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

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

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Inflammasome links traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease

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Neural Regeneration Research 2025年第6期20卷 1644-1664页

作者： Gabriela Seplovich Yazan Bouchi juan Pablo de Rivero Vaccari jennifer C.Munoz Pareja Andrew Reisner Laura Blackwell Yehia Mechref Kevin K.Wang j.Adrian Tyndall Binu Tharakan Firas Kobeissy Department of Surgery Morehouse School of MedicineAtlantaGAUSA Department of Neurobiology Center for NeurotraumaMultiomics&Biomarkers(CNMB)Neuroscience InstituteMorehouse School of MedicineAtlantaGAUSA Department of Neurological Surgery and the Miami Project to Cure Paralysis University of Miami Miller School of MedicineMiamiFLUSA Division of Pediatric Critical Care Department of PediatricsUniversity of Miami Miller School of MedicineMiamiFLUSA Department of Pediatrics Emory UniversityAtlantaGAUSA Department of Neurosurgery Children’s Healthcare of AtlantaAtlantaGAUSA Department of Chemistry and Biochemistry Texas Tech UniversityLubbockTXUSA Morehouse School of Medicine AtlantaGAUSA

Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates. These misfolded proteins are characteristic of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease and can lead to downstream neuroinflammatory processes, including assembly and activation of the inflammasome complex. Inflammasomes refer to a family of multimeric protein units that, upon activation, release a cascade of signaling molecules resulting in caspase-induced cell death and inflammation mediated by the release of interleukin-1β cytokine. One specific inflammasome, the NOD-like receptor protein 3, has been proposed to be a key regulator of tau phosphorylation where it has been shown that prolonged NOD-like receptor protein 3 activation acts as a causal factor in pathological tau accumulation and spreading. This review begins by describing the epidemiology and pathophysiology of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease. Next, we highlight neuroinflammation as an overriding theme and discuss the role of the NOD-like receptor protein 3 inflammasome in the formation of tau deposits and how such tauopathic entities spread throughout the brain. We then propose a novel framework linking traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease as inflammasomedependent pathologies that exist along a temporal continuum. Finally, we discuss potential therapeutic targets that may intercept this pathway and ultimately minimize long-term neurological decline.

关键词： Alzheimer's disease caspase-1 chronic traumatic encephalopathy inflammasomes neurodegeneration neuroinflammation NLRP1 NLRP3 pyroptosis tauopathy traumatic brain injury

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Elucidating regulatory processes of intense physical activity by multi-omics analysis

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Military Medical Research 2024年第4期11卷 479-499页

作者： Ernesto S.Nakayasu Marina A.Gritsenko Young-Mo Kim jennifer E.Kyle Kelly G.Stratton Carrie D.Nicora Nathalie Munoz Kathleen M.Navarro Daniel Claborne Yuqian Gao Karl K.Weitz Vanessa L.Paurus Kent j.Bloodsworth Kelsey A.Allen Lisa M.Bramer Fernando Montes Kathleen A.Clark Grant Tietje justin Teeguarden Kristin E.Burnum-johnson Biological Sciences Division Pacific Northwest National LaboratoryRichlandWA 99352USA Environmental and Molecular Sciences Division Pacific Northwest National LaboratoryRichlandWA 99352USA Centers for Disease Control and Prevention National Institute for Occupational Safety and HealthWestern States DivisionDenverCO 80204USA Computational Analytics Division Pacific Northwest National LaboratoryRichlandWA 99352USA National Security Directorate Pacific Northwest National LaboratoryRichlandWA 99352USA Los Angeles County Fire Department Los AngelesCA 90063USA Centers for Disease Control and Prevention National Institute for Occupational Safety and HealthRespiratory Health DivisionMorgantownWV 26505USA Environmental and Molecular Toxicology Oregon State UniversityCorvallisOR 97331USA

Background:Physiological and biochemical processes across tissues of the body are regulated in response to the high demands of intense physical activity in several occupations,such as firefighting,law enforcement,military,and sports.A better understanding of such processes can ultimately help improve human performance and prevent illnesses in the work ***:To study regulatory processes in intense physical activity simulating real-life conditions,we performed a multi-omics analysis of 3 biofluids(blood plasma,urine,and saliva)collected from 11 wildland firefighters before and after a 45 min,intense exercise *** profiles ***-exercise were compared by Student’s t-test followed by pathway analysis and comparison between the different omics ***:Our multi-omics analysis identified and quantified 3835 proteins,730 lipids and 182 metabolites combining the 3 different types of *** blood plasma analysis revealed signatures of tissue damage and acute repair response accompanied by enhanced carbon metabolism to meet energy *** urine analysis showed a strong,concomitant regulation of 6 out of 8 identified proteins from the renin-angiotensin system supporting increased excretion of catabolites,reabsorption of nutrients and maintenance of fluid *** saliva,we observed a decrease in 3 pro-inflammatory cytokines and an increase in 8 antimicrobial peptides.A systematic literature review identified 6 papers that support an altered susceptibility to respiratory ***:This study shows simultaneous regulatory signatures in biofluids indicative of homeostatic maintenance during intense physical activity with possible effects on increased infection susceptibility,suggesting that caution against respiratory diseases could benefit workers on highly physical demanding jobs.

