Congenital Cytomegalovirus Infection in Children with Autism Spectrum Disorder: Systematic Review and Meta-Analysis

Association of congenital cytomegalovirus (CMV) infection with autism spectral disorder (ASD) has been suggested since 1980s. Despite the observed association, its role as a risk factor for ASD remains to be defined. In the present review, we systematically evaluated the available evidence associating congenital CMV infection with ASD using PubMed, Web of Science, Cochrane Library, and Embase databases. Any studies on children with CMV infection and ASD were evaluated for eligibility and three observational studies were included in meta-analysis. Although a high prevalence of congenital CMV infection in ASD cases (OR 11.31, 95% CI 3.07–41.66) was indicated, too few events (0–2 events) in all included studies imposed serious limitations. There is urgent need for further studies to clarify this issue.     

竞赛驱动下医学专业“课程思政”的实践教学改革探索

当今医患矛盾日益突出、医患关系不断恶化的背景下,医学高等教育坚持用社会主义核心价值观引领意识形态的潮流,遵循社会主义核心价值观做导向,做到勤学、修德、立志、成才达到全方位育人目的。为落实立德树人根本任务,深度挖掘课程德育内涵,推动"课程思政"责任共同体,教师为主体,既可创新教学改革方法,有效充分发挥课程"育人"功能,将"课程思政"贯穿教育教学全过程,目的是医学专业基础课与思想政治理论同向同行,形成协同效应",以赛促教,增进实效"多元化竞赛,深入挖掘蕴含在专业知识里的德育元素,竞赛活动为载体促进"课程思政"与医学知识融合。在调研医学课程中专业课"课程思政"的现状基础上,不断充分挖掘医学专业课程中的思政元素,做到润物细无声,构建"竞赛驱动—课程思政融入-教学改革-学生批判能力培养"的教学改革实践模式,既将以竞赛为驱动力,并以医学专业知识为载体融入思政元素,提高医学生社会价值观的形成。坚持理论学习与实践教学相衔接,体会理论知识外化为实践能力,化知为行、知行合一。以赛促教、以赛促学"从专业角度发挥课堂主渠道,做好立德树人工作。     

The meaning of quality of care in home care settings: older lesbian and bisexual women's perspectives

Research suggests that the experience of being a lesbian or bisexual woman influences women's interactions with health care providers, and their perception of the quality of care. Limited research to date, however, has examined how ageing and sexuality mediates women's experiences of quality, when accessing health care in the community. To fill a gap in the literature, this study investigated older lesbian and bisexual women's perspectives on the meaning of quality of care in the context of receiving home care services. This was a qualitative single case study. Sixteen participants, aged 55–72 from Ontario, Canada, participated in semi‐structured interviews between 2011 and 2012. The interviews were recorded and transcribed. The interview data were analysed using iterative thematic analysis and guided by a feminist ethic of care perspective. Participants described quality of care in ways that were in line with a feminist ethic of care; that is, they wanted care providers to be responsive and attentive to their needs, to involve them in the caring process and to demonstrate respect and caring. Participants also indicated that providers’ comfort with, and knowledge of, sexual diversity was important for enabling quality of care. These findings deepen our understanding of how to support quality of care for this population through changes to provider education and training, and health policy.     

Impact of a conjugate vaccine on community-wide carriage of nonsusceptible Streptococcus pneumoniae in Alaska

BACKGROUND: Streptococcus pneumoniae is a leading cause of invasive bacterial disease and pneumonia among children. Antimicrobial resistance among pneumococci has increased in recent years and complicates treatment. The introduction of heptavalent pneumococcal conjugate vaccine (PCV7) could reduce acquisition of antimicrobial-resistant pneumococci. METHODS: We obtained 1350 nasopharyngeal swabs for culture from 1275 children aged 3-59 months presenting at 3 clinics in Anchorage, Alaska, during the winters of 2000, 2001, and 2002, as PCV7 was being introduced into the routine immunization schedule. We recorded the frequency of use of antibiotics as well as the dates of doses of PCV7 for enrolled children. We used multivariate logistic regression modeling to identify independent risk factors for overall carriage of pneumococci and carriage of PCV7-type pneumococci, cotrimoxazole-nonsusceptible (COT-NS) pneumococci, or penicillin-nonsusceptible (PCN-NS) pneumococci. RESULTS: The proportion of children who were up-to-date for age, with respect to PCV7 vaccination, increased from 0% in 2000 to 55% in 2002. Carriage of PCV7-type pneumococci decreased by 43% (P<.0001). Risk of carriage of PCV7-type pneumococci was lower in 2002 than in 2000, independent of vaccination status, suggesting an indirect effect of vaccination. Carriage of COT-NS, but not PCN-NS, pneumococci also decreased (38%; P=.02), not only among vaccinated children but also among unvaccinated children without recent use of antibiotics. CONCLUSIONS: Introduction of PCV7 into the routine infant immunization schedule in a community with a high prevalence of antimicrobial-resistant pneumococci appears to reduce transmission of PCV7 vaccine serotypes and COT-NS pneumococci but has no impact on overall carriage of pneumococci or carriage of PCN-NS pneumococci.     

