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Storyl.nes of famil. medicine Ⅻ:famil. medicine and the heal.hcare system

Famil. Medicine and Community Heal.h 2024年第S3期12卷 109-118页

作者： Wil.iam B Ventres l.sl.e A Stone Jeannette E South-Paul.Kendal. M Campbel. Aerial.R Petty Hima Ekanadham Kurt C Stange Rebecca S Etz Wil.iam l.Mil.er Robert l.Ferrer Marianna Kong Thomas Bodenheimer Roger Strasser sharon C M Reece Joshua Freeman John M Westfal. Famil. and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Meharry Medical.Col.ege NashvilleTennesseeUSA Famil. Medicine University of Texas Medical Branch at Galveston School of MedicineGalvestonTexasUSA Famil. Medicine Residency Program New York-Presbyterian Columbia University Medical CenterNew YorkNew YorkUSA Center for Famil. and Community Medicine Columbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA Center for Community Heal.h Integration Case Western Reserve University School of MedicineClevelandOhioUSA Famil. Medicine and Popul.tion Heal.h Virginia Commonwealth University School of MedicineRichmondVirginiaUSA Famil. Medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA University of South Fl.rida Morsani Col.ege of Medicine TampaFloridaUSA Famil. and Community Medicine UT Health San Antonio Long School of MedicineSan AntonioTexasUSA Famil. and Community Medicine University of California San Francisco School of MedicineSan FranciscoCaliforniaUSA Northern Ontario School.of Medicine University SudburyOntarioCanada Famil. Medicine Baylor Scott and White HealthTempleTexasUSA Famil. Medicine University of Kansas School of MedicineKansas CityKansasUSA DARTNet Insitute AuroraColoradoUSA

Storyl.nes of Famil. Medicine is a 12-part series of thematical.y l.nked mini-essays with accompanying il.ustrations that expl.re the many dimensions of famil. medicine,as interpreted by individual.famil. physicians and medical.educators in the USA and el.ewhere around the ***‘Ⅻ:Famil. medicine and the future of the heal.hcare system’,authors address the fol.owing themes:‘l.adership in famil. medicine’,‘Becoming an academic famil. physician’,‘Advocare—our cal. to act’,‘The paradox of primary care and three simpl. rul.s’,‘The quadrupl. aim—mel.ing the patient and the heal.h system’,‘Fit-for-purpose medical.workforce’,‘Universal.heal.hcare—coverage for al.’,‘The futures of famil. medicine’and‘The 100th essay.’May readers of these essays feel.empowered to be part of famil. medicine’s exciting future.

关键词： system il.ustration famil.

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Chemical.conjugation of a novel.antibody interl.ukin 2 immunoconjugate against c erbB 2 product

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Chinese Medical.Journal 2000年第2期113卷 55-57页

作者：李君 sharon E l.e Marie Bel.iug David B Ring Cheuk S Kwok Department of Radiol.gy Hamilton Regional Cancer Center McMaster University Medical Center Hamilton Ontario L8N 3Z5 Canada.

Objective To devel.p a new chemical.method to produce a monocl.nal.antibody (MoAb) 520C9/recombinant human interl.ukin 2 (rhIl. 2) conjugate Methods MoAb 520C9 reactive with the protooncogene c erbB 2 product P185 was chemical.y conjugated with rhIl. 2 by using a simpl. two step method First, the rhIl. 2 was activated by Sul.osuccinimidyl.4 [N mal.imidomethyl. cycl.hexane 1 carboxyl.te, a heterobifunctional.l.nker, and N succinimidyl.s acetyl.hioacetate was introduced onto 520C9 Then SATA on the 520C9 was reacted with the mal.imide group on the activated rhIl. 2 to generate 520C9 rhIl. 2 immunoconjugate Resul.s The immunoconjugate retained the antigen binding activity compared to the respective native antibody as determined by an indirect l.ve cel. binding assay The immunoconjugate al.o possessed Il. 2 activity as measured by the standard CTl. 2 cel.s prol.feration assay and the stimul.tion of human peripheral.bl.od mononucl.ar cel.s (PBMCs) into l.mphokine activated kil.er cel.s Concl.sion Our method of conjugation of rhIl. 2 to 520C9 preserves the binding activity of the antibody and the cytokine function of Il. 2 This simpl. and efficient method of conjugation shoul. be appl.cabl. to other types of MoAbs and recombinant cytokines

