2019年至2020年期间,急诊入院和自愿出院的使用有所减少,而“综合家庭护理保护”出院模式有所增加。结论。结果表明,欧洲指南如何改善了从入院到出院的健康过程,减少了紧急情况。
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引用次数: 2
Effects of Alcohol and Tobacco Abuse on Multi-Drug Resistant Tuberculosis Treatment Outcome, Mongolia 酒精和烟草滥用对多重耐药结核病治疗结果的影响,蒙古
D. Dashdavaa, N. Dambaa, B. Oidov, Khishigsuren Zuunnast
Abstract: Alcohol and tobacco use, and drug resistance have become key issues in TB care in Mongolia. Although the use of alcohol and tobacco in patients with multi-drug resistant TB (MDR-TB) has been identified, the relationship between MDR-TB treatment outcomes, alcohol and tobacco use has not yet been studied. Aim of study: To study effects of alcohol and tobacco abuse on MDR-TB treatment outcome. Methods: This is randomly assigned case control study. Patients, who enrolled in MDR-TB short regimen between 2020 and 2021, were participated in the study. Alcohol and Nicotine dependence was assessed by Nicotine dependence standard scale and AUDIT scale. Results: Of the 64 MDR-TB patients, 55% were male and the mean age of participants was 38.07±1.75 years. Based on AUDIT, 78% and 22% patients were classified as low risky, harmful, high risk level of alcohol use (Cronbach`s alpha 0.936). Conclusion: Alcohol and tobacco abuse are higher among MDR-TB patients in Mongolia. Alcohol and Nicotine dependence associated with bad treatment outcome of MDR-TB in the country.
摘要:酒精和烟草使用以及耐药性已成为蒙古结核病治疗的关键问题。虽然已经确定耐多药结核病(MDR-TB)患者使用酒精和烟草,但尚未研究耐多药结核病治疗结果与酒精和烟草使用之间的关系。研究目的:研究酒精和烟草滥用对耐多药结核病治疗结果的影响。方法:采用随机分组病例对照研究。在2020年至2021年期间参加耐多药结核病短期治疗方案的患者参与了这项研究。采用尼古丁依赖标准量表和AUDIT量表对酒精和尼古丁依赖进行评估。结果:64例耐多药结核病患者中,55%为男性,平均年龄为38.07±1.75岁。根据审计,78%和22%的患者被划分为低风险、有害和高风险水平的酒精使用(Cronbach 's alpha 0.936)。结论:蒙古耐多药结核病患者酗酒和吸烟比例较高。在该国,酒精和尼古丁依赖与耐多药结核病治疗结果不良相关。
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引用次数: 0
The Analysis of Phage rz/rz1 Gene in Shigatoxin Bacteria 志贺毒素细菌噬菌体rz/rz1基因的分析
Tessa Sjahriani, D. Arivo, E. Wasito, W. Tyasningsih
The phage rz/rz1 gene is a membrane subunit that is required for phage lysis to breach the bacterial host's outer membrane. Because of their proclivity to excise and infect multiple hosts, they are key drivers of horizontal gene transfer resulting in the bacteria becoming a STEC. This study aim to looked at the rz/rz1 gene of E. coli strain STEC and Shigella sonnei carrying stx gene, yielded eight lytic bacteriophages, using PCR, DNA sequencing and NCBI Blast, Expasy translation and Expasy protparam for analyze. The rz/rz1 gene sequences were found to have 97.73 % to 98.90 % identical similarities with E. coli strain STEC and Shigella sonnei. According to the Kruskal-Wallis statistical test, there was a significant difference in rz/rz1 amino acid between Phage, E. coli strain STEC and Shigella sonnei (p < 0.001). The conclusion is the rz/rz1 gene of lytic bacteriophage was involved in the spread of stx gene, with significant difference of amino acid.
