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storylines of family medicine Ⅺ:professional identity formation—nurturing one’s own story

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Family Medicine and Community Health 2024年第S03期12卷 99-108页

作者： William B Ventres Leslie A stone Hamish J Wilson sumi M sexton david J Doukas Jessica P Cerdena david M Kelley Michael D Fetters Jeffrey J Haney john J Frey III Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA General Practice and Rural Health University of Otago Dunedin School of MedicineDunedinNew Zealand Family Medicine Georgetown University School of MedicineWashingtonDistrict of ColumbiaUSA Family and Community Medicine Tulane University School of MedicineNew OrleansLouisianaUSA Family Medicine Residency Program Middlesex HealthMiddletownConnecticutUSA Family Medicine University of Michigan Medical SchoolAnn ArborMichiganUSA Medical Education and Clinical sciences Washington State UniversitySpokaneWashingtonUSA Family Medicine and Community Health University of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA

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 ***‘Ⅺ:professional identity formation—nurturing one’s own story’,authors address the following themes:‘The social construction of professional identity’,‘On becoming a family physician’,‘What’s on the test?—professionalism for family physicians’,‘The ugly doc-ling’,‘Teachers—the essence of who we are’,‘Family medicine research—it starts in the clinic’,‘socially accountability in medical education’,‘Personal philosophy and how to find it’and‘Teaching and learning with storylines of Family Medicine’.May these essays encourage readers to find their own creative spark in medicine.

关键词： own becoming professional

The risk of prostate cancer on incidental finding of an avid prostate uptake on 2-deoxy-2-[^(18)F]fluoro-D-glucose positron emission tomography/computed tomography for non-prostate cancer-related pathology:A single centre retrospective study

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Asian Journal of Urology 2024年第1期11卷 33-41页

作者： Anthony Franklin Troy Gianduzzo Boon Kua david Wong Louise McEwan James Walters Rachel Esler Matthew J.Roberts Geoff Coughlina john W.Yaxley Department of Urology The Wesley HospitalBrisbaneQLDAustralia Wesley Medical Research BrisbaneQLDAustralia school of Medicine The University of QueenslandBrisbaneQLDAustralia Department of Radiology Wesley Medical ImagingBrisbaneQLDAustralia Department of Urology Royal Brisbane and Women's HospitalBrisbaneQLDAustralia

Objective:To review the risk of prostate cancer(PCa)in men with incidentally reported increased intraprostatic uptake at 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography(18F-FDG PET/CT)ordered at Department of Urology,The Wesley Hospital,Brisbane,QLD,Australia for non-PCa related ***:Retrospective analysis of consecutive men between August 2014 and August 2019 presenting to a single institution for 18F-FDG PET/CT for non-prostate related conditions was *** were classified as benign,indeterminate,or malignant depending of the results of prostate-specific antigen(PsA),PsA velocity,biopsy histopathology,and three-Tesla(3 T)multiparametric MRI(mpMRI)Prostate Imaging Reporting and Data system score,or gallium-68-prostate-specific membrane antigen(68Ga-PsMA)PET/CT ***:Three percent(273/9122)of men demonstrated 18F-FDG avidity within the ***-five percent(231/273)were further investigated,including with PsA tests(227/231,98.3%),3 T mpMRI(68/231,29.4%),68Ga-PsMA PET/CT(33/231,14.3%),and prostate biopsy(57/231,24.7%).Results were considered benign in 130/231(56.3%),indeterminate in 31/231(13.4%),and malignant in 70/231(30.3%).PCa was identified in 51/57(89.5%)of the men who proceeded to biopsy,including 26/27(96.3%)men with Prostate Imaging Reporting and Data system scores 4-5 mpMRI and six men with a positive 68Ga-PsMA PET/*** most common Gleason score on biopsy was greater than or equal to 4+5(14/51,27.5%).68Ga-PsMA PET/CT was concordant with the 18F-FDG findings in 26/33(78.8%).All 13 men with a positive concordant 18F-FDG,3 T mpMRI,and 68Ga-PsMA PET/CT had PCa on *** was no statistically significant difference in the 18F-FDG maximum standardized uptake value between the benign or malignant groups(5.7 vs.6.1;p=0.580).Conclusion:In this study,after an incidental finding of an avid intraprostatic lesion on 18F-FDG PET/CT,70 of the 231 cases(30.3%;0.8%of the entire cohort)had results c

