户外活动时间与学龄前文化课学习情况对中小学生视力不良的交互作用

目的 分析户外活动时间与学龄前参加文化课学习情况的交互作用与中小学生视力不良的关系,为制定防控中小学生视力不良的策略和措施提供科学依据。方法 采用分层整群随机抽样法于2018年9-11月在湖南省抽取8 467名小学四年级到高中三年级学生进行体格检查和问卷调查。相乘交互作用建立多因素Logistic回归模型,并计算交互作用超额危险度(RERI)、交互作用归因比(API)及交互作用指数 S (Index S)探讨户外活动时间与学龄前文化课学习对视力不良的相加交互作用。结果 8 467名调查对象中视力不良检出人数为5 612名,检出率为66.28%。学龄前参加过文化课学习者,视力不良的发生风险是不参加学习者的1.500倍(95%CI:1.331~1.689,P<0.001),每日户外活动<2 h的学生发生视力不良的风险是每日户外活动≥2 h者的1.247倍(95%CI:1.103~1.409,P<0.001)。户外活动时间与学龄前文化课学习的交互作用项具有统计学意义(P_交互=0.003)。在调整相关因素后,户外活动时间与学龄前文化课学习的RERI、API、Index S分别为0.529、0.310、3.973。结论 中小学生户外活动时间、学龄前文化课学习均与视力不良发生风险相关,并两者对视力不良有交互作用。因此,应加强学龄前儿童的户外活动,以预防视力不良发生。     

Natural language processing and entrustable professional activity text feedback in surgery: A machine learning model of resident autonomy

BackgroundEntrustable Professional Activities (EPAs) contain narrative ‘entrustment roadmaps’ designed to describe specific behaviors associated with different entrustment levels. However, these roadmaps were created using expert committee consensus, with little data available for guidance. Analysis of actual EPA assessment narrative comments using natural language processing may enhance our understanding of resident entrustment in actual practice.MethodsAll text comments associated with EPA microassessments at a single institution were combined. EPA—entrustment level pairs (e.g. Gallbladder Disease—Level 1) were identified as documents. Latent Dirichlet Allocation (LDA), a common machine learning algorithm, was used to identify latent topics in the documents associated with a single EPA. These topics were then reviewed for interpretability by human raters.ResultsOver 18 months, 1015 faculty EPA microassessments were collected from 64 faculty for 80 residents. LDA analysis identified topics that mapped 1:1 to EPA entrustment levels (Gammas >0.99). These LDA topics appeared to trend coherently with entrustment levels (words demonstrating high entrustment were consistently found in high entrustment topics, word demonstrating low entrustment were found in low entrustment topics).ConclusionsLDA is capable of identifying topics relevant to progressive surgical entrustment and autonomy in EPA comments. These topics provide insight into key behaviors that drive different level of resident autonomy and may allow for data-driven revision of EPA entrustment maps.     

Setting standards of performance expected in neurosurgery residency: A study on entrustable professional activities in competency-based medical education

BackgroundCompetency-based medical education requires evaluations of residents’ performances of tasks of the discipline (ie. entrustable professional activities (EPAs)). Using neurosurgical Faculty perspectives, this study investigated whether a sample of neurosurgical EPAs accurately reflected the expectations of general neurosurgical practice.MethodA questionnaire was sent to all Canadian neurosurgery Faculty using a SurveyMonkey® platform.ResultsThe proportion of respondents who believed the EPAs were representative of general neurosurgery competences varied significantly across all EPAs [47%–100%] (p < 0.0001). For 9/15 proposed EPAs, ≥75% agreed they were appropriate for general neurosurgery training and expected residents to attain the highest standard of performance. However, a range of 27–53% of the respondents felt the other six EPAs would be more appropriate for fellowship training and thus, require a lower standard of performance from graduating residents.ConclusionThe shift towards subspecialization in neurosurgery has implications for curriculum design, delivery and certification of graduating residents.     

