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Storylines of family medicine Ⅳ:perspectives on practice—lenses of appreciation

Family Medicine and Community Health 2024年第S3期12卷 33-42页

作者： William B Ventres Leslie A Stone Radeeb Akhtar Jeffrey M Ring Lucy M Candib Erick Messias Ronald M Epstein Marc Tunzi Amy L Lee christopher P Morley Carina M Brown David Slawson Jill Konkin David G Campbell Ian Couper Susan Williams Robert Brooks Lucie Walters Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family Medicine and Community Health Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA Independent Health Psychologist Los AngelesCaliforniaUSA Family Medicine and Community Health UMass Chan Medical SchoolWorcesterMassachusettsUSA Psychiatry and Behavioral Neurosciences Saint Louis University School of MedicineSaint LouisMissouriUSA Family Medicine University of Rochester Medical CenterRochesterNew YorkUSA Family Medicine Residency Program Natividad Medical CenterSalinasCaliforniaUSA Family Medicine Tufts University School of MedicineBostonMassachusettsUSA Public Health and Preventive Medicine SUNY Upstate Medical UniversitySyracuseNew YorkUSA Cone Health Family Medicine Residency The University of North Carolina School of MedicineGreensboroNorth CarolinaUSA Family Medicine Atrium HealthCharlotteNorth CarolinaUSA Family Medicine University of Alberta Faculty of Medicine&DentistryEdmontonAlbertaCanada Cunninghame Arm Medical Centre Australian College of Rural and Remote MedicineLakes EntranceQueenslandAustralia Ukwanda Centre for Rural Health Stellenbosch University Faculty of Medicine and Health SciencesCape TownWestern CapeSouth Africa Adelaide Rural Clinical School The University of AdelaideAdelaideSouth AustraliaAustralia Department of Rural Health Broken Hill UniversityBroken HillNew South WalesAustralia Adelaide Rural Clinical School The University of Adelaide Faculty of Health and Medical SciencesMount GambierSouth AustraliaAustralia

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅳ:perspectives on practice—lenses of appreciation’,authors address the following themes:‘Relational connections in the doctor–patient partnership’,‘Feminism and family medicine’,‘Positive family medicine’,‘Mindful practice’,‘The new,old ethics of family medicine’,‘Public health,prevention and populations’,‘Information mastery in family medicine’and‘Clinical courage.’May readers nurture their curiosity through these essays.

关键词： thematic illustration doctor

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Nature:研究利用单细胞分析阐明癌症干细胞在脑癌中的关键角色

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现代生物医学进展 2017年第6期17卷 I0003-I0003页

作者： Itay Tirosh, Andrew S. Venteicher, Christine Hebert, Leah E. Escalante, Keren Yizhak, Jonathan M. Fisher, christopher Rodman, Mariella G. Filbin, Cyril Neftel, Jackson Nyman, Benjamin Izar, Joshua M. Francis, Kenneth J. Livak, Dave Gennert, Rahul Satija, Todd R. Golub, Miguel N. Rivera, Gad Getz, Orit Rozenblatt-Rosen, Bradley E. Bernstein, Aviv Regev Mario L. Suv agrave Andrew S. Venteicher, Christine Hebert, Leah E. Escalante, Keren Yizhak, Mariella G. Filbin, Cyril Neftel, Niyati Desai, Christina C. Luo, Aanand A. Patel, Maristela L. Onozato, Nicolo Riggi, Ravindra Mylvaganam, A. John Iafrate, Matthew P. Frosch, Miguel N. Rivera, Gad Getz, Bradley E. Bernstein, David N. Louis Mario L. Suv agrave Andrew S. Venteicher, Anoop P. Patel, Brian V. Nahed, William T. Curry, Robert L. Martuza Daniel P. Cahill christopher mount Michelle Monje Mariella G. Filbin Todd R. Golub Joshua M. Francis Todd R. Golub Aviv Regev Broad Institute of Harvard and MIT Cambridge Massachusetts 02142 USA Department of Pathology and Center for Cancer Research Massachusetts General Hospital and Harvard Medical School Boston Massachusetts 02114 USA Department of Neurosurgery Massachusetts General Hospital and Harvard Medical School Boston Massachusetts 02114 USA Departments of Neurology Neurosurgery Pediatrics and Pathology Stanford University School of Medicine Stanford California 94305 USA Department of Pediatric Oncology Dana-Farber Cancer Institute and Children’s Hospital Cancer Center Boston Massachusetts 02215 USA Department of Medical Oncology Dana-Farber Cancer Institute Boston Massachusetts 02215 USA Howard Hughes Medical Institute Koch Institute Department of Biology MIT Cambridge Massachusetts 02139 USA

