Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transg...Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transgender patients. Few studies address the successful implementation of transgender healthcare teaching and education in graduate medical education. Purpose: The purpose was to design an online asynchronous curriculum to address the need for improved transgender healthcare education in graduate medical education and assess change in knowledge and comfort in transgender healthcare for residents and fellow learners. Methods: A 6-module curriculum was developed using established guidelines and ACGME competencies as a framework for content. To assess curriculum effectiveness, participants received anonymous pre- and post-curriculum surveys which included a multiple-choice knowledge assessment, Likert scale comfort questions focusing on healthcare skills, and open-ended feedback questions. Results: Twenty-six internal medicine residents and fellows participated in the curriculum (2022-2023). There was a 69% post-survey response rate. Participants improved their gender-affirming knowledge after completing the curriculum (p Conclusion: This online curriculum was successful in increasing knowledge and comfort in transgender care for IM residents and fellows. It provides a promising framework to address this gap in curricular content.展开更多
Junwang(John)Tang(唐军旺).Prof.Junwang(John)Tang obtained his Ph.D.in physical chemistry from the Dalian Institute of Chemical Physics(DICP),Chinese Academy of Sciences,in 2001.He is currently a Member of the Academy ...Junwang(John)Tang(唐军旺).Prof.Junwang(John)Tang obtained his Ph.D.in physical chemistry from the Dalian Institute of Chemical Physics(DICP),Chinese Academy of Sciences,in 2001.He is currently a Member of the Academy of Europe,a Fellow of the European Academy of Sciences,a Fellow of the Royal Society of Chemistry(RSC),and a Fellow of the Institute of Materials,Minerals,and Mining(FIMMM).展开更多
AIM:To study the vitreo-retinal interface and macular changes on optical coherence tomography(OCT) in the fellow eyes of patients with macular hole.·METHODS:Patients with idiopathic macular hole in one or both ey...AIM:To study the vitreo-retinal interface and macular changes on optical coherence tomography(OCT) in the fellow eyes of patients with macular hole.·METHODS:Patients with idiopathic macular hole in one or both eyes presented to our institute between January 2003 and December 2009 were evaluated retrospectively.Demographic details,best-corrected visual acuity and vitreo-retinal interface,and macular changes of the fellow eye on OCT were studied.·RESULTS:Seventy patients underwent OCT of both eyes during the study period.The average age group was 61.96 years and 35(50%) were females.Among the fellow eyes,normal foveal contour was noted in 36(51.4%) eyes and 34(48.6%) eyes were observed to have vitreo-retinal interface changes.Of them,13(18.6%) eyes had some stage of full thickness macular hole and 21(30.0%) eyes had interface changes.There was no statistical correlation between involved eye lesions(P =0.64) or visual acuity(P =0.55) as predictors of development of either fellow eye lesions or poor visual acuity.·CONCLUSION:There is a significant chance of having vitreo-retinal interface findings in the fellow eyes of patients presenting with macular hole.OCT should be considered in both eyes of patients with macular hole to detect early changes in the fellow eyes,which may require an early intervention.展开更多
儿科放射学分阶段目标胜任力评价系统(Pediatric Radiology Milestone Project,PRMP)由美国毕业后医学教育认证委员会(Accreditation Council for Graduate Medical Education,ACGME)与美国放射学会(American Board of Radiology,ABR)...儿科放射学分阶段目标胜任力评价系统(Pediatric Radiology Milestone Project,PRMP)由美国毕业后医学教育认证委员会(Accreditation Council for Graduate Medical Education,ACGME)与美国放射学会(American Board of Radiology,ABR)联合发布,是放射学住院医师儿科亚专业方向培训考核系统的一部分,该考核评价体系考核并记录放射学住院医师在儿科亚专业方向培训过程中所必须具备的六项胜任力,包括病患关切(Patient Care,PC)、医学知识(Medical Knowledge,MK)、基于系统的实践(Systems-based Practice,SBP)、基于实践的学习(Practice-based Learning,PBL)、职业素养(Professionalism,PROF)以及人际关系和沟通技巧(Interpersonal and Communication Skills,ICS)。考核内容全方位展示了美国放射学住院医师儿科亚专业方向胜任力培训的要点,值得国内住院医师培训机构学习和借鉴,对于完善国内培训机构考核方式及内容具有重要的指导价值。展开更多
Good evening.Today,our fellow citizens,ourway of life,our very freedom cameunder attack in a series of deliberateand deadly terrorist acts.Thevictims were in airplanes or in theiroffices:secretaries,businessmenand wom...Good evening.Today,our fellow citizens,ourway of life,our very freedom cameunder attack in a series of deliberateand deadly terrorist acts.Thevictims were in airplanes or in theiroffices:secretaries,businessmenand women,military and展开更多