Dark Tea: A popular beverage with possible medicinal application

Tea is a famous beverage that is produced from leaves of Camellia sinensis. Amongst the six major tea categories in China, dark tea is the only one that involves microbial fermentation in the manufacturing process, which contributes unique flavors and functions for the tea. In the recent decade, the reports about the biofunctions of dark teas have increased rapidly. Therefore it may be the proper time to consider dark tea as one potential homology of medicine and food. In this viewpoint, our current understanding of the chemical constituents, biological activities and possible health beneficial effects of dark teas were introduced. Some future directions and challenges to the development perspectives of dark teas were also discussed.     

Examining community pharmacists’ intention to provide pharmacist-driven vaccination services: A structural equation modelling

BackgroundThe evidence of pharmacists' current involvement in vaccination services in low- and middle-income countries (LMICs) is uncertain. This study would be a first step to develop vaccination services by investigating community pharmacists’ intention to be involved in PDV services not just during COVID-19 pandemic but also during standard service provision in Turkey which can be taken as an example across LMICs.ObjectiveConsidering the efforts to empower community pharmacists in service provision, the goal of the present study was to develop a structural equation model to explain the “Pharmacist-Driven Vaccination Service Intention Model (PDV-SIM)” by using the theory of planned behavior (TPB).MethodsBased on the constructs of TPB, a measurement tool was developed. Sub-factors of PDV service intention was determined by conducting exploratory factor analysis (EFA). In the second step, confirmatory factor analysis (CFA) was conducted to prove the theoretical structure of the tool. Finally, a model explaining the relationship between observed variables, latent constructs from TPB was developed by SEM analysis.ResultsIn the proposed PDV-SIM, patient related attitude toward PDV services, attitude toward negative consequences of PDV services, and subjective norm about PDV services had an impact on the behavioral intention of community pharmacists. Nevertheless, professional development attitude toward PDV services and perceived behavioral control were not evaluated as determinants of the behavioral intention.ConclusionResults of this study revealed that TPB is appropriate for modelling PDV service intention of community pharmacists. This model can be utilized as a guide to potential pharmacy regulatory bodies and policy makers in their efforts to enable community pharmacists as vaccinators across LMICs.     

Modification of spontaneous activity in primary vestibular neurons during development in the cat

Summary The spontaneous activity of primary vestibular neurons was studied during postnatal development in the cat. Activities were categorized as regular, intermediate and irregular on the basis of the coefficient of variation. At birth, few regularly firing units were found while the percentage of intermediate and irregular units was high. During development, the percentage of units meeting the criterion of regularity increased steadily with age. At the same time the number of intermediate and irregular units decreased. The average resting rate of all categories of unit showed an increase in firing from birth up to the adult stage, i. e., around the second postnatal month. The mean firing rate of regularly firing units was always higher than the two other categories throughout all the stages of development. These results were compared with similar work performed in the rat.Supported by grants from the C.N.R.S. (E.R.A.-187) and D.G.R.S.T. (no. 79-7-1073)     

国产替勃龙的激素活性及药效研究

为在国内开发治疗妇女更年期与手术后绝经症的新药 ,对国产替勃龙进行了多项生殖内分泌生物实验 ,结果表明该药兼具雌激素、孕激素及雄激素活性 ,并有延迟排卵作用 ,对大鼠雌激素缺乏性阴道炎也有治疗作用。其药理特性符合临床治疗女性更年期综合症要求。     

Engagement with arts and culture activities in the Danish general population: Longitudinal associations with new onset or persistent depression and mental wellbeing

Objectives

International literature suggests that arts and culture activities may benefit mental health, however, such survey studies conducted in the Danish population are scarce. Further, studies have investigated the associated risk for incident depression, but not for persistent depression. The objective of the current prospective study was to assess associations of engagement in arts and culture activities with incident/persistent depression and also mental wellbeing among Danish adults in the general population.

Design

Observational prospective study.

