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Storylines of family medicine Ⅴ:ways of thinking—honing the therapeutic self

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Family Medicine and Community Health 2024年第S03期12卷 43-51页

作者： William B Ventres Leslie A Stone Johanna F Shapiro Cynthia Haq Jéssica R B Leao Donald e Nease Jr Liz Grant Stewart W Mercer John C M Gillies Pablo González Blasco Maria Auxiliadora C De Benedetto Graziela Moreto Marcelo R Levites Jennifer e DeVoe William R Phillips jane M Uygur Thomas R egnew Colette S Stanley Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family Medicine University of California Irvine School of MedicineIrvineCaliforniaUSA Faculty of Medicine University of Sao PauloSao PauloBrazil Family Medicine University of Colorado Anschutz Medical Campus School of MedicineAuroraColoradoUSA Usher Institute Edinburgh Medical SchoolUniversity of EdinburghEdinburghUK SOBRAMFA-Medical education and Humanism Sao PauloBrazil Family Medicine Oregon Health&Science University School of MedicinePortlandOregonUSA Family Medicine University of Washington School of MedicineSeattleWashingtonUSA General Practice Royal College of Surgeons in IrelandDublinIreland General Internal Medicine Geriatrics&Palliative MedicineTulane University School of MedicineNew OrleansLouisianaUSA

Storylines of Family Medicine is a 12-part series of thematically linked 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 ***‘Ⅴ:ways of thinking—honing the therapeutic self’,authors present the following sections:‘Reflective practice in action’,‘The doctor as drug—Balint groups’,‘Cultivating compassion’,‘Towards a humanistic approach to doctoring’,‘Intimacy in family medicine’,‘The many faces of suffering’,‘Transcending suffering’and‘The power of listening to stories.’May readers feel a deeper sense of their own therapeutic agency by reflecting on these essays.

关键词： illustration dimensions suffering

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艾玛

内分泌干扰物与石油、天然气开采--潜在的环境污染与评估复杂环境混合物的建议(待续)

2013年

作者： (英)简·奥斯汀(jane Austen)

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环境与职业医学 2016年第6期33卷 627-631页

作者： Christopher D.Kassotis Donald e.Tillitt Chung-Ho Lin jane A.Mcelroy Susan C.Nagel 袁亚群(翻译) 金泰廙(审校) Nicholas School of the environment Duke UniversityDurhamNorth CarolinaUSA U.S.Geological Survey Columbia Environmental Research CenterColumbiaMissouriUSA Department of Forestry School of Natural ResourcesUniversity of MissouriColumbiaMissouriUSA Department of Family and Community Medicine School of MedicineUniversity of MissouriColumbiaMissouriUSA Department of Obstetrics Gynecology and Women's HealthSchool of MedicineUniversity of MissouriColumbiaMissouriUSA 不详

[背景]65年前发展起来的水力压裂技术,近期与水平钻井技术结合,开采了以前认为不可获得的石油及天然气储备。虽然这些技术大大提高了国内石油和天然气产量,但该过程使用了近1 000种化学物质,包括许多已知的或可疑的内分泌干扰物,这也引... 详细信息

[背景]65年前发展起来的水力压裂技术,近期与水平钻井技术结合,开采了以前认为不可获得的石油及天然气储备。虽然这些技术大大提高了国内石油和天然气产量,但该过程使用了近1 000种化学物质,包括许多已知的或可疑的内分泌干扰物,这也引发了对当地供水潜在污染的担忧。[目的]针对所使用化学品的激素和抗激素活性,讨论对钻井密集区域进行健康评估时增加内分泌评估的必要性。[方法]我们讨论了以下相关文献:a.石油及天然气开采所致地表及地下水污染;b.潜在人类暴露,尤其对地表和地下水中存在自然和人为来源的总激素和抗激素活性的情况;我们也讨论了初步分析结果和关键知识空白。[讨论]由于石油和天然气化学物的潜在环境释放会干扰内分泌受体系统,我们推荐了针对具有激素活性的复杂环境混合物的评估方法。[结论]我们描述了一个以内分泌为主的全面健康评估理念,并为这一理念提供了支持信息:应用这一组分将有助于解释报道的不良健康趋势,也有助于为环境影响评估及监测项目提供建议。

关键词：天然气开采内分泌干扰物抗激素水平钻井地下水污染水力压裂技术环境释放化学物质天然气化学环境影响评估

Development of photoreactive demineralized bone matrix 3D printing colloidal inks for bone tissue engineering

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Regenerative Biomaterials 2023年第1期10卷 1604-1617页