狄金森为美国文学作出"重大独创性贡献"。解读其第986首诗A Narrow Fellow in the Grass,就会发觉无论第一人称和第二人称视角的交替叙事,经验自我和叙述自我之间的张力,还是外聚焦和内聚焦之间的灵活转换,都反映出少年时期...狄金森为美国文学作出"重大独创性贡献"。解读其第986首诗A Narrow Fellow in the Grass,就会发觉无论第一人称和第二人称视角的交替叙事,经验自我和叙述自我之间的张力,还是外聚焦和内聚焦之间的灵活转换,都反映出少年时期和成年时期的"我"对"蛇"看法的巨大转变,从当初对大自然的"亲近喜爱"之情到现在的"恐惧敬畏"心理,表达了作者对"人与自然"关系的理性思考,从而强化了"人与自然并非总是和谐共处"这一深刻主题。可以说第986首诗的杰出叙事艺术对作品主题意义的建构起到了极大作用,并给学界研究狄金森作品的现代性写作特征提供了很好的范例。展开更多
Aim: To examine the profile and presentation of a consecutive series of giant retinal tears (GRTs) in an African population. Also to review the clinical state of the patient’s fellow eyes. Method: A retrospective obs...Aim: To examine the profile and presentation of a consecutive series of giant retinal tears (GRTs) in an African population. Also to review the clinical state of the patient’s fellow eyes. Method: A retrospective observational case series of thirty-six consecutive eyes of 36 patients with a GRT retina detachment that had vitreoretina surgery done between April 2006 and June 2013. All information was extracted from the patient’s case records. Result: Thirty-nine case records had surgery consecutively within the study period. Three case records had incomplete data and were excluded from the analysis. Thirty-six eyes were analyzed. There were mostly males (80.6%), age range 21 - 65 yrs (mean age 47 yrs). The commonest etiology was idiopathic (21 eyes). Presenting visual acuity was mostly in the counting finger and hand motion range (83%), and the mean presenting intraocular pressure was 6.8 mmHg. Most of the eyes presented with a total retina detachment (4 quadrant involvement;56%), macular involvement (96%), commonest size of the retina tear being between 90 to 180 degrees in 20 eyes;rolled over retina flap (61%) and advanced grades of PVR being very common (83%). The commonest fellow eye event noted was blindness in 16 fellow eyes;while 12 eyes had prophylactic retina laser photocoagulation to peripheral predisposing retina lesions. Conclusion: The presentation of GRT in a low resource country is often as a complex retina detachment situation, which may arise from frequent delays to assess care and other socioeconomic issues. This carries significant implications on prognosis following surgical intervention. Also this study raises the awareness that fellow eyes of GRT in Africa are at increased risk of blindness and require more careful attention.展开更多
When the earthquake curred,this man led on his fellow villagers to rescue three children from the debris without going home to take care of his wife and his own fallen house.He is well known as a"full-time"P...When the earthquake curred,this man led on his fellow villagers to rescue three children from the debris without going home to take care of his wife and his own fallen house.He is well known as a"full-time"Party Secretary,because in order to live up to展开更多
To test the hypothesis that latency delay in the fellow eyes of optic neuritis（ON） patients and to compensate for delayed transmission of visual information, latency change of multi-focal visual evoked potential（mf...To test the hypothesis that latency delay in the fellow eyes of optic neuritis（ON） patients and to compensate for delayed transmission of visual information, latency change of multi-focal visual evoked potential（mf VEP） traces in fellow eyes of 15 ON patients were analyzed. Patients with low risk（LR） for developing multiple sclerosis（MS） were examined separately from MS patients to isolate effect of cortical plasticity from potential pathological changes in disseminated disease. The small increase in latency in fellow eyes of LR group was statistically not significant. In MS patients, the latency was significantly delayed（P〈0.02）. The magnitude of the latency change in the fellow eyes did not correlate with the severity of latency delay in the affected eyes（R^2〈0.02, P=0.3）. The differences between ON patients with and without MS, reported here, suggest that the presence of disseminated disease plays critical role in latency delay of the fellow eye.展开更多
