RESUMEN
An improved understanding of the human lung necessitates advanced systems models informed by an ever-increasing repertoire of molecular omics, cellular, imaging, and pathological datasets. To centralize and standardize information across broad lung research efforts we expanded the LungMAP.net website into a new gateway portal. This portal connects a broad spectrum of research networks, bulk and single-cell multi-omics data and a diverse collection of image data that span mammalian lung development, and disease. The data are standardized across species and technologies using harmonized data and metadata models that leverage recent advances including those from the Human Cell Atlas, diverse ontologies, and the LungMAP CellCards initiative. To cultivate future discoveries, we have aggregated a diverse collection of single-cell atlases for multiple species (human, rhesus, mouse), to enable consistent queries across technologies, cohorts, age, disease, and drug treatment. These atlases are provided as independent and integrated queryable datasets, with an emphasis on dynamic visualization, figure generation, re-analysis, cell-type curation, and automated reference-based classification of user-provided single-cell genomics datasets (Azimuth). As this resource grows, we intend to increase the breadth of available interactive interfaces, supported data types, data portals and datasets from LungMAP and external research efforts.
RESUMEN
Primary care medical providers (PCPs) have become de facto providers of services for the management of both mental and chronic illnesses. Although some reports suggest that PCPs favor having Behavioral Health colleagues provide behavioral health services in primary care, others demonstrate this view is necessarily not universal. We examined attitudes regarding behavioral health services among PCPs in practices that offer such services via onsite behavioral health providers (n = 31) and those that do not (n = 62). We compared referral rates and perceived need for and helpfulness of behavioral health colleagues in treating mental health/behavioral medicine issues. In both samples, perceived need was variable (5-100%), as were PCPs' views of their own competence in mental health/behavioral medicine diagnosis and treatment. Interestingly, neither sample rated perceived access to behavioral health providers exceptionally high. Referral rates and views about the helpfulness of behavioral health services, except in relation to depression and anxiety, were lower than expected. These results suggest a need for increased collaboration with and education of PCPs about the roles and skills of behavioral health professionals.
Asunto(s)
Actitud del Personal de Salud , Prestación Integrada de Atención de Salud , Relaciones Interprofesionales , Atención Primaria de Salud/organización & administración , Psicología Clínica/organización & administración , Adulto , Medicina de la Conducta/educación , Femenino , Encuestas de Atención de la Salud , Humanos , Kentucky , Masculino , Persona de Mediana Edad , Medio Oeste de Estados Unidos , Enfermeras Practicantes , MédicosRESUMEN
BACKGROUND: The closure of large cutaneous defects of the upper face can be challenging, often requiring the use of large rotation, advancement, or transposition flaps or skin grafts. OBJECTIVE: To describe the use of the spanning suspension suture, a technique we have adapted to facilitate closure of large cutaneous defects of the upper face. METHODS: Report of an illustrated case. RESULTS: A large full-thickness defect of the temple was successfully reconstructed using the spanning suspension suture. CONCLUSION: Use of the spanning suspension suture permits recruitment of skin from the lower cheek and neck in the closure of large wounds of the upper face, avoiding the need for transposition or rotation flaps and grafts.
Asunto(s)
Carcinoma Basocelular/cirugía , Neoplasias Faciales/cirugía , Procedimientos de Cirugía Plástica/métodos , Neoplasias Cutáneas/cirugía , Técnicas de Sutura , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Cirugía de MohsRESUMEN
BACKGROUND: Combination defects involving both the nasal sidewall or ala and cheek can be challenging to reconstruct. METHODS: Patients with skin cancers involving the nasal sidewall or ala and medial cheek treated with Mohs micrographic surgery were reconstructed using a cheek advancement flap in combination with a melolabial Burow's graft. RESULTS: This technique provides a simple, reproducible, and cosmetically excellent method of repairing these defects. CONCLUSION: The use of this repair provides superb tissue matches and maintains natural aesthetic subunits, yielding an excellent result with minimal morbidity.