简介：AbstractObjective:Otolaryngologists are at increased occupational risk of Coronavirus Disease 2019 (COVID-19) infection due to exposure from respiratory droplets and aerosols generated during otologic, nasal, and oropharyngeal examinations and procedures. There have been a variety of guidelines and precautions developed to help mitigate this risk. While many reviews have focused on the personal protective equipment (PPE) and preparation guidelines for surgery in the COVID-19 era, none have focused on the more creative and unusual solutions designed to limit viral transmission. This review aims to fill that need.Data Sources:PubMed, Ovid/Medline, and ScopusMethods:A comprehensive review of literature was performed on September 28, 2020 using PubMed, Ovid/Medline, and Scopus databases. All English-language studies were included if they proposed or assessed novel interventions developed for Otolaryngology practice during the COVID-19 pandemic. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.Results:A total of 41 papers met inclusion criteria and were organized into 5 categories ('General Recommendations for Otolaryngologic Surgery’, 'Equipment Shortage Solutions’, 'Airway Procedures’, 'Nasal Endoscopy and Skull Base Procedures’, and 'Otologic Procedures’). Articles were summarized, highlighting the innovations created and evaluated during the COVID-19 pandemic. Creative solutions such as application of topical viricidal agents, make-shift mask filters, three-dimensional (3-D) printable adapters for headlights, aerosol containing separation boxes, and a variety of new draping techniques have been developed to limit the risk of COVID-19 transmission.Conclusions:Persistent risk of COVID-19 exposure remains high. Thus, there is an increased need for solutions that mitigate the risk of viral transmission during office procedures and surgeries, especially given that most COVID-19 positive patients present asymptomatically. This review examines and organizes creative solutions that have been proposed and utilized in the otolaryngology. These solutions have a potential to minimize the risk of viral transmission in the current clinical environment and to create safer outpatient and operating room conditions for patients and healthcare staff.

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简介：AbstractBackground:Tuberculosis (TB) poses a severe public health challenge in China and worldwide. This study evaluated the effects of age, period, and birth cohort on reported incidence trends of TB based on population and refined the characteristics of high-risk groups.Methods:Aggregate data that reported pulmonary tuberculosis (PTB) cases from China Tuberculosis Management Information System (TBIMS) from 2006 to 2020 were used to analyze effect coefficients through the age-period-cohort (APC) model based on intrinsic estimator (IE) method, and converted them into relative risk (RR) to estimate trends.Results:A total of 14.82 million cases of PTB were reported in China from 2006 to 2020, showing a continuous downward trend. The reporting rate increased with age by age group, with 70-74 years old being 2-3 times higher than that in 20-24 years old. APC analysis model showed that age effects were bimodal in 20-24 years old [RR= 2.29, 95% confidence interval (CI): 1.73-3.03] and 70-74 years old (RR= 1.95, 95% CI: 1.67-2.27), and lower than the overall average in the groups under 15 years old. Stratified results showed that the risk was higher for women under age 40 than men and higher for men over 40. The risk was higher in urban than in rural areas under 30 years old and slightly higher in rural than in urban between 30 and 64 years old. The risk for 15-34 years old was significantly higher in the east than in other regions. The period effects showed a decreasing trend, and the risk was higher in rural in recent years. Except for cohorts born in 1961-1965 and 2001-2005, where the RR increased, the later the cohort was born, the lower the risk. The cohort 1926-1930 in eastern had the highest risk (RR= 3.49, 95% CI: 2.44-4.98).Conclusions:The reported incidence of PTB continued to decline in China from 2006 to 2020. The young (20-24 years old) and the elderly (70-74 years old) were equally at high risk. There were differences in the age, period and cohort effects on PTB incidence among gender, urban-rural and regions. Our findings better reflected the characteristics of high-risk populations, thus contributing to the development of timely and effective intervention strategies, and providing clues for etiological research.

