BACKGROUND & AIMS: :An intact embryo-maternal communication is critical for the establishment of a successful pregnancy. To date, a huge number of studies have been performed describing the complex process of embryo-maternal signaling within the uterus. However, recent studies indicate that the early embryo communicates with the oviductal cells shortly after fertilizationand that this is important for the successful establishment of pregnancy. Only if the early embryo is capable to signal the mother within a precise timeframe and to garner a response, will the embryo be able to survive and reach the uterus. This review will give an overview of all the experimental designs which have investigated embryo-maternal interaction in the oviduct. In addition to that, it will provide a comprehensive analysis of the findings to date elucidating the morphological and molecular changes in the oviduct which are induced by the presence of the early embryo highlighting how the tubal responses affect embryo development and survival.

背景与目标： : 完整的胚胎-母体交流对于成功怀孕至关重要。迄今为止，已经进行了大量研究，描述了子宫内胚胎-母体信号传导的复杂过程。然而，最近的研究表明，受精后不久，早期胚胎与输卵管细胞相通，这对于成功建立妊娠很重要。只有早期胚胎能够在精确的时间范围内向母亲发出信号并获得反应，胚胎才能存活并到达子宫。这篇综述将概述所有研究输卵管中胚胎-母体相互作用的实验设计。除此之外，它还将对迄今为止的发现进行全面分析，阐明由早期胚胎的存在引起的输卵管的形态和分子变化，突出了输卵管反应如何影响胚胎发育和存活。

BACKGROUND & AIMS: :Iopamidol-carrying liposomes were studied as potential hepatosplenographic contrast agents. Large unilamellar vesicles (0.3-1 mu) prepared from phosphatidylcholine:Dipalmotylphosphatidic acid (PC:DPPA) 9:1 and 300 MgI/mL iopamidol solution showed favorable entrapment measured as mg entrapped iodine/mg lipids (I/L). The effect of extrusion through polycarbonate membranes on liposome characteristics and in vivo distribution was investigated. Extrusion above the transition temperature of lipids reduced the average size and size distribution and increased the I/L ratio. Distribution studies of extruded and nonextruded liposomes in rats demonstrated different behavior of the preparations; extruded liposomes showed higher spleen uptake than did unextruded, while liver uptake was comparable; lung entrapment, observed with unextruded particles, was almost eliminated with extruded liposomes. Preliminary imaging studies in rats were carried out at a dose of 250 mgI/kg; typical computed tomography (CT) scans of the liver demonstrated contrast enhancement of greater than or equal to 60 HU from 90' up to 240' after injection.

背景与目标： : 研究了携带碘帕醇的脂质体作为潜在的肝脾造影造影剂。由磷脂酰胆碱: 二棕榈基磷脂酸 (PC:DPPA) 9:1和300 MgI/mL碘帕醇溶液制备的大单层囊泡 (0.3-1 mu) 显示出良好的包封作用，以mg包封的碘/mg脂质 (I/L) 测量。研究了通过聚碳酸酯膜挤出对脂质体特性和体内分布的影响。高于脂质转变温度的挤出降低了平均尺寸和尺寸分布，并增加了I/L比。大鼠中挤出和非挤出脂质体的分布研究表明制剂的行为不同; 挤出的脂质体显示出比未挤出的更高的脾脏摄取，而肝脏摄取相当; 用未挤出的颗粒观察到的肺包封几乎被挤出的脂质体消除。以250 mgI/kg的剂量在大鼠中进行了初步成像研究; 典型的计算机断层扫描 (CT) 肝脏扫描显示，注射后从90' 到240 '的对比度增强大于或等于60 HU。

BACKGROUND & AIMS: :Buck and Duffy (1980) and Borod et al. (1985) found evidence of deficits in spontaneous expressiveness in right brain-damaged (RBD) patients relative to LBD patients and controls. Using FACS, Mammucari et al. (1988) failed to replicate this result and questioned our methods and findings. This paper replies (a) that Mammucari et al. (1988)'s review of our work is selective and misleading; (b) that there are aspects of their study that can account for their null results, including the insufficient sensitivity of FACS for the measurement of spontaneous expressiveness; and (c) that the results of Mammucari et al. (1988) regarding "aversive eye movements" to a negative film in LBD and control, but not RBD, patients are in fact compatible with our findings. This paper also suggests a general strategy for the objective and comprehensive analysis of spontaneous emotional expressiveness.

