What Gets Lost in the Numbers: A Case Study of the Experiences and Perspectives of Black and Latino Faculty in Academic Medicine

The doctoral research examines the experiences and perceptions of underrepresented minority faculty in academic medicine through a case study approach. The study focuses on several stages as presented through a model referred to as the faculty life cycle. Specifically, the study addresses the socialization, mentoring, and professional development experiences of URM faculty in academic medicine. How do URM faculty experience their environment, culture, and climate in academic medicine? And what is their perception of the impact of diversity and inclusion initiatives and offices in academic medicine? This study utilizes the conceptual frameworks of Inclusive Excellence (IE} and Culturally Engaging Campus Environments (CECE}. Analysis of the experiences and perspectives is accomplished through an intentional view of the organization (IE} while simultaneously examining the importance of culturally relevant environments in academic medicine (CECE}. Findings demonstrate that socialization, mentoring and faculty development are of extreme importance to URM faculty in academic medicine in ways that affect their perspectives on diversity and inclusion, organizational structures, culture and climate, and academic advancement. The findings describe a win or lose academic medicine culture and institutional climate plagued with challenges and misalignment with URM faculty values. Moreover, socialization into academic medicine impacts URM faculty sense of belonging and identity, and demand extraordinary self-agency and resilience. Identity as URM faculty is forced upon by the institution and adversely adds another layer to already complex intersectionalities. URM faculty mentoring is enriched by informal mentoring and shapes their own identities as mentors. Furthermore, URM faculty need development programs that acknowledge the differences in experience and create spaces for networking, affirmation and accountability. Overall, these experiences relayed by URM faculty voices inform the institution and academic medicine about its environment. Conclusions and recommendations craft the next research and practical agendas in support of URM faculty in academic medicine

Quimio-radioterapia sequencial no carcinoma pulmonar não de pequenas células: estudo retrospectivo de 100 doentes

ABSTRACTCombined chemotherapy and radiotherapy has shown to be the correct treatment of unresectable non-small cell lung cancer, aier many years of poor survival figures with standard radiotherapy alone. It has also been demonstrated that the benefit of chemotherapy is mainly achieved if cisplatin-based schedules are used. The authors present a retrospective study of 100 cases of stage III non-small cell lung cancer treated with a sequential approach of chemotherapy and radiotherapy and evaluate median and overall survival, local progression-free survival and distant progression-free survival.The results of our series are quite similar to those published in literature.REV PORT PNEUMOL 2003; IX (3): 215-22

Pneumonia organizativa – Experiência da consulta de um hospital central

AbstractAim: to characterise outpatients of a Portuguese central hospital diagnosed with organising pneumonia (OP) and compare results with current literature. Methods: medical processes with diagnosis of OP were retrospectively studied as to demographics, aetiology, clinical and radiological features, average time until and date of diagnosis, laboratory and histological changes, treatment and relapse. Results – thirteen patients with a mean follow-up of 171.6weeks (max 334 and min 28 weeks) were evaluated. Nine of these patients (70%) had cryptogenic OP (COP) while 30% had secondary OP (SOP), two with rheumatoid arthritis, one with dermatomyositis and another undergoing radiotherapy for breast cancer. Mean age was 55.6 (+-15.3years), 92% female, 77% were non-smokers. Average time until diagnosis was 77.2weeks (min 3 and max 432 weeks). Symptoms at presentation were tiredness (92%), cough (85%), fever (65%), shortness of breath (54%), thoracic pain (23%) and weight loss (23%). At the time of diagnosis, the mean erythrocyte sedimentation rate was 70mm (max 170mm and min 16mm). C-reactive protein level was increased in eight patients. Significant leucocytosis was absent. Chest X-ray and chest CT scan showed bilateral distribution in 12 patients (92%). Consolidation with an air bronchogram was present in 12 patients and in four (31%), consolidation was migratory. Four patients (30%) underwent transbronchial pulmonary biopsy, all uncharacteristic and eight patients surgical pulmonary biopsy, four showed histological confirmation of SOP. Corticosteroids were started in 11 patients and average treatment was 61.6weeks (16-288 weeks). 15% (2/13) had spontaneous resolution. Four patients (31%) relapsed, one of them five times. Two patients are dependent on a low dose of corticosteroids, one due to underlying disease and another due to multiple relapses. Therapy of relapse was corticosteroids alone in minimum effective dosage or associated to azathioprine or ciclosporin. Discussion and conclusion: such a high incidence in females (92%) may be explained by the limited sample of patients. In 70% of the patients diagnosis were established by clinical and radiology criteria. Mean time to diagnosis was very variable which suggests that in some cases the disease was not diagnosed and treated as another interstitial lung disease or as recurrent pneumonia. Most patients (53.8%) had a favourable clinical course after treatment with corticosteroids with a very low number of relapses (30.8%), much lower than described by other authors (60%). Only in experienced centres should the diagnosis of OP established by clinical and radiological criteria.Rev Port Pneumol 2010; XVI (3): 369-38