近日。来自麻省总医院、博德研究所及哈佛大学的研究人员通过联合研究，在单细胞水平上对脑瘤基因组进行了分析。他们发现。癌症干细胞或许能够诱发少突神经胶质瘤的发生，少突神经胶质瘤是一种缓慢发展但却非常难以治愈的脑癌，相关研... 详细信息

近日。来自麻省总医院、博德研究所及哈佛大学的研究人员通过联合研究，在单细胞水平上对脑瘤基因组进行了分析。他们发现。癌症干细胞或许能够诱发少突神经胶质瘤的发生，少突神经胶质瘤是一种缓慢发展但却非常难以治愈的脑癌，相关研究刊登于Nature杂志上。同时研究者还首次在人类脑瘤样本中鉴别出了癌症干细胞及其分化的后代细胞。

关键词：干细胞单细胞分析癌症脑瘤神经胶质瘤键角利用研究人员

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SARS-CoV-2:the many pros of targeting PLpro

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Signal Transduction and Targeted Therapy 2020年第1期5卷 633-634页

作者： christopher B.McClain Nicolas Vabret Department of Medicine Hematology and Medical OncologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA Precision Immunology Institute Icahn School of Medicine at Mount SinaiNew YorkNYUSA

A new study1 published in Nature compares the mechanisms used by SARS-CoV-1 and SARS-CoV-2 papain-like protease(PLpro)to promote innate immune *** findings identify SARS-CoV-2 PLpro as an attractive drug target for tr... 详细信息

关键词： attractive finding Nature

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Non-invasive diagnosis of advanced fibrosis and cirrhosis

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World Journal of Gastroenterology 2014年第45期20卷 16820-16830页

作者： Suraj Sharma Korosh Khalili Geoffrey christopher Nguyen Toronto Centre for Liver Disease Toronto Western Hospital Department of Medical Imaging University Health Network Joseph and Wolf Lebovic Health Complex Mount Sinai Hospital

Liver cirrhosis is a common and growing public health problem *** diagnosis of cirrhosis portends an increased risk of morbidity and *** biopsy is considered the gold standard for diagnosis of cirrhosis and staging of ***,despite its universal use,liver biopsy is an invasive and inaccurate gold standard with numerous *** order to overcome the limitations of liver biopsy,a number of non-invasive techniques have been investigated for the assessment of *** review will focus on currently available non-invasive markers of *** evidence behind the use of these markers will be highlighted,along with an assessment of diagnostic accuracy and performance characteristics of each ***-invasive markers of cirrhosis can be radiologic or *** techniques based on ultrasound,magnetic resonance imaging and elastography have been used to assess liver ***-based biomarkers of cirrhosis have also been *** are broadly classified into indirect and direct *** biomarkers reflect liver function,which may decline with the onset of *** biomarkers,reflect extracellular matrix turnover,and include molecules involved in hepatic *** the whole,radiologic and serum markers of fibrosis correlate well with biopsy scores,especially when excluding cirrhosis or excluding *** feature is certainly clinically useful,and avoids liver biopsy in many cases.