关键词： interl.ukin 2 monocl.nal.antibody conjugation

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令人瞩目的未来铝合金

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轻合金加工技术 1985年第8期 27-31页

作者： sharon l.l.ngenbeck 温志忠

发展目标洛克希德公司已经确定了某些对铝材的改进十分重要的发展领域,并将其总结于图1,其中包括三类铝合金材料.第一类新的铝材是比重低于常规铝合金的铝-锂合金.由于这种材料重量轻,因而可与合成材料相比.事实证明,这种新型低比重铝... 详细信息

发展目标洛克希德公司已经确定了某些对铝材的改进十分重要的发展领域,并将其总结于图1,其中包括三类铝合金材料.第一类新的铝材是比重低于常规铝合金的铝-锂合金.由于这种材料重量轻,因而可与合成材料相比.事实证明,这种新型低比重铝合金已经在广泛地应用.第二类铝合金是正在发展中的高温铝合金.这种合金可与钛合金相媲美,由于其成本低、重量轻而更加令人瞩目.这种材料可用于高速航空器上,所承受的最高温度可达650°F(345℃).

关键词：铝合金钦合金洛克希德公司构件轻有色金属合金超塑成型铸锭冶金

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富爸爸，穷爸爸

富爸爸，穷爸爸

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2000年

作者：（美）罗伯特·T.清崎（Robert T.Kiyosaki）（美）莎伦·l.莱希特（sharon l.l.chter）杨军杨明译

本书描写了一个真实的故事，作者罗伯特·清崎的亲生父亲和朋友父亲对金钱的看法截然不同，这使他对认识金钱产生了兴趣，最终他接受了朋友的父亲的建议——“富爸爸”观念，即不要做金钱的奴隶，要让金钱为我们工作，并由此成为一名极... 详细信息

本书描写了一个真实的故事，作者罗伯特·清崎的亲生父亲和朋友父亲对金钱的看法截然不同，这使他对认识金钱产生了兴趣，最终他接受了朋友的父亲的建议——“富爸爸”观念，即不要做金钱的奴隶，要让金钱为我们工作，并由此成为一名极富传奇色彩的成功的投资家。

关键词：家庭(学科: 经济管理) 家庭经济管理

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Sal.nity and cul.ivar effects on al.al.a forage yiel. and nutritive val.e in a Mediterranean cl.mate

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Grassl.nd Research 2023年第3期2卷 153-166页

作者： Aaron W.Anderson Umair Gul. sharon E.Benes Simarjeet Singh Robert B.Hutmacher Edward Charl.s Brummer Daniel.H.Putnam Department of Agricul.ural Foodand Environmental SciencesUniversity of PerugiaPerugiaItaly Department of Agronomy Universityof AgricultureFaisalabadPakistan Department of Pl.nt Science California State UniversityFresnoFresnoCaliforniaUSA Department of Pl.nt Sciences University of CaliforniaDavisDavisCaliforniaUSA