For more than an hour, a little guy sat at a bar staring into his glass. Suddenly a burly truck driver sat down next to him, grabbed the guy’s drink and gulped it down. The poor little fellow burst into tears. 'O...For more than an hour, a little guy sat at a bar staring into his glass. Suddenly a burly truck driver sat down next to him, grabbed the guy’s drink and gulped it down. The poor little fellow burst into tears. 'Oh, come on, pal,' the trucker said. 'I was just joking. Here, I’’ll buy you another.'展开更多
腹部放射学分阶段目标胜任力评价系统(The Abdominal Radiology Milestone Project),是由美国毕业后医学教育认证委员会(The Accreditation Council for Graduate Medical Education,ACGME)与美国放射学会(The American Board of Radiol...腹部放射学分阶段目标胜任力评价系统(The Abdominal Radiology Milestone Project),是由美国毕业后医学教育认证委员会(The Accreditation Council for Graduate Medical Education,ACGME)与美国放射学会(The American Board of Radiology,ABR)联合倡议发起的用于评价放射学专科医师培训考核系统的一部分,该考核评价体系考核并记录腹部放射学专科医师在培训过程中所须具备六项胜任力,包括病患关切(Patient Care,PC),医学知识(Medical Knowledge,MK),基于系统的实践(Systems-based Practice,SBP),基于实践的学习(Practice-based Learning,PBL)、职业素养(Professionalism,PROF),人际关系和沟通技巧(Interpersonal and Communication Skills,ICS)。另外,评价系统指出了多种放射亚专业评估工具,对于完善国内培训机构考核方式与内容,有着积极的指导价值。展开更多
Prof.Zhifang Chai,born in October 1942,is a radioanalytical chemist working at the Institute of High Energy Physics,Chinese Academy of Sciences and Soochow University.He graduated from Fudan University in 1964.As an A...Prof.Zhifang Chai,born in October 1942,is a radioanalytical chemist working at the Institute of High Energy Physics,Chinese Academy of Sciences and Soochow University.He graduated from Fudan University in 1964.As an Alexander von Humboldt Foundation fellow,he worked at Cologne University,Germany from1980 to 1982.展开更多
There have been rapid developments in gastroenterology(GE)over the last decade.Up until the late 1980s,GE-training was incorporated in Internal Medicine training.The introduction of endoscopy has necessitated the need...There have been rapid developments in gastroenterology(GE)over the last decade.Up until the late 1980s,GE-training was incorporated in Internal Medicine training.The introduction of endoscopy has necessitated the need for additional training.Around the world different national boards have developed their own curricula which will be discussed in this paper. Emphasis will be placed on the curriculum recently introduced in The Netherlands.The internal medicine component has become a two-year requirement (Common Trunk)and the duration of training in GE has been extended to four years.Because of the growing complexity of GE,there are now four subspecialties:Interventional Endoscopy,Neuromotility, Oncology and Hepatology that trainees can choose from.These subspecialties each have predefined specific requirements.The World Gastroenterology Organization has drawn up a standard curriculum which can be of help to the boards in different countries. The curriculum emphasizes the knowledge and skill components.The curriculum also defines the training recommendations,the requirements of training facilities and competence evaluation of fellows and facilities,while less is said about research,finance and the number of gastroenterologists required.In the coming decades the curriculum will need to be revised continuously.Personalization of the curriculum will be the next challenge for the years to come.展开更多
文摘Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transgender patients. Few studies address the successful implementation of transgender healthcare teaching and education in graduate medical education. Purpose: The purpose was to design an online asynchronous curriculum to address the need for improved transgender healthcare education in graduate medical education and assess change in knowledge and comfort in transgender healthcare for residents and fellow learners. Methods: A 6-module curriculum was developed using established guidelines and ACGME competencies as a framework for content. To assess curriculum effectiveness, participants received anonymous pre- and post-curriculum surveys which included a multiple-choice knowledge assessment, Likert scale comfort questions focusing on healthcare skills, and open-ended feedback questions. Results: Twenty-six internal medicine residents and fellows participated in the curriculum (2022-2023). There was a 69% post-survey response rate. Participants improved their gender-affirming knowledge after completing the curriculum (p Conclusion: This online curriculum was successful in increasing knowledge and comfort in transgender care for IM residents and fellows. It provides a promising framework to address this gap in curricular content.