A evidência de dor nas pessoas com deterioração cognitiva internadas numa unidade de longa duração

A dor e as alterações de comportamento são altamente prevalentes nas pessoas com o diagnóstico de demência e alguns estudos demonstram a sua correlação. Sobretudo nas situações de maior severidade desta doença onde abundam os problemas de comunicação a dor pode estar subtratada e consequentemente ser fator de perturbação de comportamento. Este trabalho tem como objetivo identificar a prevalência de dor e a relação entre os episódios de dor e as variáveis sociodemográficas, clinicas e funcionais das 80 pessoas residentes numa Unidade de longa duração (ULSD) do Centro de França. Os métodos utilizados foram a construção de guião orientador para a colheita de dados de variáveis sociodemográficas, clinicas e funcionais através do plano de cuidados diário e da consulta do processo clínico. Para a pesquisa foi essencial a consulta através do motor de busca da Elsevier com as palavras-chave: demência, dor, alterações de comportamento e ULSD. Os resultados sugerem uma população envelhecida, sendo sobretudo mulheres viúvas, com pluripatologia e polimedicação. A dor tem uma prevalência de 70% nos residentes e a analgesia é feita diariamente

Framework for resilience analysis of EU buildings

This report summarises the activities of the JRC institutional work package related to the resilience of the European building stock. It covers the fundamental components of seismic risk assessment studies, namely hazard (national design codes and recent research results), exposure (inventory of the European building stock) and vulnerability (fragility curves for reinforced concrete and masonry buildings). In addition, the report examines the resilience of the built environment with focus on the modelling of the post-event recovery process. Lastly, a workplan to integrate these components for the analysis of the resilience of the European building stock is put forward.JRC.E.4-Safety and Security of Building

Hypoglycemic, antiglycation, and cytoprotective properties of a phenol-rich extract from waste peel of punica granatum L. Var. Dente di cavallo DC2

Pomegranate peel is a natural source of phenolics, claimed to possess healing properties, among which are antioxidant and antidiabetic. In the present study, an ethyl acetate extract, obtained by Soxhlet from the peel of Dente di Cavallo DC2 pomegranate (PGE) and characterized to contain 4% w/w of ellagic acid, has been evaluated for its hypoglycemic, antiglycation, and antioxidative cytoprotective properties, in order to provide possible evidence for future nutraceutical applications. The α-amylase and α-glucosidase enzyme inhibition, interference with advanced glycation end-products (AGE) formation, and metal chelating abilities were studied. Moreover, the possible antioxidant cytoprotective properties of PGE under hyperglycemic conditions were assayed. Phenolic profile of the extract was characterized by integrated chromatographic and spectrophotometric methods. PGE resulted able to strongly inhibit the tested enzymes, especially α-glucosidase, and exerted chelating and antiglycation properties. Also, it counteracted the intracellular oxidative stress under hyperglycemic conditions, by reducing the levels of reactive oxygen species and total glutathione. Among the identified phenolics, rutin was the most abundant flavonoid (about 4 % w/w). Present results suggest PGE to be a possible remedy for hyperglycemia management and encourage further studies to exploit its promising properties

β-hexachlorocyclohexane: a small molecule with a big impact on human cellular biochemistry