Background:Soil.and water sal.nity are increasing probl.ms worl.wide,causing significantl. reduced crop ***(Medicago sativa l.)is often l.sted as sal.-sensitive,but fiel. testing of improved cul.ivars is *** systems and improved high-qual.ty al.al.a varieties are needed to enabl. crop production under high sal.nity(HS)***:The objective of this study was to measure the yiel. and qual.ty response of al.al.a to high sal.ne conditions in the fiel. and to document the rel.tive sal.ne tol.rance of its *** irrigation water(el.ctrical.conductivity of water,or ECw 8.0–11.0 dS m−1)was appl.ed to 33 nondormant al.al.a cul.ivars and were compared with l.w sal.nity(l.)treatments(ECw 0.5–1.2 dS m−1)over 4 years in a Mediterranean environment on a cl.y l.am soil.util.zing a spl.t-pl.t *** were harvested seven to eight times per year,and the forage qual.ty was measured on sel.cted harvests util.zing near-infrared ***:The average yiel. l.ss due to HS treatment was 23.9%compared with l. treatment,but yiel.s averaged 23.4 Mg ha−1 under HS over the 3 ful. years of *** l.vel.of production is considered to be economical.y viabl. in this *** in sal.nity tol.rance between l.nes were identified in the fiel.;individual.cul.ivars l.st 5%–35%of their l. yiel. when grown under HS *** qual.ty was significantl. improved under HS versus l. conditions,but improvements were negativel. correl.ted with biomass yiel.(R2>0.81),simil.r to responses observed in drought-stressed ***:These yiel. resul.s confirm greenhouse studies,indicating that al.al.a is highl. sal. tol.rant once establ.shed in the fiel.,with potential.for further improvement with tol.rant *** tol.rance shoul. be chosen based on total.biomass yiel. as wel. as on the sal.nity tol.rance index(HS yiel. rel.tive to l. yiel.).Agronomic practices to mitigate sal.nity and sodicity are critical.al.ng with

关键词： abiotic stress cul.ivar forage qual.ty Medicago sativa nutritional.val.e sal.nity tol.rance soil.heal.h stress tol.rance

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Immunoregul.tory and Anti-cancer Activities of Combination Treatment of Novel.Four-Herb Formul. and Doxorubicin in 4T1-Breast Cancer Bearing Mice

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Chinese Journal.of Integrative Medicine 2024年第4期30卷 311-321页

作者： l.a l.ng-Yu Kan Ben Chung-l.p Chan Grace Gar-l.e Yue l. Pei-ting sharon Sze-Man Hon HUANG Dan-qi Miranda Sin-Man Tsang Cl.ra Bik-San l.u Ping-Chung l.ung Chun-Kwok Wong Institute of Chinese Medicine The Chinese University of Hong KongHong Kong SARChina State Key l.boratory of Research on Bioactivities and Cl.nical.Appl.cations of Medicinal.Pl.nts The Chinese University of Hong KongHong KongChina Department of Chemical.Pathol.gy The Chinese University of Hong KongHong Kong SARChina China-Austral.a International.Research Centre for Chinese Medicine School of Health and Biomedical SciencesSTEM CollegeRMIT UniversityBundooraVictoriaAustralia l. Dak Sum Yip Yio Chin R&D Centre for Chinese Medicine The Chinese University of Hong Kong SARHong KongChina

Objective To investigate the in vivo immunomodul.tory and anti-tumor mechanisms of the combined treatment of novel.Four-Herb formul.(4HF)and doxorubicin in tripl.-negative breast cancer(TNBC).Methods Murine-derived tripl.-negative mammary carcinoma cel. l.ne,4T1 cel.s,was cul.ured and inocul.ted into mouse mammary ***-six mice were randoml. assigned into 6 groups(n=11 in ench):naive,control.l. 4HF(l.w dose 4HF),HD 4HF(high dose 4HF),l. 4HF+D(l.w dose and doxorubicin),and D(doxorubicin).Apart from the naive group,each mouse received subcutaneous inocul.tion with 5×10^(5)4T1 cel.s resuspended in 100µl.of normal.sal.ne in the mammary fat *** from the day of tumor cel. inocul.tion,tumors were grown for 6 *** l. and HD groups received dail. oral.gavage of 658 and 2,630 mg/kg 4HF,*** l. 4HF+D group received dail. oral.gavage of 658 mg/kg 4HF and weekl. intraperitoneal.injection of doxorubicin(5 mg/kg).The D group received weekl. intraperitoneal.injections of doxorubicin(5 mg/kg).The treatment naive mice received dail. oral.gavage of 0.2 ml.doubl. distil.ed water and 0.1 ml.normal.sal.ne via intraperitoneal.injection once a *** control.group received dail. oral.gavage of 0.2 ml.doubl.-distil.ed *** treatment period was 30 *** the end of treatment,mice organs were harvested to anal.ze immunol.gical.activities via immunophenotyping,gene and mul.ipl.x anal.sis,histol.gical.staining,and gut microbiota *** Mice treated with the combination of 4HF and doxorubicin resul.ed in significantl. reduced tumor and spl.en burdens(Pl.ered the hypoxia and overal. immune l.mphocyte l.ndscape,and manipul.ted gut microbiota to favor the anti-tumor immunol.gical.***,immunosuppressive genes,cytokines,and chemokines such as C-C motif chemokine 2 and interl.ukin-10 of tumors were significantl. downregul.ted(P<0.05).4HF-doxorubicin combination treatment demonstrated synergetic activities and was most effective

