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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S3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

Defining Soil and Water Assessment Tool(SWAT)hydrologic responseunits(HRUs)by field boundaries

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International Journal of Agricultural and Biological Engineering 2015年第3期8卷 69-80页

作者： margaret m.Kalcic Indrajeet Chaubey jane Frankenberger Graham Sustainability Institute University of MichiganAnn ArborMI 48104USA Department of Earth Atmosphericand Planetary SciencesPurdue UniversityWest LafayetteIN 47907USA Department of Agricultural and Biological Engineeri ng Purdue UniversityWest LafayetteIN 47907USA

The Soil and Water Assessment Tool(SWAT)is widely used to relate farm management practices to their impacts on surface waters at the watershed scale,yet its smallest spatial unit is not generally defined by physically meaningful *** hydrologic response unit(HRU)is the smallest spatial unit of the model,and the standard HRU definition approach lumps all similar land uses,soils,and slopes within a subbasin based upon user-defined *** standard method provides an efficient way to discretize large watersheds where simulation at the field scale may not be computationally *** relatively smaller watersheds,however,defining HRUs to specific spatial locations bounded by property lines or field borders would often be advantageous,yet this is not currently possible within the ArcSWAT *** this study,a simple approach is demonstrated that defines HRUs by field boundaries through addition of uniquely named soils to the SWAT user soil database and creation of a field boundary layer with majority land use and soil *** of nitrogen,phosphorus,and sediment losses were compared in a case study watershed where SWAT was set up using both the standard HRU definition and field boundary ***-scale results were reasonable and similar for both methods,but aggregating fields by majority soil type masked extremely high soil erosion predicted for a few *** from field-based HRU delineation may be quite different from the standard approach due to choosing a majority soil type in each farm *** approach is flexible such that any land use and soil data prepared for SWAT can be used and any shapefile boundary can divide HRUs.

关键词： watershed modeling Soil and Water Assessment Tool(SWAT) hydrologic response units field boundaries common land units landuse management

Breeding system and pollination ecology of a potentially invasive alien Clematis vitalba *** Ireland

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Journal of Plant Ecology 2018年第1期11卷 56-63页

作者： Conor m.Redmond jane C.Stout Faculty of Science University of South BohemiaCeske BudejoviceBranisovska 176037005 Ceske BudejoviceCzech Republic Biology Centre Institute of EntomologyThe Czech Academy of SciencesBranisovska 3137005 Ceske BudejoviceCzech Republic School of Natural Sciences and Trinity Centre for Biodiversity Research Trinity College DublinDublin 2Ireland

Aims Invasive alien plants can greatly affect native communities and eco-system processes but only a small fraction of alien plant species become *** to establishment and invasion include reproductive *** vitalba *** been a popular hor-ticultural species for the past century and is widely distributed and can be highly *** Ireland,it is considered naturalized and potentially *** this,little is known about its reproduc-tive *** We carried out manipulative field experiments in Ireland and com-pared fruit and seed set from a number of pollination treatments,namely cross-pollination,geitonogamy,autogamy and natural *** also recorded floral visitation to *** through a series of timed *** Findings We found that *** is capable of uniparental reproduction via geitonogamy and autonomous selfing,albeit at a reduced rate com-pared with outcrossing *** vitalba was visited by at least 10 native pollinator taxa,with hoverflies dominating *** fruit set nor seed set in our study population was pollen *** the lack of reproductive constraint,*** may easily spread in suitable *** is of concern in Ireland,given its prevalence in some of the country’s most floristically diverse regions.

关键词： Clematis vitalba plant invasion invasive traits mutualism

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In-host modeling

Infectious Disease modelling 2017年第2期2卷 188-202页

作者： Stanca m.Ciupe jane m.Heffernan Department of mathematics Virginia TechBlacksburgVAUSA Centre for Disease modelling Department of Mathematics&StatisticsYork UniversityTorontoONCanada

Understanding the mechanisms governing host-pathogen kinetics is important and can guide human ***-host mathematical models,together with biological data,have been used in this *** this review,we present basic models used to describe acute and chronic pathogenic *** highlight the power of model predictions,the role of drug therapy,and advantage of considering the dynamics of immune *** also present the limitations of these models due in part to the trade-off between the complexity of the model and their predictive power,and the challenges a modeler faces in determining the appropriate formulation for a given problem.

