Interdisciplinary fetal-neonatal neurology training applies neural exposome perspectives to neurology principles and practice.
Interdisciplinary fetal-neonatal neurology training applies neural exposome perspectives to neurology principles and practice.
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DOI：
10.3389/fneur.2023.1321674
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发表时间：
2023
影响因子：
3.4
通讯作者：
中科院分区：
文献类型：
--
作者：
一个跨学科的胎儿-新生儿神经学（FNN）项目在前1000天教授神经暴露的观点，适用于整个生命周期。本课程强化新生儿神经危重症护理、儿科和成人神经学培训目标。在妇幼医院中心的教学最好地融合了生殖、妊娠和儿科的医疗保健方法。健康或疾病途径的表型-基因型表达代表了发育过程中动态的神经暴露。应用于FNN训练的不确定性科学强化了共享临床决策的重要性，从而最大限度地减少偏见和认知错误。学员选择指导委员会的参与者，以最大限度地提高他们的学习经验。标准化的问题和口头报告监督着教育的进展。硕士或博士学位答辩准备和竞争性研究经费可以是特定个人的目标。应用于实践的FNN原理提供了对基因-环境相互作用的理解，认识到生殖健康对母体-胎盘-胎儿三位一体、新生儿、儿童和成人的影响。孕前和产前的逆境可能会损害一生的大脑健康。内源性和外源性毒性应激源相互作用（TSI）通过不适应发育的神经可塑性改变神经暴露。发育障碍和癫痫主要表现在头1000天。传染性和非传染性疾病继续与神经暴露体相互作用，在整个生命周期中表达各种神经系统疾病，特别是在青春期和生殖衰老的关键/敏感时期。异常或破坏性的胎儿神经病理病变改变了整个发育-衰老连续体的临床表现。对生殖、妊娠、胎盘、新生儿、儿童和成人暴露效应的综合理解提供了神经暴露的生命历程视角。外泌体研究有望改善从怀孕开始的疾病监测和药物输送。应用于FNN实践的健康和疾病的发展起源原理预测了神经系统诊断的干预措施，可以使后代受益。解决全球南方和高收入国家医疗沙漠的保健差距问题需要利益攸关方之间进行建设性对话，以实现医疗公平。人口健康政策需要一项人才资本战略，通过应用神经网络的原则和实践来减轻全球神经系统疾病的负担。这种综合神经系统护理方法将延长生存与改善生活质量的人在整个生命周期面临的神经系统疾病。
An interdisciplinary fetal-neonatal neurology (FNN) program over the first 1,000 days teaches perspectives of the neural exposome that are applicable across the life span. This curriculum strengthens neonatal neurocritical care, pediatric, and adult neurology training objectives. Teaching at maternal-pediatric hospital centers optimally merges reproductive, pregnancy, and pediatric approaches to healthcare. Phenotype–genotype expressions of health or disease pathways represent a dynamic neural exposome over developmental time. The science of uncertainty applied to FNN training re-enforces the importance of shared clinical decisions that minimize bias and reduce cognitive errors. Trainees select mentoring committee participants that will maximize their learning experiences. Standardized questions and oral presentations monitor educational progress. Master or doctoral defense preparation and competitive research funding can be goals for specific individuals. FNN principles applied to practice offer an understanding of gene–environment interactions that recognizes the effects of reproductive health on the maternal-placental-fetal triad, neonate, child, and adult. Pre-conception and prenatal adversities potentially diminish life-course brain health. Endogenous and exogenous toxic stressor interplay (TSI) alters the neural exposome through maladaptive developmental neuroplasticity. Developmental disorders and epilepsy are primarily expressed during the first 1,000 days. Communicable and noncommunicable illnesses continue to interact with the neural exposome to express diverse neurologic disorders across the lifespan, particularly during the critical/sensitive time periods of adolescence and reproductive senescence. Anomalous or destructive fetal neuropathologic lesions change clinical expressions across this developmental-aging continuum. An integrated understanding of reproductive, pregnancy, placental, neonatal, childhood, and adult exposome effects offers a life-course perspective of the neural exposome. Exosome research promises improved disease monitoring and drug delivery starting during pregnancy. Developmental origins of health and disease principles applied to FNN practice anticipate neurologic diagnoses with interventions that can benefit successive generations. Addressing health care disparities in the Global South and high-income country medical deserts require constructive dialogue among stakeholders to achieve medical equity. Population health policies require a brain capital strategy that reduces the global burden of neurologic diseases by applying FNN principles and practice. This integrative neurologic care approach will prolong survival with an improved quality of life for persons across the lifespan confronted with neurological disorders.
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影响因子：
5.2
作者：
Abdelzaher, Hana;Tawfik, Sherouk M.;Nour, Ahmed;Abdelkader, Sarah;Elbalkiny, Shaimaa Tarek;Abdelkader, Mohamed;Abbas, Walaa A.;Abdelnaser, Anwar
通讯作者：
Abdelnaser, Anwar
影响因子：
11.8
作者：
Chao, Alex;Grossman, Jarod;Carberry, Celeste;Lai, Yunjia;Williams, Antony J.;Minucci, Jeffrey M.;Purucker, S. Thomas;Szilagyi, John;Lu, Kun;Boggess, Kim;Fry, Rebecca C.;Sobus, Jon R.;Rager, Julia E.
通讯作者：
Rager, Julia E.
DOI：
10.1186/s40748-021-00136-4
发表时间：
2022-01-17
期刊：
Maternal health, neonatology and perinatology
影响因子：
--
作者：
Barañano K;Burd I
通讯作者：
Burd I
影响因子：
3
作者：
Best S;Wou K;Vora N;Van der Veyver IB;Wapner R;Chitty LS
通讯作者：
Chitty LS
影响因子：
9.8
作者：
Brosens, Ivo;Puttemans, Patrick;Benagiano, Giuseppe
通讯作者：
Benagiano, Giuseppe