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.     

黄芩苷改善肿瘤缺氧微环境抑制乳腺癌移植瘤的生长＊

目的 通过观察黄芩苷对乳腺癌组织毛细血管通透性（Capillary Vessel Permeability，CVP）、赖氨酰氧化酶（Lysyl Oxidase，LOX）及血清丙二醛（Malondialdehyde，MDA）等相关指标的影响，探讨黄芩苷可能的抗乳腺癌作用机制。方法 通过在裸鼠皮下接种MDA-MB-231乳腺癌细胞株建立乳腺癌移植瘤模型；实验分为模型组、黄芩苷组、阿霉素组、黄芩苷+阿霉素组。于接种第7日开始：黄芩苷组每天灌胃黄芩苷水溶液（100 mg·kg^-1），连续14天；阿霉素组每3天腹腔注射一次阿霉素（5mg·kg^-1），共用药5次；模型组每天灌胃生理盐水（10 mL·kg^-1），连续14天；黄芩苷+阿霉素组每天灌胃黄芩苷水溶液（100 mg·kg^-1），连续14天，并每3天腹腔注射一次阿霉素5 mg·kg^-1，共5次。给药期间监测移植瘤体积；紫外可见分光光度计620 nm下测OD值来反映黄芩苷对肿瘤毛细血管通透性的影响；硫代巴比妥酸（Thiobarbituric acid，TBA）比色法检测黄芩苷对裸鼠血清中丙二醛（MDA）的影响；免疫组化染色法检测乳腺癌组织中赖氨酰氧化酶（LOX）的表达情况。结果 ①与模型组比较，黄芩苷组、阿霉素组、黄芩苷+阿霉素组瘤体重量均明显减轻（P<0.05）；黄芩苷+阿霉素组瘤体重量较阿霉素组明显减轻（P<0.05）。②与模型组比较，黄芩苷组降低乳腺癌组织毛细血管的通透性，而阿霉素组则增加肿瘤组织中毛细血管的通透性，差异均具有统计学意义（P<0.05）。③黄芩苷组能够明显抑制荷瘤裸鼠血清MDA的表达，与模型组比较差异有显著统计学意义（P<0.01）；阿霉素组促进MDA的表达，与模型组比较差异有统计学意义；黄芩苷+阿霉素组促进MDA的表达，与模型组比较差异无统计学意义。④与模型组比较，黄芩苷组裸鼠乳腺癌组织LOX的表达显著下调（P<0.01），阿霉素组肿瘤组织中LOX表达增加（P<0.05）；黄芩苷+阿霉素组能下调裸鼠乳腺癌组织LOX的表达，与模型组比较差异无统计学意义。结论 黄芩苷能够明显抑制乳腺癌移植瘤的生长，其机制可能与黄芩苷降低肿瘤组织毛细血管的通透性，抑制裸鼠血清中丙二醛、乳腺癌组织中赖氨酰氧化酶的表达，从而改变肿瘤缺氧微环境有关。     

Safety and feasibility of robotic assisted percutaneous coronary intervention compared to standard percutaneous coronary intervention- a systematic review and meta-analysis

ObjectiveRobotically assisted PCI offers a great alternative to S–PCI. This has gained even more relevance during the COVID-19 pandemic era however safety of R–PCI compared to S–PCI has not been studied well. This study explores the safety and efficacy of robotically assisted PCI (R–PCI) compared to standard PCI (S–PCI) for the treatment of coronary artery disease (CAD).MethodsPubMed, Scopus, Ovid, and Google scholar databases were searched for studies comparing R–PCI to S–PCI. Outcomes included clinical success, procedure time, fluoroscopy time, contrast use and radiation exposure.ResultsTheauthors included 5 studies comprising 1555 patients in this meta-analysis. Clinical success was comparable in both arms (p = 0.91). Procedure time was significantly longer in R–PCI group (risk ratio: 5.52, 95% confidence interval: 1.85 to 9.91, p = 0.003). Compared to S–PCI, patients in R–PCI group had lower contrast use (meandifference: −19.88, 95% confidence interval: −21.43 to −18.33, p < 0.001), fluoroscopy time (mean difference:-1.82, 95% confidence interval: −3.64 to −0.00, p = 0.05) and radiation exposure (mean difference:-457.8, 95% confidence interval: −707.14 to −208.14, p < 0.001).ConclusionR–PCI can achieve similar success as S–PCI at the expense of longer procedural times. However, radiation exposure and contrast exposure were lower in the R–PCI arm.     