关键词： problem. app formulation

A simple model for fitting mild, severe, and known cases during an epidemic with an application to the current SARSCoV- 2 pandemic

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Infectious Disease modelling 2021年第1期6卷 313-323页

作者： matthew I.Betti jane m.Heffernan mathematics and Computer Science Mount Allison UniversitySackvilleNew BrunswickCanada mathematics and Statistics Centre for Disease ModellingYork UniversityTorontoOntarioCanada

One of the major difficulties with modelling an ongoing epidemic is that often data is limited or incomplete,making it hard to estimate key epidemic parameters and outcomes(*** rate,peak time,reporting rate,reproduction number).In the current study,we present a model for data-fitting limited infection case data which provides estimates for important epidemiological parameters and *** model can also provide reasonable short-term(one month)*** apply the model to the current and ongoing COVID-19 outbreak in Canada both at the national and provincial/territorial level.

关键词： Basic reproduction number Epidemic curve fitting COVID-19 Other words

micromorphology of Surface Crusts in the Knersvlakte,South Africa

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Journal of mountain Science 2009年第2期6卷 189-196页

作者： Sarah-jane C.Fox Anthony J.mills Rosa m.Poch Department of Soil Science Stellenbosch UniversityStellenbosch South Africa Department of Environment and Soil Science University of LleidaRovira Roure 191 Lleida

Soils in the Knersvlakte are particularly prone to crusting and have lower inherent infiltrability than other soils across western southern Africa. micromorphological techniques were used to examine the structure and porosity of soil crusts in the Knersvlakte to ascertain why crusting is so intense in this region. Quantile regression using boundary lines was employed to examine the relationships between infiltrability and soil properties for all samples （n = 67）. This analysis showed that infiltrability is potentially maximal at low water- dispersible ＇clay plus silt＇ content and low silt content （r^2 = 0.72 and 0.64; respectively, n = 67）（Figure 2）. The strength of crusts, pH, EC, clay mineralogy, and water-dispersible clay, silt and ＇clay plus silt＇ content were compared, and a pore analysis using optical microscopy was undertaken on images of six soil thin sections （n = 6）（circular and parallel polarizers）. Pore analysis was further undertaken on five horizontal slices of equal dimensions taken through each soil thin section. The porosity samples with low infiltrability （〈 100 mm·hr^-1, n = 4） had greater crust strength, lower porosity （both total and in the least porous slice） and greater water-dispersible ＇day plus silt＇ and silt content than the porosity samples with high infiltrability （〉 100mm·hr^-1, n = 2）. The porosity samples with low infiltrability showed a trend of lower pH and greater water dispersible clay percentage. Porosity varied within the porosity samples due to the presence of dense clay/silt bands （〈 0.5 mm in width） with relatively few air vesicles. The porosity samples with horizontal slices of low porosity （but large numbers of air vesicles） had low infiltrability, while those without slices of low porosity （and relatively few air vesicles） had high infiltrability. We conclude that the intense crusting and resultant low infiltrability of soils in the Knersvlakte appears to be related to the formation of thin, dense clay/silt bands in the

关键词： Infiltrability optical microscopy porosity air vesicles

Fibroblast growth factor(FGF)signaling in development and skeletal diseases

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Genes & Diseases 2014年第2期1卷 199-213页

作者： Chad m.Teven Evan m.Farina jane Rivas Russell R.Reid The Laboratory of Craniofacial Biology Section of Plastic&Reconstructive SurgeryDepartment of SurgeryThe University of Chicago Medical Center5841 South Maryland AvenueMC 6035ChicagoIL 60637USA The University of Chicago Pritzker School of medicine ChicagoIL 60637USA

Fibroblast growth factors(FGF)and their receptors serve many functions in both the developing and adult *** contain 18 FGF ligands and four FGF receptors(FGFR).FGF ligands are polypeptide growth factors that regulate several developmental processes including cellular proliferation,differentiation,and migration,morphogenesis,and ***-FGFR signaling is also critical to the developing axial and craniofacial *** particular,the signaling cascade has been implicated in intramembranous ossification of cranial bones as well as cranial suture *** the adult,FGFs and FGFRs are crucial for tissue *** signaling generally follows one of three transduction pathways:RAS/mAP kinase,PI3/AKT,or *** pathway likely regulates specific cellular *** expression of FGF and improper activation of FGFRs are associated with various pathologic conditions,unregulated cell growth,and ***,aberrant signaling has been implicated in many skeletal abnormalities including achondroplasia and *** biology and mechanisms of the FGF family have been the subject of significant research over the past 30 ***,work has focused on the therapeutic targeting and potential of FGF ligands and their associated *** majority of FGF-related therapy is aimed at age-related *** understanding of FGF signaling and biology may reveal additional therapeutic roles,both in utero and *** review discusses the role of FGF signaling in general physiologic and pathologic embryogenesis and further explores it within the context of skeletal development.

