Impact of gastroesophageal reflux control through tailored proton pump inhibition therapy or fundoplication in patients with Barrett's esophagus

AIM To determine the impact of upwards titration of proton pump inhibition(PPI) on acid reflux, symptom scores and histology, compared to clinically successful fundoplication.METHODS Two cohorts of long-segment Barrett's esophagus(BE) patients were studied. In group 1(n = 24), increasing doses of PPI were administered in 8-wk intervals until acid reflux normalization. At each assessment, ambulatory 24 h p H recording, endoscopy with biopsies and symptom scoring(by a gastroesophageal reflux disease health related quality of life questionnaire, GERD/HRLQ) were performed. Group 2(n = 30) consisted of patients with a previous fundoplication. RESULTS In group 1, acid reflux normalized in 23 of 24 patients, resulting in improved GERD/HRQL scores(P = 0.001), which were most pronounced after the starting dose of PPI(P < 0.001). PPI treatment reached the same level of GERD/HRQL scores as after a clinically successful fundoplication(P = 0.5). Normalization of acid reflux in both groups was associated with reduction in papillary length, basal cell layer thickness, intercellular space dilatation, and acute and chronic inflammation of squamous epithelium. CONCLUSION This study shows that acid reflux and symptom scores co-vary throughout PPI increments in long-segment BE patients, especially after the first dose of PPI, reaching the same level as after a successful fundoplication. Minor changes were found among GERD markers at the morphological level.

Extent of lymphadenectomy has no impact on postoperative complications after gastric cancer surgery in Sweden

Objective: Curative gastric cancer surgery entails removal of the primary tumor with adequate margins including regional lymph nodes. European randomized controlled trials with recruitment in the 1990's reported increased morbidity and mortality for D2 compared to D1. Here, we examined the extent of lymphadenectomy during gastric cancer surgery and the associated risk for postoperative complications and mortality using the strengths of a population-based study.Methods: A prospective nationwide study conducted within the National Register of Esophageal and Gastric Cancer. All patients in Sweden from 2006 to 2013 who underwent gastric cancer resections with curative intent were included. Patients were categorized into D0, D1, or D1+/D2, and analyzed regarding postoperative morbidity and mortality using multivariable logistic regression.Results: In total, 349(31.7%) patients had a D0, 494(44.9%) D1, and 258(23.4%) D1+/D2 lymphadenectomy.The 30-d postoperative complication rates were 25.5%, 25.1% and 32.2%(D0, D1 and D1+/D2, respectively), and 90-d mortality rates were 8.3%, 4.3% and 5.8%. After adjustment for confounders, in multivariable analysis, there were no significant differences in risk for postoperative complications between the lymphadenectomy groups. For90-d mortality, there was a lower risk for D1 vs. D0.Conclusions: The majority of gastric cancer resections in Sweden have included only a limited lymphadenectomy(D0 and D1). More extensive lymphadenectomy(D1+/D2) seemed to have no impact on postoperative morbidity or mortality.

新时代教师育人能力内涵重构与路径探析

教师育人能力是新时代赋予教师的使命,指向教师全面育人能力的发展。新时代下教师育人能力内涵包括知识育人、思想育人、道德育人、文化育人、和谐育人与科学育人六个维度。当前教师育人能力主要存在教师育人能力的异化与教师育人能力的僵化两个问题。因此,需要以德立身,加强师德师风建设;自主学习,促进专业能力发展;教学相长,引导教师角色转变以提高教师育人能力实现全面育人。

Magnetic phase transition and continuous spin switching in a high-entropy orthoferrite single crystal