背景与目标： : Buck和Duffy (1980) 和Borod等人 (1985) 发现右脑受损 (RBD) 患者相对于LBD患者和对照组的自发表达能力不足的证据。使用FACS，mamucari等人 (1988) 未能复制该结果，并质疑我们的方法和发现。本文回答 (a) mamucari等人 (1988) 对我们工作的审查是选择性的和误导性的; (b) 他们的研究有一些方面可以解释他们的无效结果，包括FACS对自发表现力测量的敏感性不足; 并且 (c) mammicuari等人 (1988) 关于LBD和对照 (而不是RBD) 患者对底片的 “厌恶性眼球运动” 的结果实际上与我们的发现兼容。本文还提出了客观综合分析自发情绪表现力的一般策略。

BACKGROUND & AIMS: INTRODUCTION:This pilot study used a simulation-based platform to evaluate the effect of an automated mechanical chest compression device on team communication and patient management. METHODS:Four-member emergency department interprofessional teams were randomly assigned to perform manual chest compressions (control, n = 6) or automated chest compressions (intervention, n = 6) during a simulated cardiac arrest with 2 phases: phase 1 baseline (ventricular tachycardia), followed by phase 2 (ventricular fibrillation). Patient management was coded using an Advanced Cardiovascular Life Support-based checklist. Team communication was categorized in the following 4 areas: (1) teamwork focus; (2) huddle events, defined as statements focused on re-establishing situation awareness, reinforcing existing plans, and assessing the need to adjust the plan; (3) clinical focus; and (4) profession of team member. Statements were aggregated for each team. RESULTS:At baseline, groups were similar with respect to total communication statements and patient management. During cardiac arrest, the total number of communication statements was greater in teams performing manual compressions (median, 152.3; interquartile range [IQR], 127.6-181.0) as compared with teams using an automated compression device (median, 105; IQR, 99.5-123.9). Huddle events were more frequent in teams performing automated chest compressions (median, 4.0; IQR, 3.1-4.3 vs. 2.0; IQR, 1.4-2.6). Teams randomized to the automated compression intervention had a delay to initial defibrillation (median, 208.3 seconds; IQR, 153.3-222.1 seconds) as compared with control teams (median, 63.2 seconds; IQR, 30.1-397.2 seconds). CONCLUSIONS:Use of an automated compression device may impact both team communication and patient management. Simulation-based assessments offer important insights into the effect of technology on healthcare teams.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Baby boomers approaching retirement will include unprecedented numbers of physicians, many of whom want to remain productive. OBJECTIVE:To determine interest in health care-related volunteering during retirement among physicians trained to provide general medical care to adults. DESIGN:Cross-sectional mailed survey conducted May through July 2006. SETTING:North Carolina. PARTICIPANTS:910 physicians, 55 years of age or older, whose primary specialty involved direct, nonsurgical care of adults. MEASUREMENTS:Current volunteerism and future interest in selected activities. RESULTS:Of the respondents, 89.8% were male and 87.4% were white; 57.4% worked full-time, 21.7% worked part-time, and 21.0% were retired. Of current retirees, 37.1% expressed interest in volunteering. Areas of greatest interest were medical teaching, working in free medical clinics, and international care. Strong incentives included staying mentally active (67.3%) or involved in medicine (61.2%) and contributing to society (60.5%). Substantial barriers included concerns about malpractice (61.5%) and paperwork or bureaucracy (46.0%). The majority of respondents (66.7%) felt that lack of payment would not influence volunteering. LIMITATIONS:The 59% overall response rate and exclusion of unlicensed retired physicians limit study generalizability. The data were provided by self-response and could not be independently validated. CONCLUSION:Retired physicians are a potential source of manpower that could contribute to provision of health care, particularly in medical teaching and clinical care of underserved persons.