Methods

Data stem from a Danish nationally representative panel study of 5000 adults (aged 15+ years) conducted in 2019 and 2020, which was linked to Danish register data. An exposure variable was constructed for frequency of attending concerts, theatres, museums, and cinemas. Validated scales were used to assess the presence of depression (PHQ-8) and levels of mental wellbeing (SWEMWBS). Binary logistic regression analyses were conducted to assess the risk of incident depression (among participants free of depression at baseline), as well as the risk of persistent depression (among participants with depression at baseline), while multinomial logistic regression was used to assess odds for moderate and high mental wellbeing (low as base outcome) while adjusting for baseline values.

Result

In terms of incident depression, quarterly engagement in arts and culture activities (compared to never) was associated with an OR of .43 (95%CI .23–.80), while 8 times or more was associated with an OR of .53 (.29–.97). In terms of persistent depression, quarterly engagement was associated with an OR of .30 (.10–.90), while 8 times per year or more was associated with an OR of .26 (.07–.92). Similar to the patterns for incident/persistent depression, associations with moderate mental wellbeing showed higher odds for quarterly engagement and 8 times per year or more. Quarterly engagement was also associated with higher odds for high mental wellbeing but did not reach statistical significance.

Conclusions

The results support the involvement of the cultural and creative sectors in health strategies. Mental health promotion initiatives as well as arts and culture sectors may encourage the general public to engage in arts and culture activities with frequencies of at least once per quarter.     

Human leukocyte interferon-α in cream,for the treatment of genital warts in asian women a placebo-controlled,double-blind study

The purpose of this double-blind, placebo-controlled study was to determine and compare the clinical efficacy and tolerance of human leukocyte -interferon (incorporated 2 × 10⁶ IU/g) in hydrophilic cream to cure genital warts. Preselected Asian female patients (n=150) aged 18–40 years (mean 22.5), with the clinical and biopsy-confirmed diagnosis of genital warts (mean 2.64), predominantly flat vaginal condylomas, were randomly allocated to 3 parallel groups. Each patient was given a coded tube containing 80 g placebo/active preparation with a graduated applicator. Patients were instructed to inject 6 g of the either alloted placebo/active cream deep into the vagina thrice a day for 3 consecutive days (group A) or 4 consecutive days (group B) per week, and if not cured the same treatment was extended to 3 more weeks (maximum 4 weeks active treatment). To assess the clinical efficacy patients were examined on a week-to-week basis. A total clearance of warts (biopsy-confirmed) was evaluated as a complete cure. Patients cured during the treatment were spared further treatment and were requested to visit us after 16 weeks for relapse control. As for the remaining patients, empty tubes were collected, and similarly coded replacement tubes were given for further treatment (in total 588 tubes were used). By the end of the treatment 57.2% lesions (227/397) were eliminated in all the groups: 48% patients in group A, 90% patients in group B, and 10% patients in placebo groups taken as completely cured. Of the 150 patients 128 (85.3%) did not complain of any drug-related adverse symptoms. Transitory increase in body temperature (mean 38.4°C), accompanied by headache (14.6%) and generalized itching (6.6%) were the most frequently reported side effects; however, treatment was well tolerated by all the patients, and there were no dropouts. Our findings indicate that clinical efficacy is dose dependent, that is, the results of group B were significantly superior to that of group A (P < 0.05). Of the 49.3% cured patients (74/150) followed up for 6 months (monthly basis) seven had a relapse, and none had reinfection. It is concluded that clinical efficacy of leukocyte interferon-a to cure genital warts is dose dependent. These results further support the view that leukocyte interferon-a incorporated in hydrophilic cream can be considered a reliable, safe, and home-based treatment to cure vulvar and vaginal warts.Abbreviation HPV human papillomavirus     

阳离子抗菌肽研究进展

阳离子抗菌肽广泛分布于多种生物 ,越来越多的证据表明它们在机体天然免疫中有着重要的作用。广谱抗菌、抗病毒、抗肿瘤细胞及其它特性也使得其具有潜在的医药价值。对抗菌肽的研究正不断深入。该文从一般性质、作用机制、构效关系、重组表达、应用价值、存在的问题与发展方向等方面 ,对阳离子抗菌肽的最新研究进展进行综述