关键词： Prostatecancer Positionemission tomography Multiparametric magneticresonance imaging Prostatebiopsy

Projected Changes in Extreme Event Indices for Alaska

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Atmospheric and Climate sciences 2024年第2期14卷 191-209页

作者： john E. Walsh Kyle Redilla Norman shippee Lukas Cheung david Bigelow Ronni Wilcock International Arctic Research Center University of Alaska Fairbanks Fairbanks USA stantec Ottawa Canada stantec Montreal Canada stantec Calgary Canada Two Bears Environmental Consulting Anchorage USA

As climate has warmed in recent decades, Alaska has experienced a variety of high-impact extreme events that include heat waves, wildfires, coastal storms and freezing rain. Because the warming is projected to continue, it is essential to consider future changes when planning adaptation actions and building resilience. In this study, we synthesize information on future changes in extreme events in Alaska from an ensemble of regional climate model simulations performed as part of Arctic-CORDEX (Coordinated Regional Climate Downscaling Experiment). A set of 13 extreme event indices, based on those developed by the World Climate Research Programme’s Expert Team on Climate Change Detection and Indices (ETCCDI), are evaluated from the Arctic-CORDEX output for Alaska. Of the 13 indices, six pertain to temperature, five to total precipitation, one to wind and one to snow. The results for locations in seven different climate zones of Alaska include large increases (5˚C - 10˚C) in the temperature thresholds for the five hottest and coldest days of the year, and large increases in warm spell duration and decreases in cold spell duration. Changes in the cold day temperature threshold are generally larger than the changes in the hot day temperature threshold, consistent with the projections of a stronger warming in winter than in summer in Alaska yearly maximum 1-day and 5-day precipitation amounts as well as the yearly number of consecutive wet days are projected to increase at all locations. The indices for heavy snow days and high-wind days show mixed changes, although the results indicate increases in heavy snow days at the more northern locations and increases in windy days at coastal locations. The changes in the extreme event indices continue through 2100 under the higher-emission (RCP 8.5) emission scenario, while the changes generally stabilize under the lower-emission (RCP 4.5) scenario. .

关键词： Extreme Events Temperature Precipitation Alaska Climate

storylines of family medicine Ⅸ:people and places—diverse populations and locations of care

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Family Medicine and Community Health 2024年第S3期12卷 79-88页

作者： William B Ventres Leslie A stone Emad R Abou-Arab Julio Meza david s Buck Jerome W Crowder Jennifer Y C Edgoose Alexander Brown Ellen J Plumb Amber K Norris Jay J Allen Lauren E Giammar john E Wood scott M Dickson G Austin Brown Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family Medicine University of Michigan Medical SchoolAnn ArborMichiganUSA Family Medicine University of California Los AngelesDavid Geffen School of MedicineLos AngelesCaliforniaUSA Community Medicine University of HoustonTilman J Fertitta Family College of MedicineHoustonTexasUSA social and Behavioral sciences University of HoustonTilman J Fertitta Family College of MedicineHoustonTexasUSA Family Medicine and Community Health University of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA NH Dartmouth Family Medicine Residency ConcordNew HampshireUSA san Francisco VA Medical Center San FranciscoCaliforniaUSA Duluth Family Medicine Residency Program University of Minnesota Medical School Duluth CampusDuluthMinnesotaUSA UAMs Northeast Regional Campus Family Medicine Residency Program JonesboroArkansasUSA Cascades East Family Medicine Residency Program Oregon Health&Science University School of MedicineKlamath FallsOregonUSA

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 ***‘Ⅸ:people and places—diverse populations and locations of care’,authors address the following themes:‘LGBTQIA+health in family medicine’,‘A family medicine approach to substance use disorders’,‘shameless medicine for people experiencing homelessness’,“Difficult”encounters—finding the person behind the patient’,‘Attending to patients with medically unexplained symptoms’,‘Making house calls and home visits’,‘Family physicians in the procedure room’,‘Robust rural family medicine’and‘Full-spectrum family medicine’.May readers appreciate the breadth of family medicine in these essays.