文摘Junwang(John)Tang(唐军旺).Prof.Junwang(John)Tang obtained his Ph.D.in physical chemistry from the Dalian Institute of Chemical Physics(DICP),Chinese Academy of Sciences,in 2001.He is currently a Member of the Academy of Europe,a Fellow of the European Academy of Sciences,a Fellow of the Royal Society of Chemistry(RSC),and a Fellow of the Institute of Materials,Minerals,and Mining(FIMMM).
文摘AIM:To study the vitreo-retinal interface and macular changes on optical coherence tomography(OCT) in the fellow eyes of patients with macular hole.·METHODS:Patients with idiopathic macular hole in one or both eyes presented to our institute between January 2003 and December 2009 were evaluated retrospectively.Demographic details,best-corrected visual acuity and vitreo-retinal interface,and macular changes of the fellow eye on OCT were studied.·RESULTS:Seventy patients underwent OCT of both eyes during the study period.The average age group was 61.96 years and 35(50%) were females.Among the fellow eyes,normal foveal contour was noted in 36(51.4%) eyes and 34(48.6%) eyes were observed to have vitreo-retinal interface changes.Of them,13(18.6%) eyes had some stage of full thickness macular hole and 21(30.0%) eyes had interface changes.There was no statistical correlation between involved eye lesions(P =0.64) or visual acuity(P =0.55) as predictors of development of either fellow eye lesions or poor visual acuity.·CONCLUSION:There is a significant chance of having vitreo-retinal interface findings in the fellow eyes of patients presenting with macular hole.OCT should be considered in both eyes of patients with macular hole to detect early changes in the fellow eyes,which may require an early intervention.
文摘儿科放射学分阶段目标胜任力评价系统(Pediatric Radiology Milestone Project,PRMP)由美国毕业后医学教育认证委员会(Accreditation Council for Graduate Medical Education,ACGME)与美国放射学会(American Board of Radiology,ABR)联合发布,是放射学住院医师儿科亚专业方向培训考核系统的一部分,该考核评价体系考核并记录放射学住院医师在儿科亚专业方向培训过程中所必须具备的六项胜任力,包括病患关切(Patient Care,PC)、医学知识(Medical Knowledge,MK)、基于系统的实践(Systems-based Practice,SBP)、基于实践的学习(Practice-based Learning,PBL)、职业素养(Professionalism,PROF)以及人际关系和沟通技巧(Interpersonal and Communication Skills,ICS)。考核内容全方位展示了美国放射学住院医师儿科亚专业方向胜任力培训的要点,值得国内住院医师培训机构学习和借鉴,对于完善国内培训机构考核方式及内容具有重要的指导价值。
文摘Good evening.Today,our fellow citizens,ourway of life,our very freedom cameunder attack in a series of deliberateand deadly terrorist acts.Thevictims were in airplanes or in theiroffices:secretaries,businessmenand women,military and
文摘狄金森为美国文学作出"重大独创性贡献"。解读其第986首诗A Narrow Fellow in the Grass,就会发觉无论第一人称和第二人称视角的交替叙事,经验自我和叙述自我之间的张力,还是外聚焦和内聚焦之间的灵活转换,都反映出少年时期和成年时期的"我"对"蛇"看法的巨大转变,从当初对大自然的"亲近喜爱"之情到现在的"恐惧敬畏"心理,表达了作者对"人与自然"关系的理性思考,从而强化了"人与自然并非总是和谐共处"这一深刻主题。可以说第986首诗的杰出叙事艺术对作品主题意义的建构起到了极大作用,并给学界研究狄金森作品的现代性写作特征提供了很好的范例。
文摘Aim: To examine the profile and presentation of a consecutive series of giant retinal tears (GRTs) in an African population. Also to review the clinical state of the patient’s fellow eyes. Method: A retrospective observational case series of thirty-six consecutive eyes of 36 patients with a GRT retina detachment that had vitreoretina surgery done between April 2006 and June 2013. All information was extracted from the patient’s case records. Result: Thirty-nine case records had surgery consecutively within the study period. Three case records had incomplete data and were excluded from the analysis. Thirty-six eyes were analyzed. There were mostly males (80.6%), age range 21 - 65 yrs (mean age 47 yrs). The commonest etiology was idiopathic (21 eyes). Presenting visual acuity was mostly in the counting finger and hand motion range (83%), and the mean presenting intraocular pressure was 6.8 mmHg. Most of the eyes presented with a total retina detachment (4 quadrant involvement;56%), macular involvement (96%), commonest size of the retina tear being between 90 to 180 degrees in 20 eyes;rolled over retina flap (61%) and advanced grades of PVR being very common (83%). The commonest fellow eye event noted was blindness in 16 fellow eyes;while 12 eyes had prophylactic retina laser photocoagulation to peripheral predisposing retina lesions. Conclusion: The presentation of GRT in a low resource country is often as a complex retina detachment situation, which may arise from frequent delays to assess care and other socioeconomic issues. This carries significant implications on prognosis following surgical intervention. Also this study raises the awareness that fellow eyes of GRT in Africa are at increased risk of blindness and require more careful attention.