关键词： Cirrhosis Biomarker Non-invasive Fibrosis Viral Non-alcoholic fatty liver disease Primary biliary cirrhosis Autoimmune hepatitis Hepatitis B virus Hepatitis C virus

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Comparing children＇s Homo sapiens and chimpanzees＇ Pan troglodytes quantity judgments of sequentially presented sets of items

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Current Zoology 2011年第4期57卷 419-420,421-428页

作者： Michael J. BERAN Julie S. JOHNSON-PYNN christopher READY Language Research Center Georgia State University Atlanta GA 30302 USA Department of Psychology Berry College Mount Berry GA 30149 USA

We presented a quantity judgment task that involved comparing two sequentially presented sets of items to preschoolers and chimpanzees using nearly identical procedures that excluded verbal instructions to children. Trial difficulty in this task reflected the ratio difference between sets of discrete items where larger ratios （e.g., 0.80 as from comparing 4 to 5） were more difficult than smaller ones （e.g., 0.50 as from comparing 4 to 8）. Children also completed verbal-based tasks probing the relationskip between counting proficiency and performance on the quantity judgment task of sequentially presented identical sized items. Both species＇ performance was best when ratios between comparison sets were small regardless of set size in all types of tasks. Generally, chimpanzees and older children performed better than younger children except at larger ratios. Children＇s counting proficiency was not related to success in choosing the larger of two quantities of identical-sized items. These results indicate that chimpanzees and children share an approximate number sense that is reflected through analog magnitude estimation when comparing quantities [Current Zoology 57 （4）： 419-428, 2011].

关键词： Numerical cognition Quantity judgments Children Chimpanzees Pan troglodytes

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Characterizing functional consequences of DNA copy number alterations in breast and ovarian tumors by spaceMap

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Journal of Genetics and Genomics 2018年第7期45卷 361-371页

作者： christopher J.Conley Umut Ozbek Pei Wang Jie Peng Department of Statistics University of California Davis Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai Department of Genetics and Genomic Sciences Icahn School of Medicine at Mount Sinai

We propose a novel conditional graphical model -- spaceMap -- to construct gene regulatory networks from multiple types of high dimensional omic profiles. A motivating application is to characterize the perturbation of DNA copy number alterations （CNAs） on downstream protein levels in tumors. Through a penalized multivariate regression framework, spaceMap jointly models high dimensional protein levels as responses and high dimensional CNAs as predictors. In this setup, spaceMap infers an undirected network among proteins together with a directed network encoding how CNAs perturb the protein network, spaceMap can be applied to learn other types of regulatory relationships from high dimensional molecular profiles, especially those exhibiting hub structures. Simulation studies show spaceMap has greater power in detecting regulatory relationships over competing methods. Additionally, spaceMap includes a network analysis toolkit for biological interpretation of inferred networks. We applies spaceMap to the CNAs, gene expression and proteomics data sets from CPTAC-TCGA breast （n = 77） and ovarian （n = 174） cancer studies. Each cancer exhibits disruption of＇ion transmembrane transport＇ and ＇regulation from RNA polymerase lI promoter＇ by CNA events unique to each cancer. Moreover, using protein levels as a response yields a more functionally-enriched network than using RNA expressions in both cancer types. The network results also help to pinpoint crucial cancer genes and provide insights on the functional consequences of important CNA in breast and ovarian cancers.

关键词： Integrative genomics Proteogenomics Conditional graphical models Network analysis

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Liver Fibrosis Helps to Distinguish Autoimmune Hepatitis from DILI with Autoimmune Features: A Review of Twenty Cases

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Journal of Clinical and Translational Hepatology 2019年第1期7卷 21-26页

作者： christopher A.Febres-Aldana Sarah Alghamdi Kritika Krishnamurthy Robert J.Poppiti Department of Pathology and Laboratory Medicine Mount Sinai Medical CenterMiami BeachFLUSA Herbert Wertheim College of Medicine Florida International UniversityMiamiFLUSA