作者： Katie J.Hogan Hayriye Oztatlı Marissa R.Perez Sophia Si Reyhan Umurhan elysa Jui Ziwen Wang emily Y.Jiang Sa R.Han Mani Diba K.jane Grande-Allen Bora Garipcan Antonios G.Mikos Department of Bioengineering Rice UniversityMS-1426500 Main StreetHoustonTX 77030USA Baylor College of Medicine Medical Scientist Training Program HoustonTX 77030USA Institute of Biomedical engineering Bo�gazic¸i University_Istanbul34684Turkey

Demineralized bone matrix(DBM)has been widely used clinically for dental,craniofacial and skeletal bone repair,as an osteoinductive and osteoconductive material.3D printing(3DP)enables the creation of bone tissue engineering scaffolds with complex geometries and *** methacryloylated gelatin nanoparticles(GNP-MAs)3DP inks have been developed,which display gel-like behavior for high print fidelity and are capable of post-printing photocrosslinking for control of scaffold swelling and ***,novel DBM nanoparticles(DBM-NPs,∼400 nm)were fabricated and characterized prior to incorporation in 3DP *** objectives of this study were to determine how these DBM-NPs would influence the printability of composite colloidal 3DP inks,assess the impact of ultraviolet(UV)crosslinking on 3DP scaffold swelling and degradation and evaluate the osteogenic potential of DBM-NP-containing composite colloidal *** addition of methacryloylated DBM-NPs(DBM-NP-MAs)to composite colloidal inks(100:0,95:5 and 75:25 GNP-MA:DBM-NP-MA)did not significantly impact the rheological properties associated with printability,such as viscosity and shear recovery or *** crosslinking with a UV dosage of 3 J/cm2 directly impacted the rate of 3DP scaffold swelling for all GNP-MA:DBM-NP-MA ratios with an∼40%greater increase in scaffold area and pore area in uncrosslinked versus photocrosslinked scaffolds over 21 days in phosphate-buffered saline(PBS).Likewise,degradation(hydrolytic and enzymatic)over 21 days for all DBM-NP-MA content groups was significantly decreased,∼45%less in PBS and collagenase-containing PBS,in UV-crosslinked versus uncrosslinked *** incorporation of DBM-NP-MAs into scaffolds decreased mass loss compared to GNP-MA-only scaffolds during collagenase *** in vitro osteogenic study with bone marrow-derived mesenchymal stem cells demonstrated osteoconductive properties of 3DP scaffolds for the DBM-NP-MA contents examine

关键词： demineralized bone matrix colloidal hydrogels 3D printing bone tissue engineering

Strategic options for syphilis control in Papua New Guineae impact and cost-effectiveness projections using the syphilis interventions towards elimination (SITe) model

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Infectious Disease Modelling 2021年第1期6卷 584-597页

作者： Shepherd Machekera Peniel Boas Poruan Temu Zimmbodilion Mosende Namarola Lote Angela Kelly-Hanku S.Guy Mahiane Robert Glaubius jane Rowley Anup Gurung eline Korenromp Government of Papua New Guinea National Department of HealthAOPI CenterWaigani DrivePO Box5896Port MoresbyPapua New Guinea World Vision International Ruta PlaceMorata StGordons.P.O Box 4254BorokoNational Capital DistrictPort MoresbyPapua New Guinea UNAIDS Papua New Guinea Country Office Port MoresbyPapua New Guinea WHO Papua New Guinea Country Office Communicable Disease&Health Emergency Dept.AOPI CentreWaigani DrivePort MoresbyPapua New Guinea Papua New Guinea Institute of Medical Research 441 Homate StreetPO Box 60GorokaEastern Highland ProvincePapua New Guinea Kirby Institute UNSW SydneyWallace Wurth BuildingHigh StreetUNSW Australia KensingtonNSW 2052SydneyAustralia Avenir Health ModellingPlanning and Policy Analysis Dept.655 Winding Brook DriveGlastonburyCT06033USA Independent Consultant 135 Gloucester TerraceW26DXLondonUK Avenir Health ModellingPlanning and Policy Analysis Dept.150 Route de FerneyPO box 2100CH-1211 Geneva 2Switzerland

Objectives:Papua New Guinea(PNG)has among the highest rates of sexually transmitted infections(STIs)globally and is committed to reducing their *** Syphilis Interventions Towards elimination(SITe)model was used to explore the expected impact and cost of alternative syphilis intervention scale-up ***:SITe is a dynamical model of syphilis transmission among adults 15-49 *** are divided into nine groups based on sexual behaviour and into six stages of *** model was calibrated to PNG using data from routine surveillance,biobehavioural surveys,research studies and program *** included syphilis prevalence,risk behaviours,intervention coverage and service delivery unit *** compared different interventions(clinical treatment,contact tracing,syphilis screening,and condom promotion)for incidence and cost per infection averted over ***:Increasing treatment coverage of symptomatic primary/secondary-stage syphilis cases from 25-35%in 2020 to 60%from 2023 onwards reduced estimated incidence over 2021-2030 by 55%,compared to a scenario assuming constant coverage at 2019-2020 *** introduction of contact tracing in 2020,assuming 0.4 contacts per symptomatic person treated,reduced incidence over 2021-2030 by 10%.Increasing screening coverage by 20-30 percentage points from the 2019-2020 level reduced incidence over 2021-2030 by 3e16%depending on the target ***-up clinical,symptom-driven treatment and contact tracing had the lowest cost per infection averted,followed by condom promotion and periodic screening of female sex workers and men who have sex with ***:PNG could considerably reduce its syphilis burden by scaling-up clinical treatment and contact tracing alongside targeted behavioural risk reduction *** is a useful tool countries can apply to inform national STI programming and resource allocation.