背景与目标：

BACKGROUND & AIMS: :Cancer communication near the end of life has a growing evidence base, and requires clinicians to draw on a distinct set of communication skills. Patients with advanced and incurable cancers are dealing with the emotional impact of a life-limiting illness, treatment decisions that are complex and frequently involve consideration of clinical trials, and the challenges of sustaining hope while also having realistic goals. In this review, the authors sought to provide a guide to important evidence about communication for patients with advanced cancer regarding communication at diagnosis, discussing prognosis, decision making about palliative anticancer therapy and phase 1 trials, advance care planning, transitions in focus from anticancer to palliative care, and preparing patients and families for dying and death.

背景与目标： : 生命即将结束的癌症交流具有越来越多的证据基础，并且要求临床医生利用一套独特的交流技巧。患有晚期和无法治愈的癌症的患者正在处理限制生命的疾病的情感影响，复杂且经常涉及临床试验的治疗决策，以及在维持希望的同时也具有现实目标的挑战。在这篇综述中，作者试图为晚期癌症患者的沟通提供重要证据指南，包括诊断时的沟通，讨论预后，姑息抗癌治疗的决策和1期试验，预先护理计划，从抗癌到姑息治疗的重点过渡，让病人和家人为死亡做好准备。

BACKGROUND & AIMS: OBJECTIVE:This study aimed to identify communication preferences for receiving a cancer diagnosis in South Korean patients and explore differences depending on cancer stage-with or without recurrence/metastasis. METHODS:A total of 312 patients from five cancer centers in South Korea completed the Korean version of the Measure of Patients' Preferences questionnaire, Mini-Mental Adjustment to Cancer scale, Insomnia Severity Index, and Hospital Anxiety and Depression Scale. RESULTS:Among patients without recurrence/metastasis, four factors were indicated: "additional information," "medical information," "emotional support," and "supportive environment." Among patients with recurrence/metastasis, five factors were indicated: "medical information and explanation," "emotional support," "supportive environment," "additional information," and "informing family." In the group without recurrence/metastasis, a positive attitude was a significant predictor of the preference for all four factors and a lower anxiety level was a predictor of the preference for additional information. Patients who reported a high level of anxious preoccupation preferred supportive environments. In the group with recurrence/metastasis, patients who showed a high level of cognitive avoidance preferred to receive medical and additional information and emotional support. CONCLUSIONS:Cancer patients' preferences for communication when receiving bad news differ whether recurrence/metastasis or not in South Korea. Especially, patients with recurrence/metastasis preferred a clear explanation of medical information, and physicians informing patients' families about their diagnosis and prognosis. Thus, physicians should take patients' medical and psychological characteristics into consideration when delivering the news regarding their condition.

背景与目标：

BACKGROUND & AIMS: :Studies of the mechanistic (mammalian) target of rapamycin inhibitors (mTOR) represent a step towards the targeted treatment of gynecological cancers. It has been shown that women with increased levels of mTOR signaling pathway targets have worse prognosis compared to women with normal mTOR levels. Yet, targeting mTOR alone has led to unsatisfactory outcomes in gynecological cancer. The aim of our review was therefore to provide an overview of the most recent clinical results and basic findings on the interplay of mTOR signaling and cold shock proteins in gynecological malignancies. Due to their oncogenic activity, there are promising data showing that mTOR and Y-box-protein 1 (YB-1) dual targeting improves the inhibition of carcinogenic activity. Although several components differentially expressed in patients with ovarian, endometrial, and cervical cancer of the mTOR were identified, there are only a few investigated downstream actors in gynecological cancer connecting them with YB-1. Our analysis shows that YB-1 is an important player impacting AKT as well as the downstream actors interacting with mTOR such as epidermal growth factor receptor (EGFR), Snail or E-cadherin.