Background and Aims:Drug-induced liver injury with autoimmune features(AI-DILI)mimics the clinical presentation,and laboratory and pathologic features of idiopathic autoimmune hepatitis(AIH).We aimed to identify histopathologic hallmarks to differentiate these ***:All liver biopsies archived for the past 10 years were reviewed retrospectively to identify cases of recently detected liver injury associated with predominantly lymphoplasmacytic interphase hepatitis,positive markers for liver autoimmunity,and negative tests for viral *** cases were divided into AIH(n=12)or AI-DILI(n=8)*** qualitative evaluation of necroinflammatory changes and liver fibrosis were performed according to the Scheuer scoring *** densities were determined using ImageJ(V1.51t,National Institutes of Health,Bethesda,MD,USA).Fibrosis was assessed on Masson trichrome-stained slides,and collagen deposition was estimated following a protocol of color ***:Necroinflammatory changes as well as densities(portal and lobular)of neutrophils and eosinophils,intracellular cholestasis,and regenerative changes did not differ between the two groups(P≥0.05).Neutrophil densities but not eosinophils showed a positive correlation with the severity of hepatocellular damage(r=0.6and 0.58,*** aminotransferase,P<0.05).Ceroidladen macrophages but not histiocytic aggregates appeared to be more common in AI-DILI(P<0.05).AIH patients presented more often with evidence of chronic damage,including higher scores of fibrosis and collagen deposition,in comparison to AI-DILI(P<0.05).Conclusions:Although there is no histologic feature pathognomonic for AI-DILI or AIH,advanced stages of liver fibrosis can be used to support the diagnosis of AIH in some *** diagnosis of AI-DILI requires follow-up and demonstration of complete remission after drug withdrawal with no need for immunosuppression.

关键词： DILI Autoimmune hepatitis Liver fibrosis Digital pathology

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Metabolic and performance responses of male runners wearing 3 types of footwear: Nike Vaporfly 4%, Saucony Endorphin racing flats, and their own shoes

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Journal of Sport and Health Science 2022年第3期11卷 275-284页

作者： Kim Hébert-Losier Steven J.Finlayson Matthew W.Driller Blaise Dubois Jean-François Esculier christopher Martyn Beaven Division of Health EngineeringComputing and ScienceTe Huataki Waiora School of HealthUniversity of WaikatoMount MaunganuiTauranga 3116New Zealand Sport and Exercise Science School of Allied HealthHuman Services and SportLa Trobe UniversityMelbourneVIC 3086Australia Research&Development the Running ClinicLac-BeauportQC G3B 2J8Canada

Purpose We compared running economy(RE)and 3-km time-trial(TT)variables of runners wearing Nike Vaporfly 4%(VP4),Saucony Endorphin lightweight racing flats(FLAT),and their habitual running(OWN)*** Eighteen male recreational runners(age=33.5±11.9 year(mean±SD),peak oxygen uptake(VO_(2peak))=55.8±4.4 mL/kg·min)attended 4 sessions approximately 7 days *** first session consisted of a VO_(2peak) test to inform subsequent RE speeds set at 60%,70%,and 80%of the speed eliciting *** subsequent sessions,treadmill RE and 3-km TTs were assessed in the 3 footwear conditions in a randomized,counterbalanced crossover *** Oxygen consumption(mL/kg·min)was less in VP4(from 4.3%to 4.4%,p≤0.002)and FLAT(from 2.7%to 3.4%,p≤0.092)*** across intensities,with a non-significant difference between VP4 and FLAT(1.0%-1.7%,p≥0.292).Findings related to energy cost(W/kg)and energetics cost of transport(J/kg·m)were ***43-km TT performance(11:07.6±0:56.6 mm:ss)was enhanced *** by 16.6 s(2.4%,p=0.005)and *** by 13.0 s(1.8%,p=0.032).The 3-km times between OWN and FLAT(0.5%,p=0.747)were *** runners(n=11,61%)ran their fastest TT in *** Overall,VP4 improved laboratory-based RE measures in male recreational runners at relative speeds compared to OWN,but the RE improvements in VP4 were not significant *** runners exhibited better treadmill TT performances in VP4(61%)***(22%)and OWN(17%).The variability in RE(-10.3%to 13.3%)and TT(-4.7%to 9.3%)improvements suggests that responses to different types of shoes are individualized and warrant further investigation.