关键词： Syphilis Prevention Treatment Cost-effectiveness Resource allocation National program strategy

Are Invasive Genotypes Superior? An experimental Approach Using Native and Invasive Genotypes of the Invasive Grass <i>Phalaris Arundinacea</i>

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Open Journal of ecology 2017年第2期7卷 125-139页

作者： jane Molofsky Alexandra R. Collins eric Imbert Tadas Bitinas Sébastien Lavergne Department of Plant Biology University of Vermont Burlington VT USA Division of Information Technology & Sciences Champlain College Burlington VT USA Institut des Sciences de l’evolution Université de Montpellier Montpellier France Departamento de ecología Universidad de Alicante Alicante Spain Laboratoire d’ecologie Alpine (LeCA) CNRS-Université Grenoble Alpes Grenoble France

The admixture and recombination of individuals from the native range into a new range may lead to the production of invasive genotypes that have higher fitness and wider climatic tolerances than the native genotypes. In this paper, we compare the survival and growth of native eU and invasive NA genotypes when planted back into the native eU range near where the eU genotypes were collected. We test this hypothesis using the invasive wetland grass Phalaris arundinacea. If invasive genotypes have evolved to have higher survival and growth, then they should outperform the native eU genotypes under field conditions that are better suited to the eU genotypes. Individual plants of the wetland grass, Phalaris arundinacea collected from native europe (Czech Republic (CZ) and France (FR)) and North America (Vermont (VT) and North Carolina (NC)) were planted into common gardens in Trebon, Czech Republic (49.0042°N, 14.7721°e) and Moussac, France (43.9808°N, 4.2241°e). Invasive genotypes from North Carolina (NC) survived as well or better than native genotypes in both the Trebon and Moussac garden. Additionally, invasive NC genotypes suffered higher herbivore damage than native genotypes but their growth and survival were not significantly different than genotypes from the other re-gions. A companion field experiment that simulated biomass removal through grazing indicated that invasive NC genotypes recovered faster following grazing than genotypes from other regions. Our results suggest that not all invasive genotypes are superior and regional differences in aggressiveness between invasive genotypes are as great as differences between individuals from native and invasive populations. Introduction of genotypes leading to invasion depends upon the environmental conditions and the suitability of the climate for the introduced individuals.

关键词： Invasive Plants Admixture Invasive Genotypes enemy Release Hypothesis evolution of Increased Competitive Ability Common Garden experiment Phalaris arundinacea

The role of p53 in developmental syndromes

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Journal of Molecular Cell Biology 2019年第3期11卷 200-211页

作者： Margot e.Bowen Laura D.Attardi Division of Radiation and Cancer Biology in the Department of Radiation Oncology Stanford University School of MedicineStanfordCA 94305USA Department of Genetics Stanford University School of MedicineStanfordCA 94305USA

While it is well appreciated that loss of the p53 tumor suppressor protein promotes cancer,growing evidence indicates that increased p53 activity underlies the developmental defects in a wide range of genetic *** inherited or de novo mutations that cause these syndromes affect diverse cellular processes,such as ribosome biogenesis,DNA repair,and centriole duplication,and analysis of human patient samples and mouse models demonstrates that disrupting these cellular processes can activate the p53 ***,many of the developmental defects in mouse models of these syndromes can be rescued by loss of p53,indicating that inappropriate p53 activation directly contributes to their pathogenesis.A role for p53 in driving developmental defects is further supported by the observation that mouse strains with broad p53 hyperactivation,due to mutations affecting p53 pathway components,display a host of tissue-specific developmental defects,including hematopoietic,neuronal,craniofacial,cardiovascular,and pigmentation ***,germline activating mutations in TP53 were recently identified in two human patients exhibiting bone marrow failure and other developmental *** in mice suggest that p53 drives developmental defects by inducing apoptosis,restraining proliferation,or modulating other developmental programs in a cell type-dependent ***,we review the growing body of evidence from mouse models that implicates p53 as a driver of tissue-specific developmental defects in diverse genetic syndromes.

关键词： p53 Mdm2 development embryo congenital defect syndrome genetic disorder