Hormone exposure and its suppressive effect on risk of high-grade gliomas among patients with breast cancer

BackgroundPrior reports demonstrate the expression of estrogen and progesterone receptors in high-grade gliomas (HGGs), but the relationship between hormone receptor-positive disease and risk of HHGs in patients with breast cancer (BC) remains uncharacterized.MethodsUsing the SEER 18 registries (2000–2017), we examined the temporal trend of the incidence of HGGs and BC. The standardized incidence ratio was calculated to assess the risk of subsequent HGG in BC patients.ResultsDuring the study period, the incidence of BC and HGGs remained comparable for men and women. Among 976,134 patients with BC, we found a decreased incidence of HGGs in females, but not in males. Female BC patients with hormone receptor-positive disease were at a lower risk of developing glioblastoma and anaplastic astrocytoma.ConclusionOur study findings allude to the protective role of hormone exposure in the development of HGGs, which may lead to the development of therapies targeting hormonal pathways.     

Identifying Trends of Percutaneous Injuries at an Australian Dental School

ObjectivesThe aim of this study was to retrospectively examine trends in percutaneous exposure incidences (PEIs) at the School of Dentistry (SoD) from 2009 to 2019 and to report on the underreporting rate of PEIs, current attitudes, and awareness of PEI safety protocols from clinical staff and students at the SoD in 2019.MethodsRetrospective data were collected from deidentified archival incident reports from 2009 to 2019 from the SoD's incident reporting system (UQSafe and Legacy Database). Additionally, cross-sectional data were collected via the validated Percutaneous Exposure Incident Questionnaires (PEIQ) completed by clinical staff and students of the SoD in 2019.ResultsFrom the archival data, the majority (79.9%) of the 618 reported PEIs involved students. Local anaesthetic-related procedures were the most common cause in the archival (31.5%) and survey data (23.7%), whereas the needle-prick was the most common causative instrument in both data sets. Additionally, the finger was the most common site of injury found in the archival (53.0%) and survey data (52.8%). From 345 responses to the survey, 42.1% of PEIs sustained were not reported.ConclusionsStudents were at a higher risk of sustaining a PEI than staff members between 2009 and 2019. The reported knowledge on PEI classification and preventative measures is inadequate, suggesting that further PEI education is necessary. The study provides evidence of the trends in PEIs as well as data on the attitudes and awareness of student and staff at a dental teaching faculty to support the development of PEI safety management protocols.     

江西省2017年度临床核医学应用频度调查与分析

目的 掌握江西省临床核医学应用频度和受检者的分布特点，估算2017年全省临床核医学应用频度。方法 对全省范围内开展临床核医学工作的各级医疗机构进行普查，以发放调查问卷的形式对样本医院进行应用频度调查与分析。结果 除正电子发射断层扫描（PET）检查男性多于女性外，其余临床核医学诊疗项目均为女性多于男性；全省临床核医学诊疗应用频度为0.67人次/千人口，其中诊断频度为0.58人次/千人口，治疗频度为0.09次/千人口。结论 与"九五"期间相比，江西省临床核医学应用频度迅猛发展，有必要进一步规范核医学诊疗工作，增强核医学工作人员的放射防护意识，促进核医学健康有序地发展。     

Exposición solar en la enfermedad inflamatoria intestinal ambulatoria: factores predictivos y correlación con la concentración sérica de vitamina D

IntroductionSunlight exposure is the main source of vitamin D. Our aim was to describe both sun exposure and sun protection behaviour in a series of patients with inflammatory bowel disease (IBD), and to study their potential association with vitamin D concentration.Patients and methodsA cross sectional, observational study. The clinical-demographic variables were obtained via clinical interviews and medical history review. The sunlight exposure assessment was carried out using the Sun Exposure Questionnaire and the concentration of 25-hydroxy vitamin D (25OHD) was measured by an electro-chemiluminescence immunoassay. Questionnaires were conducted on quality of life, physical activity, weekly vitamin D intake and sun protection behaviour.Results149 patients were included. In 69% of patients, deficient or insufficient 25OHD values were recorded. 67% showed low sun exposure. A modest significant correlation was observed between the total score of the solar exposure questionnaire and the 25OHD concentration in the complete series (r = 0.226, P = .006) and in the summer (r = 0.274, P = .01). The sun protection behaviour questionnaire score did not influence the 25OHD concentration. In the multivariate analysis, only the presence of clinical activity was associated with low sun exposure (OR = 3.23).DiscussionSun exposure according to the questionnaire used was low, was associated with the presence of clinical activity and was weakly correlated with serum 25OHD concentration. More studies are needed to explore the use of individual questionnaires for sun exposure and its relationship with vitamin D in patients with IBD.