检索结果-南通市图书馆

Disruptive behavior in the workplace: Challenges for gastroenterology fellows

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2017年第18期23卷 3315-3321页

作者： Nalinee Srisarajivakul Catherine Lucero Xiao-Jing Wang Michael Poles Colleen Gillespie Sondra Zabar Elizabeth Weinshel lisa malter Division of Gastroenterology VA New York Harbor Healthcare System Division of General Internal Medicine NYU School of Medicine Division of Gastroenterology and Hepatology Weill Cornell Medical College Department of Internal Medicine Emory University School of Medicine

To assess first-year gastroenterology fellows’ ability to address difficult interpersonal situations in the workplace using objective structured clinical examinations (OSCE).METHODSTwo OSCEs (“distracted care team” and “frazzled intern”) were created to assess response to disruptive behavior. In case 1, a fellow used a colonoscopy simulator while interacting with a standardized patient (SP), nurse, and attending physician all played by actors. The nurse and attending were instructed to display specific disruptive behavior and disregard the fellow unless requested to stop the disruptive behavior and focus on the patient and procedure. In case 2, the fellow was to calm an intern managing a patient with massive gastrointestinal bleeding. The objective in both scenarios was to assess the fellows’ ability to perform their duties while managing the disruptive behavior displayed by the actor. The SPs used checklists to rate fellows’ performances. The fellows completed a self-assessment *** fellows from four gastrointestinal fellowship training programs participated in the OSCE. In the “distracted care team” case, one-third of the fellows interrupted the conflict and refocused attention to the patient. Half of the fellows were able to display professionalism despite the heated discussion nearby. Fellows scored lowest in the interprofessionalism portion of post-OSCE surveys, measuring their ability to handle the conflict. In the “frazzled intern” case, 68% of fellows were able to establish a calm and professional relationship with the SP. Despite this success, only half of the fellows were successfully communicate a plan to the SP and only a third scored “well done” in a domain that focused on allowing the intern to think through the case with the fellow’s *** must receive training on how to approach disruptive behavior. OSCEs are a tool that can assess fellow skills and set a culture for open discussion.

关键词： Disruptive behavior Fellowship education and training Objective structured clinical examinations

Tamoxifen Treatment in Correlation with Increased ET-1 Levels Is Associated with the Development of Breast Cancer Metastases

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Cancer Therapy 2018年第5期9卷 438-463页

作者： Melanie von Brandenstein Julia Straube Christina-Maria Geisbusch Luca Ozretic Yasemin Ural Verena Kirn Wolfram malter Jochen W.U.Fries Department of Urology University Hospital of KoelnKoelnGermany Department of Molecular and Experimental Surgery University Hospital ErlangenErlangenGermany Department of Pediatric and Adolescent Psychiatry Psychsomatic and Psychotherapy University Clinic RTWH AachenGermany Department of Cellular Pathology Royal Free HospitalLondonUK Department of Urology University Hospital of KoelnKoelnGermany Department of Gynecology and Obstetrics University Hospital of KoelnKoelnGermany Department of Pathology University Hospital of KoelnKoelnGermany

Background: In breast cancer patients, a correlation between endothelin-1 (ET-1) and lymph node metastasis was found. While breast cancer with a positive ER status can be treated with Tamoxifen, several studies describe increasing Tamoxifen resistance in patients. We analyzed the relationship between Tamoxifen, ET-1 overexpression, and ER leading to Tamoxifen resistance. Methods: Breast cancer cell lines were treated with Tamoxifen, ET-1, estrogen and combinations. Using qRT-PCR, immune-precipitation, Western blot, EMSA and immunohistology target gene expression and ER complex partners were investigated. Human biopsies and mastectomy specimens were immunohistologically studied for Vimentin 3, and ERβ. Results: Breast cancer cells stimulated with a combination of Tamoxifen and ET-1 downregulate ERα, while upregulating intracellular ET-1, and ERβ. Immunoprecipation of nuclear extracts with ET-1, ERα or ERβ agarose conjugated antibodies reveals a complex formation change replacing ERα by ERβ once Tamoxifen forms a complex with ET-1. ERβand ET-1 migrate into the nucleus. ET-1 stimulation upregulates metastases promoting target genes (IL-6, Wnt11), including a novel one, Vimentin 3. Tissue analyses show Vim3 and ERβ expression in metastases of ERα positive breast cancer, and in ERα negative biopsies/mastectomy specimens. Conclusion: We are the first to describe a complex consisting of Tamoxifen, ERβ and ET-1, whose nuclear transmigration causes an overexpression of target genes. This mechanism may explain Tamoxifen resistance. Future pathologic analyses should include estrogen beta receptor status as well as the ET-1 expression. This concept presents a new treatment approach for individualized medicine in breast cancer patients with increased ET-1 levels.

关键词： Endothelin-1 Estrogen Estrogen Receptors Tamoxifen Vimentin3

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

罗伯斯庇尔 1版

1983年

作者：（法）热拉尔·瓦尔特（G.malter）姜靖藩等

本书对罗伯斯庇尔生平的一些活动作一番分析一评述，对已发表的罗伯斯庇尔传记作一些补充和更正。

ISBN: (纸本)11017·569

本书对罗伯斯庇尔生平的一些活动作一番分析一评述，对已发表的罗伯斯庇尔传记作一些补充和更正。

关键词：罗伯斯庇尔学科:生平事迹

来源：汇雅图书（南通市图书馆... 评论

在线全文

汇雅图书（南通市图书馆）

学校读者我要写书评

暂无评论

新眼光看老数论（I）

数学译林 2013年第3期32卷 238-249页

作者： Aimeric malter Dierk Schleicher Don Zagier 朱尧辰(译) 姚景齐(校)

我们在此给出3个数论结果，它们都有经典来源，但也有现代理论．我们将讲述：（1）怎样借助迭代某个简单函数系统地数出所有有理数；（2）如何应用对合和对合对的简单性质求出任何一个模4余1的素数的二平方和表示；（3）怎样应用有理系... 详细信息

我们在此给出3个数论结果，它们都有经典来源，但也有现代理论．我们将讲述：（1）怎样借助迭代某个简单函数系统地数出所有有理数；（2）如何应用对合和对合对的简单性质求出任何一个模4余1的素数的二平方和表示；（3）怎样应用有理系数二次多项式的性质，找到Euler（欧拉）猜想（即任何一个四次幂不可能是3个四次幂之和）的反例．

关键词：数论二次多项式 Euler 函数系统现代理论有理数平方和性质

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

罗伯斯庇尔

罗伯斯庇尔