噬菌体rz/rz1基因是噬菌体裂解破坏细菌宿主外膜所必需的膜亚基。由于它们倾向于切除和感染多个宿主,它们是水平基因转移的关键驱动因素,导致细菌成为产志贺毒素大肠杆菌。本研究旨在研究大肠杆菌STEC菌株和携带stx基因的sonneshigella的rz/rz1基因,获得8个裂解噬菌体,采用PCR、DNA测序和NCBI Blast、Expasy translation和Expasy protparam进行分析。rz/rz1基因序列与大肠杆菌STEC和索尼氏志贺氏菌的相似性为97.73% ~ 98.90%。经Kruskal-Wallis统计检验,噬菌体、大肠杆菌STEC和索内志贺氏菌的rz/rz1氨基酸含量差异有统计学意义(p < 0.001)。结论:裂解噬菌体rz/rz1基因参与了stx基因的传播,氨基酸差异显著。
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引用次数: 0
Spatial equity and healthcare access in the COVID-19 pandemic COVID-19大流行中的空间公平和医疗保健可及性
H. Sritart, Somchat Taertulakarn, S. Kanbara, H. Miyazaki
Healthcare facilities around the world become overwhelmed by the number of infected coronavirus patients that needed to be treated during the COVID-19 outbreak, resulting in medical staff and healthcare services shortages. Regarding to understand and minimize the inequalities in healthcare services, it is crucial to evaluate the available healthcare resource, particularly the intensive care unit (ICU) beds that are critical for the COVID-19 pandemic. Therefore, this study aims to explore and determine the spatial distribution of the confirmed COVID-19 patients and the healthcare capacities in the province of Ubon Ratchathani, Thailand. Applying the GIS platform with the data analysis of 2SFCA (Two-Step Floating Catchment Area) based approach, we emphasize the spatial distribution of both patients and healthcare resources in the study area. The spatial accessibility index regarding the physicians and ICU beds was determined and highlighted in each district. Additionally, the vulnerable regions were identified by the level of healthcare accessibility. We believe this study offers valuable insight in gaining a better understanding and supporting effective response activities toward pandemic resilience.
在2019冠状病毒病爆发期间,世界各地的医疗机构因需要治疗的冠状病毒感染患者数量过多而不堪重负,导致医务人员和医疗服务短缺。为了了解和尽量减少医疗服务中的不平等现象,必须评估现有的医疗资源,特别是对COVID-19大流行至关重要的重症监护病房(ICU)床位。因此,本研究旨在探讨和确定泰国乌汶府新冠肺炎确诊患者的空间分布和卫生保健能力。利用GIS平台和基于2SFCA (Two-Step Floating Catchment Area)方法的数据分析,我们强调了研究区域内患者和医疗资源的空间分布。确定并突出了各区医生和ICU床位的空间可达性指数。此外,根据医疗保健可及性水平确定了脆弱地区。我们认为,这项研究为更好地理解和支持有效的应对活动以适应大流行提供了有价值的见解。
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引用次数: 1
Effects of Nigella Sativa on Female Infertility: A Systematic Review 黑草对女性不孕症的影响:系统综述
Amirul Amalia, H. Hendarto, Arifa Mustika, Inta Susanti
Objective. Nigella sativa is a plant that contains a lot of antioxidants. Nigella sativa is an important medicinal herb that has been utilized for centuries. Given Nigella sativa efficacy in treating a variety of disorders, this systematic study attempts to assess Nigella sativa effect on the female reproductive system. Materials and methods. This systematic review was conducted on the Randomize Control Trial (RCT) through electronic databases such as Google Scholar, Science Direct, Pubmed, Scopus and Proquest from January 2012 to January 2022. The keywords or phrases used were Nigella sativa, Black Seeds, Black Cumin, Thymoquinonee, Infertility, Women dan Female. Results. 14 articles were selected for analysis. The results showed that Nigella sativa and its constituent, Thymoquinone can reduce MDA levels, increase SOD, increase TAS, increase the number of ovarian follicles, and increase body weight. Conclusion. Nigella sativa can improve reproductive parameters in women.