背景与目标： : 雷帕霉素抑制剂 (mTOR) 的机制 (哺乳动物) 靶标的研究代表了妇科癌症靶向治疗的一步。研究表明，与mTOR水平正常的女性相比，mTOR信号通路靶标水平升高的女性预后较差。然而，单独靶向mTOR导致妇科癌症的结果不令人满意。因此，我们审查的目的是概述妇科恶性肿瘤中mTOR信号传导和冷休克蛋白相互作用的最新临床结果和基本发现。由于其致癌活性，有前景的数据表明mTOR和Y-box蛋白1 (YB-1) 双重靶向改善了对致癌活性的抑制。尽管在mTOR的卵巢癌，子宫内膜和宫颈癌患者中发现了几种差异表达的成分，但在妇科癌症中只有少数研究的下游参与者将其与YB-1联系起来。我们的分析表明，YB-1是影响AKT以及与mTOR相互作用的下游参与者的重要参与者，例如表皮生长因子受体 (EGFR)，蜗牛或E-cadherin。

BACKGROUND & AIMS: :Gap junction-mediated intercellular coupling is higher in the equatorial region of the lens than at either pole, a property believed to be essential for lens transparency. We show that fibroblast growth factor (FGF) upregulates gap junctional intercellular dye transfer in primary cultures of embryonic chick lens cells without detectably increasing either gap junction protein (connexin) synthesis or assembly. Insulin and insulin-like growth factor 1, as potent as FGF in inducing lens cell differentiation, had no effect on gap junctions. FGF induced sustained activation of extracellular signal-regulated kinase (ERK) in lens cells, an event necessary and sufficient to increase gap junctional coupling. We also identify vitreous humor as an in vivo source of an FGF-like intercellular communication-promoting activity and show that FGF-induced ERK activation in the intact lens is higher in the equatorial region than in polar and core fibers. These findings support a model in which regional differences in FGF signaling through the ERK pathway lead to the asymmetry in gap junctional coupling required for proper lens function. Our results also identify upregulation of intercellular communication as a new function for sustained ERK activation and change the current paradigm that ERKs only negatively regulate gap junction channel activity.

背景与目标： : 间隙连接介导的细胞间耦合在晶状体的赤道区域比在任一极处都要高，这一特性被认为对晶状体透明性至关重要。我们显示，成纤维细胞生长因子 (FGF) 在胚胎雏鸡晶状体细胞的原代培养物中上调间隙连接细胞间染料转移，而不会明显增加间隙连接蛋白 (连接蛋白) 的合成或组装。胰岛素和胰岛素样生长因子1在诱导晶状体细胞分化方面与FGF一样有效，对间隙连接没有影响。FGF诱导晶状体细胞中细胞外信号调节激酶 (ERK) 的持续激活，这是增加间隙连接偶联所必需且足以的事件。我们还将玻璃体液鉴定为FGF样细胞间通讯促进活性的体内来源，并表明完整晶状体中FGF诱导的ERK激活在赤道区域高于极性和核心纤维。这些发现支持一个模型，在该模型中，通过ERK途径的FGF信号传导的区域差异导致适当的晶状体功能所需的间隙连接耦合的不对称性。我们的结果还确定了细胞间通讯的上调是持续ERK激活的新功能，并改变了ERKs仅负调节间隙连接通道活性的当前范例。