文摘When the earthquake curred,this man led on his fellow villagers to rescue three children from the debris without going home to take care of his wife and his own fallen house.He is well known as a"full-time"Party Secretary,because in order to live up to
基金Supported by Save Neuron Grant(Novartis)Grants from Biogen Idec,Sydney Eye Hospital FoundationKing Saud University
文摘To test the hypothesis that latency delay in the fellow eyes of optic neuritis（ON） patients and to compensate for delayed transmission of visual information, latency change of multi-focal visual evoked potential（mf VEP） traces in fellow eyes of 15 ON patients were analyzed. Patients with low risk（LR） for developing multiple sclerosis（MS） were examined separately from MS patients to isolate effect of cortical plasticity from potential pathological changes in disseminated disease. The small increase in latency in fellow eyes of LR group was statistically not significant. In MS patients, the latency was significantly delayed（P〈0.02）. The magnitude of the latency change in the fellow eyes did not correlate with the severity of latency delay in the affected eyes（R^2〈0.02, P=0.3）. The differences between ON patients with and without MS, reported here, suggest that the presence of disseminated disease plays critical role in latency delay of the fellow eye.
文摘For more than an hour, a little guy sat at a bar staring into his glass. Suddenly a burly truck driver sat down next to him, grabbed the guy’s drink and gulped it down. The poor little fellow burst into tears. 'Oh, come on, pal,' the trucker said. 'I was just joking. Here, I’’ll buy you another.'
文摘腹部放射学分阶段目标胜任力评价系统(The Abdominal Radiology Milestone Project),是由美国毕业后医学教育认证委员会(The Accreditation Council for Graduate Medical Education,ACGME)与美国放射学会(The American Board of Radiology,ABR)联合倡议发起的用于评价放射学专科医师培训考核系统的一部分,该考核评价体系考核并记录腹部放射学专科医师在培训过程中所须具备六项胜任力,包括病患关切(Patient Care,PC),医学知识(Medical Knowledge,MK),基于系统的实践(Systems-based Practice,SBP),基于实践的学习(Practice-based Learning,PBL)、职业素养(Professionalism,PROF),人际关系和沟通技巧(Interpersonal and Communication Skills,ICS)。另外,评价系统指出了多种放射亚专业评估工具,对于完善国内培训机构考核方式与内容,有着积极的指导价值。
文摘Prof.Zhifang Chai,born in October 1942,is a radioanalytical chemist working at the Institute of High Energy Physics,Chinese Academy of Sciences and Soochow University.He graduated from Fudan University in 1964.As an Alexander von Humboldt Foundation fellow,he worked at Cologne University,Germany from1980 to 1982.
文摘There have been rapid developments in gastroenterology(GE)over the last decade.Up until the late 1980s,GE-training was incorporated in Internal Medicine training.The introduction of endoscopy has necessitated the need for additional training.Around the world different national boards have developed their own curricula which will be discussed in this paper. Emphasis will be placed on the curriculum recently introduced in The Netherlands.The internal medicine component has become a two-year requirement (Common Trunk)and the duration of training in GE has been extended to four years.Because of the growing complexity of GE,there are now four subspecialties:Interventional Endoscopy,Neuromotility, Oncology and Hepatology that trainees can choose from.These subspecialties each have predefined specific requirements.The World Gastroenterology Organization has drawn up a standard curriculum which can be of help to the boards in different countries. The curriculum emphasizes the knowledge and skill components.The curriculum also defines the training recommendations,the requirements of training facilities and competence evaluation of fellows and facilities,while less is said about research,finance and the number of gastroenterologists required.In the coming decades the curriculum will need to be revised continuously.Personalization of the curriculum will be the next challenge for the years to come.