关键词： Footwear Individual responses Minimalist Physiology Running

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Strategies towards robust interpretations of in situ zircon oxygen isotopes

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Geoscience Frontiers 2023年第2期14卷 241-255页

作者： Janne Liebmann christopher L.Kirkland John B.Cliff christopher J.Spencer Aaron J.Cavosie Timescales of Mineral Systems Group The Institute for Geoscience Research(TIGeR)School of Earth and Planetary SciencesCurtin UniversityPerthAustralia Pacific Northwest National Laboratory RichlandWashington 99354United States Department of Geological Sciences and Geological Engineering Queen’s UniversityKingstonONCanada Space Science and Technology Centre The Institute for Geoscience Research(TIGeR)School of Earth and Planetary ScienceCurtin UniversityPerthAustralia

Oxygen isotopes are a versatile tool to address a wide range of questions in the Earth *** include geothermometry,paleoclimatology,tracing of geochemical reservoirs,fluid-rock interaction,magmatic petrogenesis,and identification of extra-terrestrial *** arguably provides one of the most robust records of primary magmatic O isotope ratio due to low diffusion rates in crystalline *** ability to correlate zircon O isotopes with temporal and petrogenetic information(e.g.U-Pb geochronology,Lu-Hf isotopes,and trace elements)makes this mineral a key archive for understanding Earth’s crustal ***,zircon O isotope geochemistry has found widespread usage to address fundamental questions across the earth and planetary *** general apparent ease of O isotopic acquisition through the advancement of rapid in situ techniques(*** ion mass spectrometry;SIMS)and associated dedicated national laboratories has led to the generation of large O isotopic data sets of variable quality,highlighting the importance of a coherent workflow for data collection,reduction,and *** paper presents a set of approaches for measurement,assessment,and reporting of zircon O isotope *** focus in this contribution is on in situ analysis via secondary ion mass spectrometry using large geometry instruments,but other commonly used techniques are briefly reviewed for *** work aims to provide an analytical framework necessary for geologically meaningful interpretation of O isotope *** addition,we describe inherent geological(***-induced disturbance of the zircon O isotopic system)and analytical(*** due to sample topography effects)challenges and outline means to identify and avoid such issues as a prerequisite to the generation of robust primary O isotopic signatures for geological interpretation.

关键词： In situ Oxygen isotopes Zircon SIMS Secondary ion mass spectrometry Off-mount standard

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Outcomes of combination MRI-targeted and transperineal template biopsy in restaging low-risk prostate cancer for active surveillance

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Asian Journal of Urology 2018年第3期5卷 184-193页

作者： Kenneth Chen Kae Jack Tay Yan Mee Law Hakan Aydin Henry Ho christopher Cheng John Shyi Peng Yuen Department of Urology Singapore General HospitalSingapore Department of Diagnostic Radiology Singapore General HospitalSingapore Department of Pathology Singapore General HospitalSingapore

Objective:Active surveillance(AS)offers a strategy to reduce overtreatment and now is a widely accepted treatment option for low-risk prostate *** ideal tool for risk-stratification would detect aggressive cancers and exclude such men from taking up AS in the first *** evaluate if a combination of transperineal template biopsy with magnetic resonance imaging(MRI)-targeted biopsy identifies significant prostate cancer amongst men initially diagnosed with low-risk prostate ***:This prospective,single-blinded study included men with low-risk prostate cancer(D’Amico’s Criteria)diagnosed on conventional transrectal ultrasound-guided *** first underwent multiparametric MRI of the prostate6 weeks after initial *** suspicious lesion is mapped and assigned a Prostate Imaging Reporting and Data System(PIRADS)*** biopsy is first performed with the surgeon blinded to MRI findings followed by MRI-targeted biopsy using a robotic transperineal biopsy ***:The age of the 19 men included is 65.4±4.9 years(mean±SD).Prostate specific antigen(PSA)at diagnosis and at the time of transperineal biopsy were comparable(7.3±1.7 ng/mL and 7.0±1.8 ng/mL,p Z 0.67),so were prostate volumes(34.2±8.9 mL and 32.1±13.4 mL,p Z 0.28).MRI-targeted biopsy had a higher percentage of cancer detection per core compared to template biopsy(11.7%vs.6.5%,p Z 0.02),this was more than 3 times superior for Gleason 7 disease(5.9%vs.1.6%,pmount histology confirmed tumour location and *** six patients with PIRADS 5 lesions had cancer detected(66.6%significant disease).Conclusion:A combination of MRI-targeted and template biopsy may optimally risk-classi

关键词： Active surveillance Magnetic resonance imaging Targeted biopsy Transperineal prostate biopsy Robotic biopsy Low-risk prostate cancer

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