关键词： Multi-omics analysis Intense exercise Human performance Biofluids Metabolism Immunity

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Tooth loss patterns in older adults with special needs:a Minnesota cohort

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International journal of Oral Science 2011年第1期3卷 27-33页

作者： jennifer j.Clark Department of Dental Ecology University of North CarolinaChapel HillNC 27599USA

This study was conducted to detail tooth loss patterns in older adults with special needs. A total of 491 elderly subjects with special needs were retrospectively selected and followed during 10/1999-12/2006. Medical, dental, cognitive, and functional assessments were abstracted from dental records and used to predict risk of tooth loss. Tooth loss events were recorded for subjects during follow-up. Chi-squared tests were used to study the association between tooth loss and the selected risk factors. Logistic, poisson, and negative binomial regressions were developed to study tooth loss patterns. Overall, 27% of the subjects lost at least one tooth during follow-up. Fourteen subjects had tooth loss events per 100 person-years. Tooth loss pattern did not differ significantly among different special-needs subgroups （i.e. community-dwelling vs. long-term care, physically disabled vs. functionally independent）. Special-needs subjects with three or more active dental conditions at arrival had more than twice the risk of losing teeth than those without any existing conditions. After adjusting other factors, the number of carious teeth or retained roots at arrival was a significant predictor of tooth loss for older adults with special needs （P=0.001）. These findings indicate that appropriately managing active caries and associated conditions is important to prevent tooth loss for older adults with special needs.

关键词： tooth loss elderly special needs

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Effect of seismic retrofit of bridges on transportation networks

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Earthquake Engineering and Engineering Vibration 2003年第2期2卷 169-179页

作者： Masanobu Shinozuka Yuko Murachi michal j.Orlikowski Department of Civil and Environmental Engineering University of CaliforniaIrvineUSA Distinguished Professor and Chair Department of Civil and Environmental Engineering University of CaliforniaIrvineUSA Research Associate Department of Civil and Environmental Engineering Princeton UniversityUSA Undergraduate Student.

The objective of this research is to determine the effect earthquakes have on the performance of transportation network *** do this,bridge fragility curves,expressed as a function of peak ground acceleration(PGA)and peak ground velocity(PGV),were *** damage was evaluated under the 1994 Northridge earthquake and scenario earthquakes.A probabilistic model was developed to determine the effect of repair of bridge damage on the improvement of the network performance as days passed after the *** an example,the system performance degradation measured in terms of an index,'Drivers Delay,'is calculated for the Los Angeles area transportation system,and losses due to Drivers Delay with and without retrofit were estimated.

关键词： fragility curves seismic retrofit probabilistic model bridges transportation networks drivers delay performance index Northridge earthquake.

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Non-gaussian Test Models for Prediction and State Estimation with Model Errors

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Chinese Annals of Mathematics,Series B 2013年第1期34卷 29-64页

作者： michal BRANICKI Nan CHEN Andrew j.MAjDA Department of Mathematics and Center for Atmosphere Ocean Science Courant Institute of Mathematical SciencesNew York University

Turbulent dynamical systems involve dynamics with both a large dimensional phase space and a large number of positive Lyapunov exponents. Such systems are ubiqui- tous in applications in contemporary science and engineering where the statistical ensemble prediction and the real time filtering/state estimation are needed despite the underlying complexity of the system. Statistically exactly solvable test models have a crucial role to provide firm mathematical underpinning or new algorithms for vastly more complex scien- tific phenomena. Here, a class of statistically exactly solvable non-Gaussian test models is introduced, where a generalized Feynman-Ka~ formulation reduces the exact behavior of conditional statistical moments to the solution to inhomogeneous Fokker-Planck equations modified by linear lower order coupling and source terms. This procedure is applied to a test model with hidden instabilities and is combined with information theory to address two important issues in the contemporary statistical prediction of turbulent dynamical systems： the coarse-grained ensemble prediction in a perfect model and the improving long range forecasting in imperfect models. The models discussed here should be use- ful for many other applications and algorithms for the real time prediction and the state estimation.

