Associations of residential greenspace exposure and fetal growth across four areas in Spain

An accumulating body of evidence has associated exposure to greenspace with improved birth outcomes, including higher birth weight and lower risk of low birth weight; however, evidence on such association with in-utero fetal growth is scarce. We explored the influence of maternal exposure to residential greenspace and fetal growth in four INMA (Infancia y Medio Ambiente) Spanish birth cohorts (2003–2008), with 2,465 participants. Residential greenspace was characterised by the Normalised Difference Vegetation Index (NDVI) average across 100 m, 300 m, and 500 m buffers around the residence. Repeated ultrasound measurements of the abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and estimated fetal weight (EFW) were used. We created customised-generalised least squares models to evaluate associations of residential greenspace exposure on each fetal growth parameter, controlled for the relevant confounders. There were associations between the 500 m buffer and BPD, FL, and AC. We also found associations in the 300 m buffer and FL and AC. The associations in the 100 m buffer were null. Estimates were higher among participants with lower socioeconomic status. Mediation analyses found that air pollution might explain 15–37% of our associations. Mediation by physical activity was not observed. Greenspace exposure may be beneficial for fetal growth.     

Barrett’s esophagus: Review of natural history and comparative efficacy of endoscopic and surgical therapies

Barrett's esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC). Progression to cancer typically occurs in a stepwise fashion through worsening dysplasia and ultimately, invasive neoplasia. Established EAC with deep involvement of the esophageal wall and/or metastatic disease is invariably associated with poor long-term survival rates. This guides the rationale of surveillance of Barrett’s in an attempt to treat lesions at an earlier, and potentially curative stage. The last two decades have seen a paradigm shift in management of Barrett’s with rapid expansion in the role of endoscopic eradication therapy (EET) for management of dysplastic and early neoplastic BE, and there have been substantial changes to international consensus guidelines for management of early BE based on evolving evidence. This review aims to assist the physician in the therapeutic decision-making process with patients by comprehensive review and summary of literature surrounding natural history of Barrett’s by histological stage, and the effectiveness of interventions in attenuating the risk posed by its natural history. Key findings were as follows. Non-dysplastic Barrett’s is associated with extremely low risk of progression, and interventions cannot be justified. The annual risk of cancer progression in low grade dysplasia is between 1%-3%; EET can be offered though evidence for its benefit remains confined to highly select settings. High-grade dysplasia progresses to cancer in 5%-10% per year; EET is similarly effective to and less morbid than surgery and should be routinely performed for this indication. Risk of nodal metastases in intramucosal cancer is 2%-4%, which is comparable to operative mortality rate, so EET is usually preferred. Submucosal cancer is associated with nodal metastases in 14%-41% hence surgery remains standard of care, except for select situations.     

基于世界卫生组织康复胜任力架构构建硕士研究生层次特殊体育教育专业研究

目的 探讨硕士研究生层次特殊体育教育专业教育体系。方法 运用世界卫生组织康复胜任力架构(RCF),形成特殊体育教育专业胜任力,并应用于特殊体育教育专业建设,探讨硕士研究生层次的特殊体育教育专业建设理论架构与方法体系。结果 基于RCF,构建了特殊体育教育教师的胜任力架构,涉及特殊体育教师的实践、专业精神、学习与发展、管理与领导力和研究5个领域,胜任力和活动的熟练程度须达到相应水平。特殊体育教育专业建设应在培养目标、教学方式、专业课程设置和教学评估4个方面突出RCF特色和围绕胜任力的培养进行建设。结论 运用RCF构建了基于胜任力的特殊体育教育硕士研究生层次的专业教育方案。该方案使用RCF说明特殊教师职业能力标准,并可以将此转化为基于胜任力的硕士研究生层次特殊体育教育专业建设的内容。运用RCF构建基于胜任力的特殊体育教育体系,该体系可以用于确定硕士研究生层次的特殊体育教育专业建设中的培养目标、教学形式、专业核心课程和教学评估内容与方法。     

A Mock Telephone Triage Experience for Nurse Practitioner Students

The ability to manage patient telephone calls competently and confidently is an important skill for nurse practitioners (NPs). A curriculum intervention was implemented in a pediatric NP program to promote this skill. Thirty-nine NP students participated in a mock telephone triage experience to determine whether triage, involving student/faculty mock parent telephone calls, would increase the student’s confidence and competence. A Likert scale pre/post questionnaire surveying perceived confidence, competence, and readiness to practice revealed an increase in students’ confidence in decision making, assessing the patient, and making a diagnosis over the phone.     

基于合作对象探讨我国学术期刊专题/专栏建设

【目的】 了解学术期刊专题/专栏建设的现状,以切实发挥学术期刊专题/专栏建设的作用,为期刊的品牌建设、学术创新、影响力提升和办刊质量提高提供策略。【方法】 采用问卷调查法,对全国范围内397名专题/专栏合作对象(包括期刊主编、编委、审稿人、作者)进行调查,了解他们对期刊专题/专栏建设的态度和意见,从合作对象视角探讨影响学术期刊专题/专栏建设成功率和有效性的因素。【结果】 合作对象态度上,表示支持专题/专栏建设工作的比例较高(71.28%),但供稿率不高(43.37%),存在态度和行为分离的现象。排名前5的供稿率影响因素是期刊被本专业领域研究者认可、期刊被数据库收录情况、期刊影响力、期刊品牌、期刊的处理速度。最优的约稿方式是行业内的学术带头人联系约稿,其次是熟识的专家委托和期刊主编亲自联系进行约稿。合作对象最希望获得的帮助是稿件快速审理发表和确定选题方向。【结论】 为提高学术期刊专题/专栏建设质量,应进一步挖掘重要合作对象的作用,有针对性地选择高供稿率的合作对象;努力挖掘和利用影响合作对象供稿的因素,在期刊品牌建设、扩大影响力方面下功夫;优化约稿方式方法,重视行业学术带头人的作用;同时通过稿件快速审理发表、帮助确定选题并提供发表后推广等服务,提高合作对象对专题/专栏建设工作的认可度和参与度。     

Anisodamine affects the pigmentation,mineral density,craniofacial area,and eye development in zebrafish embryos

Anisodamine is one of the major components of the tropine alkaloid family and is widely used in the treatment of pain, motion sickness, pupil dilatation, and detoxification of organophosphorus poisoning. As a muscarinic receptor antagonist, the low toxicity and moderate drug effect of anisodamine often result in high doses for clinical use, making it important to fully investigate its toxicity. In this study, zebrafish embryos were exposed to 1.3-, 2.6-, and 5.2-mM anisodamine for 7 days to study the toxic effects of drug exposure on pigmentation, mineral density, craniofacial area, and eye development. The results showed that exposure to anisodamine at 1.3 mM resulted in cranial malformations and abnormal pigmentation in zebrafish embryos; 2.6- and 5.2-mM anisodamine resulted in significant eye development defects and reduced bone density in zebrafish embryos. The associated toxicities were correlated with functional development of neural crest cells through gene expression (col1a2, ddb1, dicer1, mab21l1, mab21l2, sox10, tyrp1b, and mitfa) in the dose of 5.2-mM exposed group. In conclusion, this study provides new evidence of the developmental toxicity of high doses of anisodamine in aqueous solutions to organisms and provides a warning for the safe use of this drug.