Organochlorine pesticides (OCPs) belong to a heterogeneous class of organic compounds blacklisted by the Stockholm Convention in 2009 due to their harmful impact on human health. Among OCPs, β-hexachlorocyclohexane (β-HCH) is one of the most widespread and, at the same time, poorly studied environmental contaminant. Due to its physicochemical properties, β-HCH is the most hazardous of all HCH isomers; therefore, clarifying the mechanisms underlying its molecular action could provide further elements to draw the biochemical profile of this OCP. For this purpose, LNCaP and HepG2 cell lines were used as models and were subjected to immunoblot, immunofluorescence, and RT-qPCR analysis to follow the expression and mRNA levels, together with the distribution, of key biomolecules involved in the intracellular responses to β-HCH. In parallel, variations in redox homeostasis and cellular bioenergetic profile were monitored to have a complete overview of β-HCH effects. Obtained results strongly support the hypothesis that β-HCH could be an endocrine disrupting chemical as well as an activator of AhR signaling, promoting the establishment of an oxidative stress condition and a cellular metabolic shift toward aerobic glycolysis. In this altered context, β-HCH can also induce DNA damage through H2AX phosphorylation, demonstrating its multifaceted mechanisms of action

Self-organization of (001) cubic crystal surfaces

Self-organization on crystal surface is studied as a two dimensional spinodal decomposition in presence of a surface stress. The elastic Green function is calculated for a $(001)$ cubic crystal surface taking into account the crystal anisotropy. Numerical calculations show that the phase separation is driven by the interplay between domain boundary energy and long range elastic interactions. At late stage of the phase separation process, a steady state appears with different nanometric patterns according to the surface coverage and the crystal elastic constants

β-Caryophyllene Counteracts Chemoresistance Induced by Cigarette Smoke in Triple-Negative Breast Cancer MDA-MB-468 Cells

Exposure to cigarette smoke (CS) has been associated with an increased risk of fatal breast cancers and recurrence, along with chemoresistance and chemotherapy impairment. This strengthens the interest in chemopreventive agents to be exploited both in healthy and oncological subjects to prevent or repair CS damage. In the present study, we evaluated the chemopreventive properties of the natural sesquiterpene beta-caryophyllene towards the damage induced by cigarette smoke condensate (CSC) in triple negative breast cancer MDA-MB-468 cells. Particularly, we assessed the ability of the sesquiterpene to interfere with the mechanisms exploited by CSC to promote cell survival and chemoresistance, including genomic instability, cell cycle progress, autophagy/apoptosis, cell migration and related pathways. beta-Caryophyllene was found to be able to increase the CSC-induced death of MDA-MB-468 cells, likely triggering oxidative stress, cell cycle arrest and apoptosis; moreover, it hindered cell recovery, autophagy activation and cell migration; at last, a marked inhibition of the signal transducer and activator of transcription 3 (STAT3) activation was highlighted: this could represent a key mechanism of the chemoprevention by beta-caryophyllene. Although further studies are required to confirm the in vivo efficacy of beta-caryophyllene, the present results suggest a novel strategy to reduce the harmful effect of smoke in cancer patients and to improve the survival expectations in breast cancer women

Binary metal oxides for composite ultrafiltration membranes

A new ultrafiltration membrane was developed by the incorporation of binary metal oxides inside polyethersulfone. Physico-chemical characterization of the binary metal oxides demonstrated that the presence of Ti in the TiO2?ZrO2 system results in an increase of the size of the oxides, and also their dispersity. The crystalline phases of the synthesized binary metal oxides were identified as srilankite and zirconium titanium oxide. The effect of the addition of ZrO2 can be expressed in terms of the inhibition of crystal growth of anocrystalline TiO2 during the synthesis process. For photocatalytic applications the band gap of the synthesized semiconductors was determined, confirming a gradual increase (blue shift) in the band gap as the amount of Zr loading increases. Distinct distributions of binary metal oxides were found along the permeation axis for the synthesized membranes. Particles with Ti are more uniformly dispersed throughout the membrane cross-section. The physico-chemical characterization of membranes showed a strong correlation between some key membrane properties and the spatial particle distribution in the membrane structure. The proximity of metal oxide fillers to the membrane surface determines the hydrophilicity and porosity of modified membranes. Membranes incorporating binary metal oxides were found to be promising candidates for wastewater treatment by ultrafiltration, considering the observed improvement influx and anti-fouling properties of doped membranes. Multi-run fouling tests of doped membranes confirmed the stability of permeation through membranes embedded with binary TiO2?ZrO2 particles