简介：AbstractBackground:Excessive exposure to fluoride can reduce intelligence. Methylenetetrahydrofolate dehydrogenase, cyclohydrolase, and formyltetrahydrofolate synthetase 1 (MTHFD1) polymorphisms have important roles in neurodevelopment. However, the association of MTHFD1 polymorphisms with children’s intelligence changes in endemic fluorosis areas has been rarely explored.Methods:A cross-sectional study was conducted in four randomly selected primary schools in Tongxu County, Henan Province, from April to May in 2017. A total of 694 children aged 8 to 12 years were included in the study with the recruitment by the cluster sampling method. Urinary fluoride (UF) and urinary creatinine were separately determined using the fluoride ion-selective electrode and creatinine assay kit. Children were classified as the high fluoride group and control group according to the median of urinary creatinine-adjusted urinary fluoride (UFCr) level. Four loci of MTHFD1 were genotyped, and the Combined Raven’s Test was used to evaluate children’s intelligence quotient (IQ). Generalized linear model and multinomial logistic regression model were performed to analyze the associations between children’s UFCr level, MTHFD1 polymorphisms, and intelligence. The general linear model was used to explore the effects of gene-environment and gene-gene interaction on intelligence.Results:In the high fluoride group, children’s IQ scores decreased by 2.502 when the UFCr level increased by 1.0 mg/L (β= –2.502, 95% confidence interval [CI]: –4.411, –0.593), and the possibility for having "excellent" intelligence decreased by 46.3% (odds ratio = 0.537, 95% CI: 0.290, 0.994). Children with the GG genotype showed increased IQ scores than those with the AA genotype of rs11627387 locus in the high fluoride group (P < 0.05). Interactions between fluoride exposure and MTHFD1 polymorphisms on intelligence were observed (Pinteraction < 0.05).Conclusion:Our findings suggest that excessive fluoride exposure may have adverse effects on children’s intelligence, and changes in children’s intelligence may be associated with the interaction between fluoride and MTHFD1 polymorphisms.

简介：AbstractBackground:Osteoarthritis (ΟΑ) is characterized by cartilage breakdown and subchondral sclerosis. Micro-fractures of the calcified tissues have been, also, detected, but their exact role has not been elucidated yet. This study was to examine the frequency of cracks during OA progression and to correlate them with the underlying cellular modifications and matrix metalloproteinase-2 (MMP-2) expression using histological/immunohistological methods.Methods:Overall, 20 patients and 3 controls (9 specimens per patient), aged 60-89 years, diagnosed with hip/knee OA were included. The development of cracks was examined in 138 sections, whereas the expression of MMP-2 was examined in 69 additional sections.Results:Based on Mankin score, three groups of OA severity were analyzed: Group I (mild) was constituted of sections with score 1-5 while Groups II (moderate) and III (severe) with score 6-7 and greater or equal to 8, respectively. Demographic characteristics did not reveal any association between the number of microdefects and age or body mass index (BMI). Cartilage micro-cracks were increased during moderate and severe OA, while bone cracks were increased during mild and severe OA. In knee OA, cartilage cracks were not correlated with Mankin score, whereas in hip OA they appeared association with severity score. Bone cracks were positively correlated with matrix apoptotic osteocytes and osteoblastic cells, but not with osteoclasts. MMP-2 immunostaining was increasing by OA severity in the osteochondral unit. Similarly, MMP-2 was expressed on the microcracks’ wall mainly in Group III.Conclusion:Our data displayed that bone cracks during primary OA stages, represent an early adaptative mechanism aiming to maintain cartilage integrity. Accumulation of bone defects and concomitant increase of apoptotic osteocytes activated an abnormal remodeling due to osteoblastic activity, in which MMP-2 played a pivotal role, leading to subchondral sclerosis promoting further osteochondral deformities.