关键词： illustration family dimensions

A systematic scoping review of study methodology for randomized controlled trials investigating probiotics in athletic and physically active populations

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Journal of sport and Health science 2024年第1期13卷 61-71页

作者： Alex E.Mohr david B.Pyne Geovana silva Fogaça Leite Deborah Akins Jamie Pugh College of Health solutions Arizona State UniversityPhoenixAZ 85004USA Research Institute for sport and Exercise University of CanberraCanberraACT 2617Australia Laboratory of Functional Fermented Food Faculty of Pharmaceutical SciencesUniversity of São PauloSão Paulo 05508-030Brazil Research Institute for sport and Exercise sciences Liverpool John Moores UniversityLiverpool L33AFUK

Background:The purported ergogenic and health effects of probiotics have been a topic of great intrigue among researchers,practitioners,and the lay public *** has also been an increased research focus within the realm of sports science and exercise medicine on the athletic gut ***,compared to other ergogenic aids and dietary supplements,probiotics present unique study *** objectives of this systematic scoping review were to identify and characterize study methodologies of randomized controlled trials investigating supplementation with probiotics in athletes and physically active ***:Four databases(MEDLINE,CINAHL,Cochrane CENTRAL,and Cochrane Database of systematic Reviews)were searched for randomized controlled studies involving healthy athletes or physically active *** intervention with probiotics and inclusion of a control and/or placebo group were *** peer-reviewed articles in English were considered,and there were no date *** were extracted and presented in tabular form to detail study protocols,characteristics,and *** in randomized controlled trials was determined with the RoB 2.0 ***:A total of 45 studies were included in the review,with 35 using a parallel group design and 10 using a cross-over *** half the studies used a single probiotic and the other half a multi-strain *** probiotic dose ranged from 2×10^(8)to 1×10^(11)colony forming units daily,and the length of intervention was between 7 and 150 *** than half the studies directly assessed gastrointestinal symptoms,gut permeability,or the gut *** sex ratio of participants was heavily weighted toward males,and only 3 studies exclusively investigated ***-level adverse events were reported in only 2 studies,although the methodology of reporting varied *** risk of bias was generally low,although details on randomization were lacking in some s

关键词： Exercise Experimental methodology Gastrointestinal symptoms Gut microbiota Probiotic supplementation

Fusobacterium is toxic for head and neck squamous cell carcinoma and its presence may determine a better prognosis

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Cancer Communications 2024年第8期44卷 879-883页

作者： Anjali Chander Jacopo Iacovacci Aize Pellon Radhika Kataria Anita Grigoriadis john Maher Cynthia sears Gilad Bachrach Teresa Guerrero Urbano Mary Lei Imran Petkar Anthony Kong Tony Ng Ester Orlandi Nicola Alessandro Iacovelli Loris De Cecco Mara serena serafini david Moyes Tiziana Rancati Miguel Reis Ferreira Centre for Host-Microbiome Interactions King’s College LondonLondonUK Comprehensive Cancer Centre King’s College LondonLondonUK Department of Oncology Guys and St Thomas NHS Foundation TrustLondonUK Data science Unit Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly Medicine Department Johns Hopkins University School of MedicineBaltimoreMarylandUSA Institute of Biomedical and Oral Research The Hebrew University-Hadassah School of Dental MedicineHadassah Ein Kerem CampusJerusalemIsrael Dipartimento di scienze Clinico-Chirurgiche Diagnostiche e PediatricheUniversitàdegli studi di PaviaPaviaItaly Radiation Oncology Department Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly Department of Medicine Weill Cornell MedicineNew YorkUSA

Head and neck squamous cell carcinoma(HNsCC)is a devastating *** morbid treatment,5-year survival rates remain poor(28%-67%)[1].There is a significant knowledge gap regarding how the microbiota may impact HNsCC treatment efficacy[2].We used microbiome data from two independent cohorts to test and validate the hypothesis that oral bacteria are associated with HNsCC prognosis and in vitro models to investigate mechanistic *** are detailed in supplementary Materials.