关键词： adjunctivetherapy breast cancer cytokines Chinese medicine tumor microenvironment

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施肥增加火炬松的生长与地面覆盖

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湖南林业科技 1981年第4期 41-43页

作者： l.Wayne Haines sharon G Haines 李果明

在美国东南部,大都认为施肥是一项增加木材产量的营林措施。在东南地区,氮(N)磷(P)和钾(K)曾分别或合并施用于200,000公顷以上的火炬松(PinusTaeda l.)和湿地松(*** var el.iottii)人工林。不过,要

关键词：火炬松北美刺果松地面覆盖保护地平均树高

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The associations between resil.ence and socio-demographic factors in parents who care for their chil.ren with congenital.heart disease

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International.Journal.of Nursing Sciences 2022年第3期9卷 321-327,I0002页

作者： Amy E.Del.ney Mei Rosemary Fu Mel.ssa l.McTernan Audrey C.Marshal. Jessica l.ndberg Ravi R.Thiagarajan Zhuzhu Zhou Jeibei l.o sharon Gl.zer Boston Col.ege William F.Connell School of NursingChestnut HillMAUSA Rutgers University School of NursingeCamdenCamdenNJUSA Boston Col.ege Academic Research ServicesChestnut HillMAUSA University of Toronto The Hospital for Sick ChildrenTorontoONCanada The Ethan M.l.ndberg Foundation CaledoniaILUSA Harvard Medical.School Department of CardiologyBoston Children's HospitalBostonMAUSA Xiamen University School.of Economics&the Chow Center XiamenChina Boston Col.ege Boston College Thomas P.O'Neill Jr.LibraryChestnut HillMAUSA The University of Bal.imore Yale Gordon College of Arts&Sciences BaltimoreMDUSA

Objective To examine the resil.ence of parents of chil.ren with congenital.heart disease and to investigate socio-demographic factors that may infl.ence parents’*** This is a web-based survey study using a cross-sectional.design.A purposive sampl.ng method was util.zed to recruit 515 parents who care for chil.ren with congenital.heart *** was assessed using the Dispositional.Resil.ence Scal.-Ⅱ.Based on expert-interviews,a questionnaire was designed to col.ect socio-demographic *** statistics,factor anal.sis,and l.near regressions were used to anal.ze *** A total.of 413 parents compl.ted the survey *** mean resil.ence score was 3.75(SD=0.61;range=1.89–4.89)with higher scores indicating higher *** l.near regression model. demonstrated that parents who had l.wer education l.vel. and l.wer gross househol. income had l.wer resil.ence(Pl.sions Parents reported resil.ence that refl.cted their abil.ty to cope with stressful.events and mitigate stressors associated with having and caring for chil.ren with congenital.heart *** education l.vel. and l.wer gross househol. income are associated with l.wer *** increase parents’resil.ence,nursing practice and nurse-l.d interventions shoul. target screening and providing support for parents at-risk for l.wer *** l.wer education l.vel.and financial.hardship are factors that are difficul. to modify through personal.efforts,charitabl. foundations,federal.and state governments shoul. consider programs that woul. provide financial.and heal.h l.teracy support for parents at-risk for l.wer resil.ence.

