RESUMO
ABSTRACT: To explore the relationship between general movements (GMs) and neonatal behavior neurological assessment (NBNA)/cerebral magnetic resonance imaging (MRI) in preterm infants.Forty preterm infants were examined with GMs assessment before gestational age of 40âweeks; NBNA was performed at the age of 40âweeks; cerebral MRI was performed at the age of 42âweeks.Our experiment showed that preterm infants with poor GMs scores are more likely to have low NBNA scores (Pâ=â.001); preterm infants with abnormal cerebral MRI are more likely to have low NBNA scores (Pâ=â.002); preterm infants with poor GMs scores are more likely to have abnormal cerebral MRI (Pâ=â.012).GM assessment is correlated with NBNA and MRI results in preterm infants for neurological development.
Assuntos
Técnicas de Diagnóstico Neurológico/instrumentação , Recém-Nascido Prematuro/fisiologia , Movimento/fisiologia , Técnicas de Diagnóstico Neurológico/normas , Técnicas de Diagnóstico Neurológico/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Triagem NeonatalRESUMO
Flood disasters have appeared more frequently in recent years because of climate change and urbanization, and Integrated Flood Risk Management (IFRM) has emerged as an effective method to reduce damage from these floods. This research studies IFRM methods in three aspects: flood risk identification of high-risk areas, flood risk assessment to quantify economic losses, and flood risk management to identify structural measures with the greatest engineering benefits. These methods were applied to Beijing as a case study, and the results showed that the Zuoan-Road area was a high-risk area with economic losses ranging from 0.7 million to 35.9 million euros over different return periods. There are five structural measures in Zuoan-Road area, with engineering benefits ranging from 0.97 to 1.60 over different return periods, and the one with the greatest engineering benefits had a fifty-year return period. The results of this research can be used to support urban flood risk management in Beijing.
Assuntos
Desastres , Inundações , Pequim , Mudança Climática , Medição de Risco , UrbanizaçãoRESUMO
Importance: Congenital cytomegalovirus infection (cCMVi) is one of the most common infections associated with childhood hearing loss. Prevention and mitigation of cCMVi-related hearing loss will require an increase in newborn screening, which is not yet available in China. Objective: To estimate the cost-effectiveness of newborn screening strategies for cCMVi from the perspective of the Chinese health care system. Design, Setting, and Participants: A decision tree for a simulated cohort population of 15â¯000â¯000 live births was developed to compare the costs and health effects of 3 mutually exclusive interventions: (1) no screening, (2) targeted screening using CMV polymerase chain reaction assay for newborns who fail a universal hearing screening, and (3) universal screening for CMV among all newborns. Markov diagrams were used to evaluate the lifetime horizon (76 years). Main Outcomes and Measures: Cost, hearing-related health outcomes, and incremental cost-effectiveness ratios (ICERs) were estimated based on a direct medical costs perspective. Costs and ICERs were reported in 2018 US dollars. Results: Incidence of cCMVi among newborns was reported to be approximately 0.7% in China. Targeted screening was less costly but also less effective than universal screening, identifying 41% of cases needing antiviral treatment and preventing nearly half of less severe or profound hearing loss. To avoid 1 CMV-related severe or profound hearing loss, 13 and 16 newborns need to be treated by targeted and universal screening, respectively. The ICERs of targeted and universal screening vs no screening were $79 and $2087 per quality-adjusted life-year gained, respectively, at the discounted rate of 3.5%. Both screening options were cost-effective for the Chinese health care system based on the willingness-to-pay threshold of 3 × gross domestic product per capita. The sensitivity analysis showed that the prevalence of cCMVi, as well as diagnosis and treatment costs, were key factors that may be associated with decision-making. Conclusions and Relevance: To achieve cost-effectiveness and best health outcomes, universal screening could be considered for the Chinese population. While the results are specific to China, the model may easily be adapted for other countries.