Rare-earth orthoferrite REFeO_(3)(where RE is a rare-earth ion)is gaining interest.We created a high-entropy orthoferrite(Tm_(0.2)Nd_(0.2)Dy_(0.2)Y_(0.2)Yb_(0.2))FeO_(3)(HEOR)by doping five RE ions in equimolar ratios and grew the single crystal by optical floating zone method.It strongly tends to form a single-phase structure stabilized by high configurational entropy.In the low-temperature region(11.6‒14.4 K),the spin reorientation transition(SRT)ofΓ_(2)(F_(x),C_(y),G_(z))‒Γ_(24)‒Γ_(4)(G_(x),A_(y),F_(z))occurs.The weak ferromagnetic(FM)moment,which comes from the Fe sublattices distortion,rotates from the a-to c-axis.The two-step dynamic processes(Γ_(2)‒Γ_(24)‒Γ_(4))are identified by AC susceptibility measurements.SRT in HEOR can be tuned in the range of 50‒60000 Oe,which is an order of magnitude larger than that of orthoferrites in the peer system,making it a candidate for high-field spin sensing.Typical spin-switching(SSW)and continuous spin-switching(CSSW)effects occur under low magnetic fields due to the strong interactions between RE‒Fe sublattices.The CSSW effect is tunable between 20‒50 Oe,and hence,HEOR potentially can be applied to spin modulation devices.Furthermore,because of the strong anisotropy of magnetic entropy change()and refrigeration capacity(RC)based on its high configurational entropy,HEOR is expected to provide a novel approach for refrigeration by altering the orientations of the crystallographic axes(anisotropic configurational entropy).

A critical review of sulfate aerosol formation mechanisms during winter polluted periods

Sulfate aerosol contributes to particulate matter pollution and plays a key role in aerosol radiative forcing,impacting human health and climate change.Atmospheric models tend to substantially underestimate sulfate concentrations during haze episodes,indicating that there are still missing mechanisms not considered by the models.Despite recent good progress in understanding the missing sulfate sources,knowledge on different sulfate formation pathways during polluted periods still involves large uncertainties and the dominant mechanism is under heated debate,calling for more field,laboratory,and modeling work.Here,we review the traditional sulfate formation mechanisms in cloud water and also discuss the potential factors affecting multiphase S(Ⅳ)oxidation.Then recent progress in multiphase S(Ⅳ)oxidation mechanisms is summarized.Sulfate formation rates by different prevailing oxidation pathways under typical winter-haze conditions are also calculated and compared.Based on the literature reviewed,we put forward control of the atmospheric oxidation capacity as a means to abate sulfate aerosol pollution.Finally,we conclude with a concise set of research priorities for improving our understanding of sulfate formation mechanisms during polluted periods.

Comparing the performance of time series models with or without meteorological factors in predicting incident pulmonary tuberculosis in eastern China

Background: Many studies have compared the performance of time series models in predicting pulmonary tuberculosis(PTB),but few have considered the role of meteorological factors in their prediction models.This study aims to explore whether incorporating meteorological factors can improve the performance of time series models in predicting PTB.Methods:: We collected the monthly reported number of PTB cases and records of six meteorological factors in three cities of China from 2005 to 2018.Based on this data,we constructed three time series models,including an autoregressive integrated moving average(ARIMA)model,the ARIMA with exogenous variables(ARIMAX)model,and a recurrent neural network(RNN)model.The ARIMAX and RNN models incorporated meteorological factors,while the ARIMA model did not.The mean absolute percentage error(MAPE)and root mean square error(RMSE)were used to evaluate the performance of the models in predicting PTB cases in 2018.Results: Both the cross-correlation analysis and Spearman rank correlation test showed that PTB cases reported in the study areas were related to meteorological factors.The predictive performance of both the ARIMA and RNN models was improved after incorporating meteorological factors.The MAPEs of the ARIMA,ARIMAX,and RNN models were 12.54%,11.96%,and 12.36%in Xuzhou,15.57%,11.16%,and 14.09%in Nantong,and 9.70%,9.66%,and 12.50%in Wuxi,respectively.The RMSEs of the three models were 36.194,33.956,and 34.785 in Xuzhou,34.073,25.884,and 31.828 in Nantong,and 19.545,19.026,and 26.019 in Wuxi,respectively.Conclusions: Our study revealed a possible link between PTB and meteorological factors.Taking meteorological factors into consideration increased the accuracy of time series models in predicting PTB,and the ARIMAX model was superior to the ARIMA and RNN models in study settings.