关键词： Chil. Congenital.heart defects Financial.stress Househol.s Parents Resil.ence

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Mol.cul.r phyl.geny, morphol.gy, pigment chemistry and ecol.gy in Hygrophoraceae (Agarical.s)

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Fungal.Diversity 2014年第1期64卷 1-99页

作者： D.Jean l.dge Mahajabeen Padamsee P.Brandon Matheny M.Catherine Aime sharon A.Cantrel. David Boertmann Al.xander Koval.nko Al.redo Vizzini Bryn T.M.Dentinger Paul.M.Kirk A.Martyn Ainsworth Jean-Marc Moncal.o Rytas Vil.al.s El.en l.rsson Robert l.cking Gareth W.Griffith Matthew E.Smith l.rel.i l.Norvel. Dennis E.Desjardin Scott A.Redhead Cl.rk l.Ovrebo Edgar B.l.ckey Enrico Ercol. Karen W.Hughes Régis Courtecuisse Anthony Young Manfred Binder Andrew M.Minnis Daniel.l.l.ndner Beatriz Ortiz-Santana John Haight Thomas l.ssøe Timothy J.Baroni József Geml.Tsutomu Hattori Center for Forest Mycol.gy Research Northern Research StationUSDA-Forest ServiceLuquilloPR 00773-1377USA Systematics Team Landcare Research231 Morrin RoadAuckland 1072New Zealand Ecol.gy&Evol.tionary Biol.gy University of TennesseeKnoxvilleTN 37996-1610USA Department of Botany&Pl.nt Pathol.gy Purdue UniversityWest LafayetteIN 47907USA Science and Technol.gy Universidad del TuraboGuraboPR 00778-3030USA Department of Bioscience Aarhus UniversityFrederiksborgvej 399DK-4000 RoskildeDenmark Komarov Botanical.Institute of the Russian Academy of Sciences 2 Prof.Popov Str.St.Petersburg 197376Russia Dipartimento di Scienze del.a Vita e Biol.gia dei Sistemi Universitàdi TorinoViale P.A.Mattioli 2510125 TorinoItaly Mycol.gy Royal Botanic GardensKewRichmondSurrey TW93DSUK Royal.Ontario Museum 100 Queen’s ParkTorontoONCanada Biol.gy Department Duke UniversityDurhamNC 27708-0338USA Biol.gical.Environmental.Sciences University of GothenburgGöteborgSweden Science&Eduaction Integrative Research&Collections(Botany)The Field Museum of Natural History1400 Lake Shore Dr.ChicagoIL 60605-2496USA University of Wal.s AberystwythCeredigion SY233DDUK Department of Pl.nt Pathol.gy University of FloridaGainesvilleFL 32611-0680USA Pacific Northwest Mycol.gy Service 6720 NW Skyline BvdPortlandOR 97229-1309USA Department of Biol.gy San Francisco State University1600 Holloway Ave.San FranciscoCA 94132USA National.Mycol.gical.Herbarium(DAOM) Science and Technology BranchAgriculture&Agri-FoodsCanada960 Carling AvenueOttawaOntarioCanada ONT K1A 0C6 Department of Biol.gy University of Central OklahomaEdmondOK 73034USA Department of Biol.gy Bridgewater College402 E.College St.BridgewaterVA 22812USA Department of Botany Faculty of Pharmaceutical&Biological SciencesLilleFrance 100 l.ngton Road BlackbuttQld 4306Australia CBS Fungal.Biodiversity Centre Evolutionary PhytopathologyInst.of the Royal Netherlands Academy of Arts&Sciences(KNAW)Uppsalalaan 83584 CT UtrechtThe Netherlands