BACKGROUND & AIMS: PRIMARY OBJECTIVE:To evaluate the effectiveness of a communication training programme for paid carers to improve their conversational interactions with people with TBI. RESEARCH DESIGN:Single blinded randomized controlled study. METHODS AND PROCEDURES:Ten paid carers were randomly selected from a post-acute residential rehabilitation programme and allocated to either a training or control group. Training comprised a 17-hour programme (across 8 weeks) with conversational interactions (i.e. structured and casual) between paid carers and people with TBI videotaped pre-training, post-training and at 6-months follow-up. Interactions were rated on the Adapted Measure of Support in Conversation (MSC), Adapted Measure of Participation in Conversation (MPC) and Global Impression Scales of conversation. MAIN OUTCOMES AND RESULTS:Trained paid carers were more able to acknowledge and reveal the competence of people with TBI. Conversations were perceived as more appropriate, interesting and rewarding compared to the control group. Improvements were confined to the structured conversation and were maintained for 6 months. CONCLUSIONS:Training paid carers has a positive effect on improving conversational interactions with people with TBI in a long-term care facility. These improvements can help to foster increased independence for the person with TBI in the home and community.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:Online discussion forums are often used by people with eating disorders. METHOD:This study analyses 2,072 threads containing a total of 14,903 postings from an unmoderated German "prorecovery" forum for persons suffering from bulimia nervosa (www.ab-server.de) during the period from October 2004 to May 2006. The threads were inductively analyzed for underlying structural types, and the various types found were then analyzed for differences in temporal and quantitative parameters. RESULTS:Communication in the online discussion forum occurred in three types of thread: (1) problem-oriented threads (78.8% of threads), (2) communication-oriented threads (15.3% of threads), and (3) metacommunication threads (2.6% of threads). Metacommunication threads contained significantly more postings than problem-oriented and communication-oriented threads, and they were viewed significantly more often. Moreover, there are temporal differences between the structural types. CONCLUSION:Topics relating to active management of the disorder receive great attention in prorecovery forums.

背景与目标：

BACKGROUND & AIMS: :Apart from classroom presentations to their instructors and peer groups, STEM students have limited opportunities or encouragement to engage in guided communication of scientific concepts to others (family, friends, or the general public). A critical need exists for accurate, comprehensible science to be disseminated to these groups. To develop student proficiency in communication of complex biomolecular concepts impacting diverse audiences, I introduce learning approaches and assessments easily adapted to fit the needs of individual instructors and any molecular biology or biochemistry laboratory or lecture course in a remote/online environment. To help students develop an appreciation of the needs of different audiences and the nuanced drivers of clear communication, I provided them the choice of projects of similar length: Option (1) Create a scientific news release and short podcast or video clip newscast describing a recent advancement in understanding the molecular/biochemical basis of a disease; or Option (2) Create a lesson plan and mini-video designed to teach a simple biochemical or molecular mechanism of disease with learning objectives, a brief activity, and appropriate assessment mechanisms. Students who chose the scientific news release/newscast activity distilled complex biomolecular concepts using the 5 W's of journalism-who, what, where, why, when-and learned to accurately communicate the relevance of advanced scientific discoveries and recent events for a broader audience. Students who chose the lesson plan designed activities centered on biomolecular science concepts that build upon what their audience already knows, revealing possibilities for undergraduates to contribute to educational outreach to secondary school teachers and classes.

背景与目标： : 除了向教师和同伴小组进行课堂演讲外，STEM学生参与与他人 (家人，朋友或公众) 进行有指导的科学概念交流的机会或鼓励有限。迫切需要将准确，可理解的科学传播给这些群体。为了培养学生对影响不同受众的复杂生物分子概念的沟通能力，我介绍了易于适应的学习方法和评估，以适应个别讲师和任何分子生物学或生物化学实验室或远程/在线环境中的讲座课程的需求。为了帮助学生了解不同受众的需求以及清晰沟通的细微差别，我为他们提供了相似长度的项目选择: 选项 (1) 创建科学新闻发布和简短的播客或视频剪辑新闻广播，描述在理解疾病的分子/生化基础方面的最新进展; 或选项 (2) 创建课程计划和迷你视频，旨在教授具有学习目标的疾病的简单生化或分子机制，简短的活动和适当的评估机制。选择科学新闻发布/新闻广播活动的学生使用新闻业的5 w提炼了复杂的生物分子概念-谁，什么，为什么，什么时候-并学会了准确传达先进科学发现和最近事件的相关性更广泛的受众。选择课程计划的学生设计的活动以生物分子科学概念为中心，这些概念建立在听众已经知道的基础上，揭示了本科生为中学教师和班级的教育推广做出贡献的可能性。