关键词： Prediction Model error Information theory Feynman-Kac framework Fokker planck Turbulent dynamical systems

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Diagnostic accuracy of ePOS score in predicting DNR labeling after ICU admission:A prospective observational study(ePOS-DNR)

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journal of Intensive Medicine 2024年第2期4卷 216-221页

作者： Omar E.Ramadan Ahmed F.Mady Mohammed A.Al-Odat Ahmed N.Balshi Ahmed W.Aletreby Taisy j.Stephen Sheena R.Diolaso jennifer Q.Gano Waleed Th.Aletreby Department of Critical Care King Saud Medical CityRiyadhSaudi Arabia Anesthesia Department Faculty of MedicineAin Shams UniversityCairoEgypt Anesthesia Department Faculty of MedicineTanta UniversityTantaEgypt Faculty of Medicine Alexandria UniversityAlexandriaEgypt Nursing Department King Saud Medical CityRiyadhSaudi Arabia

Background Resuscitation can sometimes be futile and making a do-not-resuscitate(DNR)decision is in the best interest of the *** electronic poor outcome screening(ePOS)score was developed to predict 6-month poor outcomes of critically ill *** explored the diagnostic accuracy of the ePOS score in predicting DNR decisions in the intensive care unit(ICU).Methods This study was conducted at the ICU of a tertiary referral hospital in Saudi Arabia between March and May ***,we calculated ePOS scores for all eligible consecutive admissions after 48 h in the ICU and recorded the DNR *** ability of the score to predict DNR was explored using logistic ***'s ideal cut-off value was calculated using the DeLong method,and different diagnostic accuracy measures were generated with corresponding 95%confidence intervals(CIs).Results We enrolled 857 patients,125 received a DNR order and 732 did *** average ePOS score of DNR and non-DNR patients was 28.2±10.7 and 15.2±9.7,*** score,as a predictor of DNR order,had an area under receiver operator characteristic(AUROC)curve of 81.8%(95%CI:79.0 to 84.3,P17 was associated with a sensitivity of 87.2(95%CI:80.0 to 92.5,P17 may help guide clinical decisions to withhold or commence resuscitative measures.

关键词： Do-not-resuscitate(DNR) Resuscitation Intensive care unit(ICU) Diagnostic accuracy Sensitivity Specificity

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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

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Sharp Interpolation Inequalities on the Sphere:New Methods and Consequences

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Chinese Annals of Mathematics,Series B 2013年第1期34卷 99-112页

作者： jean DOLBEAULT Maria j. ESTEBAN michal KOWALCZYK Michael LOSS Ceremade Université Paris DauphinePlace de Lattre de Tassigny Departamento de Ingeniería Matemática and Centro de Modelamiento Matemático (UMI 2807 CNRS) Universidad de Chile Skiles Building Georgia Institute of Technology

This paper is devoted to various considerations on a family of sharp interpo- lation inequalities on the sphere, which in dimension greater than 1 interpolate between Poincare, logarithmic Sobolev and critical Sobolev （Onofri in dimension two） inequalities. The connection between optimal constants and spectral properties of the Laplace-Beltrami operator on the sphere is emphasized. The authors address a series of related observations and give proofs based on symmetrization and the ultraspherical setting.

关键词： Sobolev inequality Interpolation Gagliardo-Nirenberg inequality Logarithmic Sobolev inequality Heat equation

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Data-driven analysis of process,structure,and properties of additively manufactured Inconel 718 thin walls

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npj Computational Materials 2022年第1期8卷 1168-1182页

作者： Lichao Fang Lin Cheng jennifer A.Glerum jennifer Bennett jian Cao Gregory j.Wagner Department of Mechanical Engineering Northwestern UniversityEvanstonIL60208USA Department of Materials Science and Engineering Northwestern UniversityEvanstonIL60208USA DMG MORI Hoffman EstatesIL60192USA Department of Mechanical and Materials Engineering Worcester Polytechnic InstituteWorcesterMA01609USA Department of Civil and Mechanical Engineering US Military Acadeemy at West PointWest PointNY10996USA

In additive manufacturing of metal parts,the ability to accurately predict the extremely variable temperature field in detail,and relate it quantitatively to structure and properties,is a key step in predicting part performance and optimizing process *** this work,a finite element simulation of the directed energy deposition(DED)process is used to predict the space-and time-dependent temperature field during the multi-layer build process for Inconel 718 *** thermal model results show good agreement with dynamic infrared images captured in situ during the DED *** relationship between predicted cooling rate,microstructural features,and mechanical properties is examined,and cooling rate alone is found to be insufficient in giving quantitative property *** machine learning offers an efficient way to identify important features from series data,we apply a 1D convolutional neural network data-driven framework to automatically extract the dominant predictive features from simulated temperature *** good predictions of material properties,especially ultimate tensile strength,are obtained using simulated thermal history *** further interpret the convolutional neural network predictions,we visualize the extracted features produced on each convolutional layer and compare the convolutional neural network detected features of thermal histories for high and low ultimate tensile strength cases.A key result is the determination that thermal histories in both high and moderate temperature regimes affect material properties.

关键词： Inconel process additive

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