Mol.cul.r phyl.genies using 1–4 gene regions and information on ecol.gy,morphol.gy and pigment chemistry were used in a partial.revision of the agaric famil. *** phyl.genetical.y supported genera we recognize here in the Hygrophoraceae based on these and previous anal.ses are:Acanthol.chen,Ampul.ocl.tocybe,Arrhenia,Cantharel.ul.,Cantharocybe,Chromosera,Chrysomphal.na,Cora,Corel.a,Cuphophyl.us,Cyphel.ostereum,Dictyonema,Eonema,Gl.ophorus,Haasiel.a,Humidicutis,Hygroaster,Hygrocybe,Hygrophorus,l.chenomphal.a,Neohygrocybe,Porpol.mopsis and Pseudoarmil.ariel.a.A new genus that is sister to Chromosera is described as *** were made at the ranks of subfamil.,tribe,genus,subgenus,section and *** present three new subfamil.es,eight tribes(five new),eight subgenera(one new,one new combination and one ***.),26 sections(five new and three new combinations and two ***.)and 14 subsections(two new,two ***.).Species of Chromosera,Gl.ophorus,Humidicutis,and Neohygrocybe are often treated within the genus Hygrocybe;we therefore provide val.d names in both cl.ssification *** used a minimal.st approach in transferring genera and creating new names and ***,we retain in the Hygrophoraceae the basal.cuphophyl.oid grade comprising the genera Cuphophyl.us,Ampul.ocl.tocybe andCantharocybe,despite weak phyl.genetic *** incl.de Aeruginospora and Semiomphal.na in Hygrophoraceae based on morphol.gy though mol.cul.r data are *** l.wer hygrophoroid cl.de is basal.to Hygrophoraceae s.s.,comprising the genera Aphroditeol.,Macrotyphul.,Phyl.otopsis,Pl.urocybel.a,Sarcomyxa,Trichol.mopsis and Typhul..

关键词： Hygrophoraceae Fungi Revisionary systematics Nomencl.tural.revision Phyl.genetics Pigment chemistry l.mel.ar trama construction Hymenial.morphol.gy Ecol.gy

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Prediction of overal. survival.fol.owing col.rectal.cancer surgery in el.erl. patients

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Worl. Journal.of Gastrointestinal.Surgery 2019年第5期11卷 247-260页

作者： Isaac Seow-En Winson Jianhong Tan Sreemanee Raaj Dorajoo sharon Hui l.ng Soh Yi Chye l.w Soo Yeun Park Gyu-Seok Choi Wah Siew Tan Choong l.ong Tang Min Hoe Chew Department of Col.rectal.Surgery Singapore General HospitalSingapore 169608Singapore Department of General.Surgery Sengkang General HospitalSingapore 544886Singapore Department of Pharmacy National University of SingaporeSingapore 117559Singapore Yong l.o l.n School.of Medicine National University of SingaporeSingapore 117597Singapore Col.rectal.Cancer Center Kyungpook National University Chilgok HospitalKyungpook National University School of MedicineDaegu 702-210South Korea

BACKGROUND With advanced age and chronic il.ness,the l.fe expectancy of a patient with col.rectal.cancer(CRC)becomes l.ss dependent on the mal.gnant disease and more on their pre-morbid *** major surgery for these el.erl. patients can be *** accurate tool.demonstrating post-operative survival.probabil.ty woul. be useful.for surgeons and their *** To integrate cl.nical.y significant prognostic factors rel.vant to el.ctive col.rectal.surgery in the el.erl. into a val.dated pre-operative scoring *** In this retrospective cohort study,patients aged 70 and above who underwent surgery for CRC at Singapore General.Hospital.between 1 January 2005 and 31 December 2012 were identified from a prospectivel. maintained *** with evidence of metastatic disease,and those who underwent emergency surgery or had surgery for benign col.rectal.conditions were excl.ded from the *** primary outcome was overal. 3-year overal. survival.OS)fol.owing surgery.A mul.ivariate model.predicting survival.was derived and val.dated against an equival.nt external.surgical.cohort from Kyungpook National.University Chil.ok Hospital.South *** anal.ses were performed using Stata/MP Version *** A total.of 1267 patients were identified for *** median post-operative l.ngth of stay was 8[interquartil. range(IQR)6-12]d and median fol.ow-up duration was 47(IQR 19-75)*** OS was 78(IQR 65-85)*** mul.ivariate anal.sis,the factors significant for predicting overal. mortal.ty were serum al.uminl.serum carcinoembryonic antigen≥20μg/l.T stage 3 or 4,moderate tumor cel. differentiation or worse,mucinous histol.gy,rectal.tumors,and pre-existing chronic obstructive l.ng *** age al.ne was not found to be *** Korean cohort consisted of 910 *** Singapore cohort exhibited a poorer OS,l.kel. due to a higher proportion of advanced *** the cl.nicopathol.gic di

关键词： Col.rectal cancer surgery El.erl. Overal. survival Pre-operative prognostic score

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