Sex-specific association between coffee consumption and incident chronic kidney disease: a population-based analysis of 359,906 participants from the UK Biobank

Background:The risk for chronic kidney disease(CKD)is influenced by genetic predisposition,sex,and lifestyle.Previous research indicates that coffee is a potentially protective factor in CKD.The current study aims to investigate whether sex disparity exists in the coffee–CKD association,and whether genetic risk of CKD or genetic polymorphisms of caffeine metabolism affect this association.Methods:A total of 359,906 participants from the UK Biobank who were enrolled between 2006 and 2010 were included in this prospective cohort study,which aimed to estimate the hazard ratios for coffee intake and incident CKD using a Cox proportional hazard model.Allele scores of CKD and caffeine metabolism were additionally adjusted for in a subsample with qualified genetic data(n=255,343).Analyses stratified by genetic predisposition,comorbidities,and sex hormones were performed.Tests based on Bayesian model averaging were conducted to ascertain the robustness of the results.Results:Coffee was inversely associated with CKD in a dose-dependent manner.The effects of coffee did not differ across different strata of genetic risk for CKD,but were more evident among slower genetically predicted caffeine metabolizers.Significant sex disparity was observed(P value for interaction=0.013),in that coffee drinking was only associated with the risk reduction of CKD in females.Subgroup analysis revealed that testosterone and sex hormone-binding globulin(SHBG),but not estradiol,modified the coffee–CKD association.Conclusions:In addition to the overall inverse coffee–CKD association that was observed in the general population,we could also establish that a sex disparity existed,in that females were more likely to experience the benefit of the association.Testosterone and SHBG may partly account for the sex disparity.

Online Teaching for Elementary and Secondary Schools During COVID-19

This report draws on data from two articles published by the Center for Teacher Education Research of Beijing Normal University,namely,“Survey Report on the Status Quo of Online Teaching and Related Needs Among Elementary and Secondary Schools During COVID-19 Prevention and Control:Based on a Sample Survey on School Principals in China”and“Survey Report on the Status Quo of Online Teaching and Related Needs Among Elementary and Secondary School Teachers During COVID-19 Prevention and Control:Based on a Sample Survey on Teachers in China.”

HO_(2)非均相摄取系数的测量与参数化

HO_(2)自由基与环境大气气溶胶的非均相反应是HO_(2)自由基的重要汇之一,对大气氧化能力有重要影响,对大气颗粒物的物化性质等进一步产生影响。HO_(2)的非均相反应过程的定量描述对不同地区大气氧化性与臭氧生成能力等问题的探求具有重要意义。目前不同研究小组测量的摄取系数可相差3到5个数量级,深入探究不同条件下不同种类气溶胶对HO_(2)自由基的非均相摄取机制,对摄取机制进行参数化表达,并准确测量摄取系数是量化其环境影响的关键。本文深入介绍了HO_(2)非均相摄取的原理与参数化表达,总结了已有的研究结果与进展,对不同的影响因素进行总结分析,并对此领域未来的发展方向提出建议与展望。

Health consequences of early-onset compared with late-onset type 2 diabetes mellitus

Background:Although cumulating evidence has suggested that early-onset type 2 diabetes mellitus(T2DM)conferred on patients a broader tendency for complications beyond vascular ones,a comprehensive analysis of patterns of complications across all relevant systems is currently lacking.Method:We prospectively studied 1777 early-onset(age at diagnosis≤45 years)and 35889 late-onset(>45 years)T2DM patients with matched unexposed individuals from the UK Biobank.Diabetes-specific and-related complications were examined using phenomewide association analysis,with patterns identified by comorbidity network analysis.We also evaluated the effect of lifestyle modifications and glycemic control on complication development.Results:The median follow-up times for early-onset and late-onset T2DM patients were 17.83 and 9.39 years,respectively.Compared to late-onset T2DM patients,patients with early-onset T2DM faced a significantly higher relative risk of developing subsequent complications that primarily affected sense organs[hazard ratio(HR)3.46 vs.1.72],the endocrine/metabolic system(HR 3.08 vs.2.01),and the neurological system(HR 2.70 vs.1.81).Despite large similarities in comorbidity patterns,a more complex and well-connected network was observed for early-onset T2DM.Furthermore,while patients with early-onset T2DM got fewer benefits(12.67%reduction in pooled HR for all studied complications)through fair glycemic control(median HbA1c≤53 mmol/mol)compared to late-onset T2DM patients(18.01%reduction),they seemed to benefit more from favorable lifestyles,including weight control,healthy diet,and adequate physical activity.Conclusions:Our analyses reveal that early-onset T2DM is an aggressive disease resulting in more complex complication networks than late-onset T2DM.Aggressive glucose-lowering intervention,complemented by lifestyle modifications,are feasible strategies for controlling early-onset T2DM-related complications.