关键词： prognosis squamous carcinoma

Persistent Abdominal Pain Associated with splenic Lymphangioma in An Adult Patient: A Case Presentation

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Journal of Biosciences and Medicines 2024年第9期12卷 82-88页

作者： david Fernando Ortiz Pérez Janne Jorgeth Fabregas Ramirez Mario Enrique Montoya Jaramillo Juan José Iles Bravo john sebastián Osorio Muñoz Manuel Fernando Chavarro Muñoz Daniel de Jesús González Villarreal Manuel Esteban Ortiz Pérez Department of Internal Medicine Cartagena del Mar Clinical Center Cartagena Colombia

splenic lymphangioma is a rare benign lesion, predominantly seen in the pediatric population and exceptionally in adults. It is usually associated with lymphatic system malformations caused by secondary lymphangiectasia due to abnormal communication between lymphatic ducts. It often coexists with complex clinical syndromes, such as Klippel-Trenaunay syndrome, congenital epithelial cysts, or, in less frequent conditions, infectious or post-traumatic triggering events. It typically presents in the neck or axillae, with intra-abdominal cases accounting for less than 5% of all cases. We present the clinical case of a 44-year-old male patient who presented with a clinical course of approximately one month, characterized by progressive abdominal pain associated with nausea, multiple episodes of emesis, anorexia, and involuntary weight loss. A diagnostic laparoscopy was performed, revealing a poorly differentiated lesion in the splenic topography, for which a biopsy was performed, leading to the definitive diagnosis. In this scenario, splenic lymphangioma should be considered among the differential diagnoses of persistent abdominal pain, and definitive interventions should be determined based on clinical characteristics.

关键词： Lymphangioma Neoplasms splenic Neoplasms Laparoscopy Adulthood

Chronic effects of stretching on range of motion with consideration of potential moderating variables:A systematic review with meta-analysis

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Journal of sport and Health science 2024年第2期13卷 186-194页

作者： Andreas Konrad shahab Alizadeh Abdolhamid Daneshjoo saman Hadjizadeh Anvar Andrew Graham Ali Zahiri Reza Goudini Chris Edwards Carina scharf david George Behm Institute of Human Movement science Sport and HealthGraz UniversityGraz A-8010Austria school of Human Kinetics and Recreation Memorial University of NewfoundlandSt.John’sNL A1C 5S7Canada Department of sport Injuries and Corrective Exercises Faculty of Sport SciencesShahid Bahonar University of KermanKerman 76169-13439Iran

Background:It is well known that stretch training can induce prolonged increases in joint range of motion(ROM).However,to date more information is needed regarding which training variables might have greater influence on improvements in ***,the purpose of this metaanalysis was to investigate the effects of stretch training on ROM in healthy participants by considering potential moderating variables,such as stretching technique,intensity,duration,frequency,and muscles stretched,as well as sex-specific,age-specific,and/or trained state-specific adaptations to stretch ***:We searched through PubMed,scopus,Web of science,and sportDiscus to find eligible studies and,finally,assessed the results from 77 studies and 186 effect sizes by applying a random-effect ***,by applying a mixed-effect model,we performed the respective subgroup *** find potential relationships between stretch duration or age and effect sizes,we performed a ***:We found a significant overall effect,indicating that stretch training can increase ROM with a moderate effect compared to the controls(effect size=-1.002;Z=-12.074;95%confidence interval:-1.165 to-0.840;psubgroup analysis showed a significant difference between the stretching techniques(p=0.01)indicating that proprioceptive neuromuscular facilitation and static stretching produced greater ROM than did ballistic/dynamic ***,there was a significant effect between the sexes(p=0.04),indicating that females showed higher gains in ROM compared to ***,further moderating analysis showed no significant relation or ***:When the goal is to maximize ROM in the long term,proprioceptive neuromuscular facilitation or static stretching,rather than ballistic/dynamic stretching,should be *** to consider in future research as well as sports practice is that neither volume,intensity,nor frequency of stretching were

关键词： Flexibility Long-term stretching stretch training

Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse Craig s Anderson sandeep Ankolekar Lesley Cala Mark Dixon Timothy J England Kailash Krishnan Grant Mair Keith W Muir john Potter Christopher I Price Marc Randall Thompson G Robinson Christine Roffe Else C sandset Jeffrey L saver Angela shone Aloysius Niroshan siriwardena Joanna M Wardlaw Nikola sprigg Philip M Bath stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance service NHs Trust NottinghamUK stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK stroke Research in stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRs)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRs,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(sD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRs>2107(18%),Glasgow Coma scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** Is ALREADY KNOWN ON THIs TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random