BACKGROUND & AIMS: BACKGROUND:Communication in the pediatric intensive care unit (PICU) between families and the health care team affects the family experience, caregiver psychological morbidity, and patient outcomes. OBJECTIVE:To test the feasibility of studying and implementing a PICU communication intervention called PICU Supports, and to assess families' and health care teams' perceptions of the intervention. METHODS:This study involved patients requiring more than 24 hours of PICU care. An interventionist trained in PICU-focused health care navigation, a "navigator," met with parents and the health care team to discuss communication, decision-making, emotional, informational, and discharge or end-of-life care needs; offered weekly family meetings; and checked in with parents after PICU discharge. The feasibility of implementing the intervention was assessed by tracking navigator activities. Health care team and family perceptions were assessed using surveys, interviews, and focus groups. RESULTS:Of 53 families approached about the study, 35 (66%) agreed to participate. The navigator met with parents on 71% and the health care team on 85% of possible weekdays, and completed 86% of the postdischarge check-ins. Family meetings were offered to 95% of eligible patients. The intervention was rated as helpful by 97% of parents, and comments during interviews were positive. CONCLUSIONS:The PICU Supports intervention is feasible to implement and study and is viewed favorably by parents.

背景与目标：

BACKGROUND & AIMS: :We describe three cases of newborns with complex CHD characterised by communication challenges. These communication challenges were categorised as patient, family, or system-related red flags. Strategies for addressing these red flags were proposed, for the goal of optimising care and improving quality of life in this vulnerable population.

背景与目标： : 我们描述了三例以沟通挑战为特征的复杂冠心病新生儿。这些沟通挑战被归类为患者，家庭或与系统相关的危险信号。提出了解决这些危险信号的策略，目的是优化护理并改善这一弱势群体的生活质量。

BACKGROUND & AIMS: BACKGROUND:Preventable clinician communication errors are the most frequent root cause of surgical adverse events. Effective communication among surgical team members is an important overall indicator of clinical nursing excellence and is crucial to promote patient safety and reduce healthcare risk. OBJECTIVE:The purpose of this publication is to describe our research protocol, which will comprehensively investigate surgical team communication and surgical team structure. There are two overall study objectives: (a) to characterize the network factors that influence perioperative clinician communication and (b) to identify how team structure shapes communication effectiveness. Specifically, we will study the association among clinician relationships, surgical team familiarity, surgical team size, and communication effectiveness. METHODS:We will use an exploratory, prospective, cross-sectional, network-centric approach using social network analysis to determine how interdependent clinician relationships influence surgical communication patterns. Targeting an 80% response rate, we will use total population sampling to recruit all clinicians (nurses, surgeons, anesthetists, surgical technologists, students, residents) who directly provide surgical care in the operating room at a large military medical center. We will administer an electronic survey to surgical teams at the end of the surgical day to elicit clinician communication assessments and relational preferences. From the survey questions, we will develop six relational networks (interaction, close working relationship, socialization, advice seeking, advice giving, speaking up/voice) and three models that represent communication effectiveness for each participant and team. We will use various statistical methods to characterize the network factors that shape operating room clinician communication and identify how team structure shapes communication effectiveness. RESULTS:This study will start enrolling participants in 2020. DISCUSSION:We are among the first to comprehensively investigate operating room communication using social network analysis. The results of this study will provide valuable insight into nurse collaboration and communication in interprofessional teams, enable a thoughtful analysis of surgical staffing and perioperative team building, and inform future-targeted interventions to improve operating room communication weaknesses.

背景与目标：