Predictive values of plasma TNFαand IL-8 for intracranial hemorrhage in patients with acute promyelocytic leukemia

In patients with acute promyelocytic leukemia(APL),intracranial hemorrhage(ICH),if not identified promptly,could be fatal.It is the leading cause of failure of induction and early death.Thus,biomarkers that could promptly predict severe complications are critical.Here,cytokine differences between patients with APL with and without ICH were investigated to develop predictive models for this complication.The initial cytokine profiling using plasma samples from 39 patients and 18 healthy donors found a series of cytokines that were remarkedly different between patients with APL and healthy controls.The APL patients were subsequently divided into high and low white blood cell count groups.Results showed that tumor necrosis factor a and interleukin 8(IL-8)were vital in distinguishing patients with APL who did or did not develop ICH.In addition,verification in 81 patients with APL demonstrated that the two cytokines were positively correlated with the cumulative incidence of ICH.Finally,in-vitro and in-vivo experimental evidence were provided to show that IL-8 influenced the migration of APL-derived NB4 cells and impaired the blood-brain barrier in PML/RARαpositive blast-transplanted FVB/NJ mice.These assessments may facilitate the early warning of ICH and reduce future mortality levels in APL.

Measurements of HO2 uptake coefficient on aqueous（NH4）2SO4 aerosol using aerosol flow tube with LIF system

Laboratory studies of HO2 uptake coefficients,γ(HO2),were conducted at room temperature using an aerosol flow tube coupled with a laser induced fluorescence(LIF) system.The measurement was conducted with atmospherically relevant HO2 concentrations(~1×10^9 molecule/cm^3) at 51% RH.The measured γ(HO2) onto aqueous(NH4)2 SO4 aerosol was 0.001±0.0007,which was consistent with the relatively low first-order loss rate of HO2 onto aqueous(NH4)2 SO4 aerosol.Theγ(HO2) was elevated with increase of Cu(Ⅱ) concentrations in aqueous(NH4)2 SO4 aerosol.The threshold of Cu(Ⅱ) concentration was10^-3 mol/L for the dramatic increase of γ(HO2).It was found that γ(HO2) reached 0.1 when Cu(Ⅱ)concentration in aerosol was larger than 10^-3 mol/L,suggesting that γ(HO2) is very sensitive to concentration of transition metal ions in aerosol.

Bronchiectasis is one of the indicators of severe coronavirus disease 2019 pneumonia

Since 2019,an epidemic of pneumonia of unknown cause occurred around the world.[1]The analysis of respiratory tract samples led to the identification of a novel coronavirus,which was named 2019 novel coronavirus(2019-nCoV).Epidemiological data showed that 2019-nCoV could spread rapidly from person to person and cause coronavirus disease-19(COVID-19).The high infectivity of COVID-19 has led to a rapid increase in the number of cases and caused a global pandemic.To date,2019-nCoV has infected millions of people and caused hundreds of thousands of deaths worldwide.These numbers are updated every day and are expected to increase further at a great rate.COVID-19 has now become a serious threat to public health worldwide.

From External Accountability to Potential-Oriented Development:Quality Assurance System Building for Teacher Preparation in China

Purpose:From the perspective of performance standards-based teacher education,this article aimed to address progress and challenges of China’s teacher preparation quality assurance system.Design/Approach/Methods:This review is based on policy review and case studies.Retrieving to the existing research literature,this research sorted out the policies related to the quality assurance system for university-based teacher preparation in China.Furthermore,this research selected teacher preparation programs from five cases of teacher education colleges of varied levels and used interviews to analyze their attitudes and measures.Findings:The analysis reveals that the quality system for university-based teacher preparation in China’s educational institutions has gone through two main stages:the building stage and the improvement stage.The internal policy tension in China’s teacher preparation quality assurance system is primarily centralized in the dissociation among and segmentation between the relevant standards for teacher education.There is a distinction between“soft”and“hard”policy standards,and reforming the teacher certification testing system also brings a test-oriented bias and a separation of evaluation from education.Institutions of higher education are expected to follow the path of potential-oriented development and concentrate on cooperative partnerships between local communities and schools so as to nurture innovative,professional future educators with high quality.Originality/Value:This article provides a comprehensive and detailed policy analysis as well as empirical evidence for the quality assurance systemfor university-based teacher preparation in China.