简介：摘要：防止学生在初中音乐的学习过程中，因只学习现代音乐、忽略了古典音乐而出现偏离的现象，这样就无法达到高效学习、实践的目的。教师可以运用多种手段为学生实现将传统音乐和现代音乐结合的教学模式，还可以将传统音乐中的一些乐器引入现代音乐的教学环节中，从而帮助学生建立对传统音乐的认知观念，保障学生在学习音乐时不会排斥传统音乐。

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简介：AbstractBackground:China and the United States (US) ranked first and third in terms of new liver cancer cases and deaths globally in 2020. Therefore, a comprehensive assessment of trends in the incidence of primary liver cancer with four major etiological factors between China and the US during the past 30 years with age-period-cohort (APC) analyses is warranted.Methods:Data were obtained from the Global Burden of Disease 2019, and period/cohort relative risks were estimated by APC modeling from 1990 to 2019.Results:In 2019, there were 211,000 new liver cancer cases in China and 28,000 in the US, accounting for 39.4% and 5.2% of global liver cancer cases, respectively. For China, the age-standardized incidence rate (ASIR) consecutively decreased before 2005 but increased slightly since then, whereas the ASIR continuously increased in the US. Among the four etiological factors of liver cancer, the fastest reduction in incidence was observed in hepatitis B virus-related liver cancer among Chinese women, and the fastest increase was in nonalcoholic steatosis hepatitis (NASH)-related liver cancer among American men. The greatest reduction in the incidence of liver cancer was observed at the age of 53 years in Chinese men (-5.2%/year) and 33 years in Chinese women (-6.6%/year), while it peaked at 58 years old in both American men and women (4.5%/year vs. 2.8%/year). Furthermore, the period risks of alcohol- and NASH-related liver cancer among Chinese men have been elevated since 2013. Simultaneously, leveled-off period risks were observed in hepatitis C viral-related liver cancer in both American men and women.Conclusions:Currently, both viral and lifestyle factors have been and will continue to play an important role in the time trends of liver cancer in both countries. More tailored and efficient preventive strategies should be designed to target both viral and lifestyle factors to prevent and control liver cancer.

简介：摘要：音乐游戏对小学生的吸引力与影响力是非常大的，教师在小学音乐教学中合理地运用音乐游戏，可以获得学生的关注，并使学生在轻松愉悦的教学氛围中学习乐理知识、练习音乐技能、提升乐感与发展音乐核心素养。基于此，本文从游戏教学法的相关理念出发，结合具体教学实践案例，对音乐游戏在小学音乐教学中的具体应用策略展开探讨，希望能够为新课改背景下小学音乐教学的创新优化提供一定参考。

简介：摘要：随着素质教育理念的不断深入，更多的小学音乐教师开始重视起对本课程教学质量和体系的多方位改革，尤其注重对学生学习体验感的长效优化，这恰恰给音乐游戏的引入和利用提供了良好的契机。基于这一认识，笔者将不揣冒昧，结合个人工作经验和研究，就“巧用音乐游戏，助力小学音乐教学”一题撰文，试从增强课堂吸引力、优化学生音乐学习成果以及培养学生音乐爱好等角度提出一些看法，希望能够对各位的工作改良带来帮助。

简介：[摘要]小学音乐课程是通过让学生欣赏音乐作品、感受音乐律动和节奏来感知音乐的美和提升自己的音乐水平。为了提升音乐教学质量，我们需要根据小学生的年龄特点和学习能力制定教学方案。音乐游戏作为一种新兴的教学方法，通过制定符合学生需求的音乐游戏让学生能够融入到音乐学习中。本篇文章就是从音乐游戏对于音乐教学的重要性出发;分析音乐游戏开展音乐教学存在的难题;探讨运用音乐游戏开展音乐教学的具体策略。

简介：摘要：在中职教学改革中，游戏教学开始得到普及，给学生带来富有趣味的教学活动，并获得良好的内心感受。音乐教师需要发挥出音乐游戏的价值，让学生通过音乐游戏去感受音乐、理解音乐、认知音乐，把中职音乐课堂变得充满活力，发挥出教学创新的能力，促使学生在音乐中感受到快乐，沉浸在音乐游戏的良好氛围中，有效增强中职音乐教学质量。

简介：摘要：在新课标和新课改的背景下，小学音乐课堂中的音乐游戏是非常关键的教学手段之一，也能够间接影响到不同年级小学生的乐感和节奏音准，还会对小学生课余兴趣爱好的培养产生深远的影响。借助于音乐游戏，寓教于乐的课堂教学形式更受到低年级小学生的欢迎，其课堂氛围也比较和谐。本文将着重探析如何运用音乐游戏助力小学音乐教学。