HPLC-ELSD法测定肺痨灵合剂中黄芪甲苷的含量

目的:建立HPLC-ELSD法测定肺痨灵合剂中黄芪甲苷含量的方法。方法:采用高效液相色谱法(HPLC),色谱柱为Agilent XDB C18柱(4.6 mm×150 mm,5μm),流动相为乙腈-水(33:67),流速为1.0 m L/min,进样量为10μL。ELSD参数:漂移管温度为101℃,氮气流速为2.7 L/min。结果:黄芪甲苷线性范围是1.326~9.282μg,r为0.9981,平均加样回收率为98.20%,RSD为0.88%。结论:HPLC-ELSD法灵敏、简便,准确,重现性好,可用于肺痨灵合剂的定量分析与质量控制。     

Bisphenol A promotes X‐linked inhibitor of apoptosis protein‐dependent angiogenesis via G protein‐coupled estrogen receptor pathway

Bisphenol A (BPA), one of the high‐volume chemicals worldwide, has a core structure resembling that of natural estradiol. Recent evidence has demonstrated that exposure to BPA has a relationship with the risk of cancer. The objective of our study is to investigate the mechanisms underlying the pro‐angiogenic effects of BPA. We demonstrated that BPA markedly induces endothelial cell proliferation, migration and tube formation by activating endothelial nitric oxide synthase. BPA‐induced nitric oxide generation appeared to be associated with the X‐linked inhibitor of apoptosis protein (XIAP), which competes with endothelial nitric oxide synthase for caveolin‐1. BPA was shown to exert its pro‐angiogenic effect by upregulating XIAP expression via G protein‐coupled estrogen receptor (ER) activation but not via ERα or ERβ. Our data suggest that 100 nM BPA promote angiogenesis in a G protein‐coupled ER‐dependent genomic pathway, and provide a novel insight into the potential role of XIAP in mediating the pro‐angiogenic effects of BPA in endothelial cells. Copyright © 2015 John Wiley & Sons, Ltd.     

Successes in sexual health communications development,programmatic implementation and evaluation in the Torres Strait region 2006 to 2012

Objective: To evaluate the Indigenous sexual health promotion program in the Torres Strait 2006–2012 that culminated in an education‐entertainment radio drama, Kasa Por Yarn (KPY). Methods: A mixed methods approach applied to unpublished program documents and program‐derived peer‐reviewed publications was utilised. Results: Early initiatives established a strong partnership with Torres Strait Islander stakeholders. Significant community engagement throughout ensured a positive process. Telephone survey data (n=100, TSI, 15–24 years) found: 95% had heard of KPY and 80% listened to 2 or more episodes (reach); 86% recalled storylines/characters (recall); and 54% talked about KPY to family/friends (resonance). There was improvement in sexual health knowledge scores (p<0.00) in the 15–19‐year‐old Torres Strait Islander population between 2007 and 2012. The 2012 15–24‐year‐old population exposed to KPY had higher sexual health knowledge scores compared with those unexposed (p=0.02). Conclusions: This is an uncommon comprehensive evaluation of population‐based sexual health communications strategies delivered over years in a remote Australian setting. The findings are encouraging but demonstrate that positive shifts take time and are incremental. Implications: In addition to clinical strategies, strategic and sustained investment in sexual health promotion expertise that leads community partnership and program development is required to reduce youth risk and prevent HIV/AIDS in remote populations.