目标。黑草是一种含有大量抗氧化剂的植物。黑草是一种重要的草药,已经被使用了几个世纪。鉴于黑草治疗多种疾病的功效,本系统研究试图评估黑草对女性生殖系统的影响。材料和方法。本系统评价是通过谷歌Scholar、Science Direct、Pubmed、Scopus和Proquest等电子数据库对2012年1月至2022年1月期间的随机对照试验(RCT)进行的系统评价。关键词:黑籽、黑籽、黑孜然、百里醌、不育、女性和女性。结果:选择14篇文章进行分析。结果表明,黑草及其成分百里醌能降低MDA水平,升高SOD,增加TAS,增加卵巢卵泡数量,增加体重。结论。黑草可以改善女性的生殖参数。
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引用次数: 2
Prevalence of sociodemographic factors in a cohort of diabetes mellitus: a retrospective study 糖尿病队列中社会人口学因素的流行:一项回顾性研究
Madurapperumage A. Erandathi, William Yu Chung Wang, Michael Mayo, I. Shafiu
Exploring the sociodemographic factors of a cohort is a vital phase in revealing significant aspects of the societal health status. The health care sector utilises the results of exploratory analysis of the sociodemographic nature to fulfil various purposes such as constructing health care policies, allocating adequate resources, imposing necessary medications and many more. A large and growing body of evidence shows that understanding the pervasiveness of sociodemographic factors: age, ethnicity, gender, reveal crucial information. Therefore, this study aims to disclose the knowledge through analysing the sociodemographic details of a New Zealand diabetes cohort. Diabetes mellitus is a chronic fatal disease that occurs due to the inability to control proper blood sugar levels, which causes multitudinous acute and chronic complications. Diabetes became a high prevalence disease in the region of Waikato. Analysing the cohort of diabetes patients associated with complications of diabetes illustrate the prevalence of complications of diabetes among the patients. The dataset of the study has been collected from the Waikato district health board. This study intends to report the initial scanning of the dataset profile with visualising the resulting patterns of sociodemographic details from the samples and their association with complications of diabetes. The Sankey diagrams use to visualise the results of exploratory data analysis. The resulted graphs of the data screening descriptively illustrate the characteristics of the cohort associated with demographic factors. Maori population shows higher percentage (0.68) of diabetes patients than the other ethnicities, while having narrower age expansion (13-95) with early onset age, compared to others (20-103). Males (0.61%) are more vulnerable to diabetes than females (0.55%). Additionally, hypertension and cardiovascular diseases are common among the diabetes patients’ in the Waikato region. Maori male population is highly vulnerable to diabetes. This study will be beneficial in constructing and analysing the demographical categories of the cohort to comparatively study the pervasiveness of the diseases among resulting classes.
探索一个队列的社会人口因素是揭示社会健康状况重要方面的重要阶段。卫生保健部门利用社会人口性质的探索性分析结果来实现各种目的,如制定卫生保健政策、分配充足的资源、提供必要的药物等等。越来越多的证据表明,了解普遍存在的社会人口因素:年龄、种族、性别,揭示了至关重要的信息。因此,本研究旨在通过分析新西兰糖尿病队列的社会人口学细节来揭示这些知识。糖尿病是由于无法控制适当的血糖水平而发生的一种慢性致命疾病,可引起多种急性和慢性并发症。糖尿病成为怀卡托地区的一种高发疾病。分析糖尿病合并并发症的糖尿病患者队列,说明糖尿病患者中糖尿病并发症的发生率。该研究的数据集是从怀卡托地区卫生委员会收集的。本研究旨在报告数据集概况的初始扫描,并将样本的社会人口学细节的结果模式及其与糖尿病并发症的关联可视化。桑基图用于可视化探索性数据分析的结果。数据筛选的结果图表描述性地说明了与人口因素相关的队列特征。毛利人的糖尿病患者比例(0.68)高于其他族裔,但年龄扩张较小(13-95岁),发病年龄较早(20-103岁)。男性(0.61%)比女性(0.55%)更容易患糖尿病。此外,高血压和心血管疾病在怀卡托地区的糖尿病患者中很常见。毛利人男性易患糖尿病。本研究将有助于构建和分析队列的人口学分类,以比较研究疾病在相应阶层中的普遍性。
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引用次数: 0
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