简介：摘要：在当前的小学音乐教学中，提高小学音乐教师的音乐素养非常重要。具有较高音乐素养的教师在教学过程中倾向于表现出较强的专业技能和个人风格，并且会以相对抽象和难以理解的音乐与孩子进行更简单的交流，以提高课堂教学的效率。

简介：摘要：音乐是情绪的音符，音乐课在人们心中更是艺术的大门，它带领着人们走入艺术的殿堂，领略音乐的美丽。在经济社会不断发展的现在，人们对于艺术越来越重视，心灵的享受越来越得到大众的关注，与之而来的是社会对于艺术课程的关注。音乐课作为艺术课程中一门非常重要的课程，无论是小学、初中，还是高中阶段，都是作为一门学校培养学生艺术思维关键的学科。新课程概念标准下，要求音乐授课教师更加重视这门学科，不再让它为语文数学等基础学科让步，并且丰富音乐课的上课形式，强化学生感悟音乐的体验，着力于核心素养培养，培养学生音乐思维。

简介：摘要：学生在课堂上对音乐的兴趣可以提高。为了培养小学生的音乐能力，小学音乐课也可以采用动画音乐教学的方法，作为辅助课，实现小学生融入音乐课，通过音乐表达情感，充分理解和提高学生欣赏音乐的能力。本文根据作者的实际工作经验，简要分析了动画音乐在小学音乐课中的应用，希望能对相关从业者有所帮助。

简介：摘要 小学音乐教育是一门对于小学生来说非常重要的课程，不仅提高孩子对艺术的追求，而且对于孩子的气质也有很大的提升，有利于孩子从小就接受艺术的熏陶，在小学的音乐教育中融入音乐游戏可以激发孩子对于音乐的喜爱，并且更深入的感受音乐。我们所参与的音乐游戏不是一种简单的游戏，而是要进行一些与音乐特征有关的游戏，把音乐作为游戏的核心。在进行小学音乐的教学过程中，我们通常会使用音乐游戏这种教学方法以此来达到教学的目的。

简介：摘要：教师在带领小学生进行音乐教学时，可以先根据学生的生活认知设计音乐律动游戏，以此帮助学生感知生活中的音乐，并激发学生的音乐感知能力。由此可以为提高学生学习效率打下基础。接着，教师可以根据学生的兴趣与教学内容开展趣味的音乐游戏，以此帮助学生感受学习音乐知识和参与音乐教学的趣味性，从而提升学生参与小学音乐教学的兴趣。然后，教师可以结合教学的乐理知识设计音乐游戏，以使学生在愉悦的音乐游戏中掌握乐理知识，这样就可以提高学生学习乐理知识的自信心。之后，教师可以根据实际的教学情况与学生的需求创新音乐游戏，这样就能保持教学的新鲜感，并使学生保持参与教学的兴趣。当然，教师也可以根据音乐核心素养创新音乐游戏，这样就能为培养学生音乐综合素养提供帮助。最后，教师可以将德育教育内容添加进音乐游戏中，这样就能培养学生综合素质，并促进学生全面发展。

简介：摘要：随着教育大纲不断改革，音乐教学模式不断创新，音乐游戏教学融入小学音乐教学具有重大实践意义。不仅激活了小学生学习音乐的兴趣，提高学习效率和教学质量，而且夯实小学生德智体美全面发展的基础。本文根据针对小学生特性和教材教学目标，探究小学音乐游戏教学的意义和当前存在的问题，提出实施策略，对当前音乐教学具有积极意义。

简介：摘要:在小学时期,学生最大的特点是爱玩、好玩,同时具有十分旺盛的好奇心，老师指引学生对音乐的关注,并不能单纯为了引导学生唱歌，因此指导学生享受音乐,并重新认识音乐,基于培育学生的情感能力，以及对音乐的鉴赏能力，本文将针对音乐游戏在小学音乐课程中的运用进行探讨，以此培养学生的情感意识以及对音乐的鉴赏能力。