关键词： Craniosynostosis FGF signaling Fibroblast growth factor Fibroblast growth factor receptor Genetics Pathogenesis Signal transduction Skeletal development

Heterogeneity across the murine small and large intestine

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World Journal of Gastroenterology 2014年第41期20卷 15216-15232页

作者： Rowann Bowcutt Ruth Forman maria Glymenaki Simon Richard Carding Kathryn jane Else Sheena margaret Cruickshank Faculty of Life Sciences University of Manchester Department of microbiology New York University Gut Health and Food Safety Research Programme Institute of Food Research and the Norwich Medical SchoolUniversity of East Anglia

The small and large intestine of the gastrointestinal tract(GIT) have evolved to have discrete functions with distinct anatomies and immune cell *** importance of these differences is underlined when considering that different pathogens have uniquely adapted to live in each region of the ***,different regions of the GIT are also associated with differences in susceptibility to diseases such as cancer and chronic *** large and small intestine,given their anatomical and functional differences,should be seen as two separate immunological ***,this distinction is often ignored with findings from one area of the GIT being inappropriately extrapolated to the *** largely on the murine small and large intestine,this review addresses the literature relating to the immunology and biology of the two sites,drawing comparisons between them and clarifying similarities and *** also highlight the gaps in our understanding and where further research is needed.

关键词： Large intestine Small intestine Epithelial Immune microbial

When evidence is lacking:a mixed-methods approach for the development of practice guidance in liver transplantation

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Gastroenterology Report 2021年第1期9卷 22-30,I0001页

作者： Lisa B.VanWagner Blessing Aghaulor Tasmeen Hussain megan Kosirog Patrick Campbell Stewart Pine Amna Daud Daniel J.Finn Josh Levitsky Donald m.Lloyd-Jones jane L.Holl Division of Gastroenterology and Hepatology Department of MedicineNorthwestern University Feinberg School of MedicineChicagoILUSA Department of Preventive medicine Northwestern University Feinberg School of MedicineChicagoILUSA Comprehensive Transplant Center Northwestern University Feinberg School of MedicineChicagoILUSA Division of Cardiology Department of MedicineNorthwestern University Feinberg School of MedicineChicagoILUSA Department of Pediatrics Northwestern University Feinberg School of MedicineChicagoILUSA Center for Healthcare Delivery Science and Innovation and Department of Neurology Biological Sciences DivisionUniversity of ChicagoChicagoILUSA

Background most interventions for conditions with a small cohort size,such as transplantation,are unlikely to be part of a clinical *** condition-specific evidence is lacking,expert consensus can offer more precise guidance to improve *** of cardiovascular risk in liver-transplant recipients is one example for which clinicians have,to date,adapted evidence-based guidelines from studies in the general ***,even when consensus is achieved,implementation of practice guidance is often inadequate and *** report on a novel mixed-methods approach,the Northwestern methodVC,for the development of clinical-practice guidance when condition-specific evidence is *** illustrate the method through the development of practice guidance for managing cardiovascular risk in liver-transplant *** The Northwestern methodVC consists of(i)adaptation of relevant,existing,evidence-based clinical-practice guidelines for the target population;(ii)consensus by experts of the proposed practice guidance;(iii)identification of barriers to guidance adherence in current practice;and(iv)recommendation for implementation and dissemination of the practice *** method is based on an iterative,user-centered approach in which the needs,wants,and limitations of all end users,including patients,are attended to at each stage of the design and development *** The Northwestern methodVC for clinical-practice-guidance development uses a mixed-methods approach to bring together broad representation from multiple disciplines and practice settings to develop consensus considering the unique needs and preferences of patients,caregivers,and practitioners who are directly impacted by clinical-practice-guidance *** hypothesize that a priori involvement of end users in the guidance-development process will lead to sustainable implementation of guidance statements into clinical practice.

关键词： liver transplantation practice guideline consensus methodology