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Article ; Online: A Competency-Guided Approach to Optimizing a Physician-Scientist Curriculum.

Estrada, Lourdes / Williams, Megan A / Williams, Christopher S

Medical science educator

2022 Volume 32, Issue 2, Page(s) 523–528

Abstract: Physician-scientists are uniquely positioned to achieve significant biomedical advances to improve the human condition. Their clinical and scientific training allows them to bridge fields and contribute to cutting-edge, clinically relevant research. The ... ...

Abstract	Physician-scientists are uniquely positioned to achieve significant biomedical advances to improve the human condition. Their clinical and scientific training allows them to bridge fields and contribute to cutting-edge, clinically relevant research. The need for a highly skilled physician-scientist workforce has never been more acute. We propose a competency-guided program design (CGPD) framework that focuses on core skills to enhance the physician-scientist training curriculum. In partnership with clinical and graduate curricula, the CGPD framework can be employed as a tool to meaningfully integrate physician-scientist training, address barriers to attract and sustain the physician-scientist workforce, and avoid overprogramming that detracts from a solid foundation of clinical and graduate research training.
Language	English
Publishing date	2022-03-07
Publishing country	United States
Document type	Editorial
ISSN	2156-8650
ISSN (online)	2156-8650
DOI	10.1007/s40670-022-01525-w
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Article ; Online: Precision Cancer Medicine: Dynamic Learning of Cancer Biology in a Clinically Meaningful Context.

Zivanov, Catherine / Li, Xuanyi / Shah, Kaustav P / Estrada, Lourdes / Cutrer, William B / Hooks, Mary / Keedy, Vicki / Dahlman, Kimberly Brown

Medical science educator

2021 Volume 31, Issue 3, Page(s) 1029–1042

Abstract: Purpose: Precision medicine is revolutionizing healthcare practices, most notably in oncology. With cancer being the second leading cause of death in the USA, it is important to integrate precision oncology content in undergraduate medical education.: ...

Abstract	Purpose: Precision medicine is revolutionizing healthcare practices, most notably in oncology. With cancer being the second leading cause of death in the USA, it is important to integrate precision oncology content in undergraduate medical education. Methods: In 2015, we launched a Results: To date, 72 medical students have taken the Conclusion: The
Language	English
Publishing date	2021-04-02
Publishing country	United States
Document type	Journal Article
ISSN	2156-8650
ISSN (online)	2156-8650
DOI	10.1007/s40670-021-01267-1
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Article: An autoimmune polyglandular syndrome complicated with celiac disease and autoimmune hepatitis.

Dieli-Crimi, Romina / Núñez, Concepción / Estrada, Lourdes / López-Palacios, Natalia

Annals of hepatology

2016 Volume 15, Issue 4, Page(s) 588–591

Abstract: Autoimmune polyglandular syndrome (APS) is a combination of different autoimmune diseases. The close relationship between immune-mediated disorders makes it mandatory to perform serological screening periodically in order to avoid delayed diagnosis of ... ...

Abstract	Autoimmune polyglandular syndrome (APS) is a combination of different autoimmune diseases. The close relationship between immune-mediated disorders makes it mandatory to perform serological screening periodically in order to avoid delayed diagnosis of additional autoimmune diseases. We studied a patient with type 1 diabetes (T1D) who later developed an autoimmune thyroid disease (ATD) and was referred to our hospital with a serious condition of his clinical status. The patient was suffering from an advance stage of celiac disease (CD), the delay in its diagnosis and in the establishment of a gluten-free dietled the patient to a severe proteincalorie malnutrition. Later, the patient developed an autoimmune hepatitis (AIH). We consider that clinical deterioration in patients with APS should alert physicians about the possible presence of other immune-mediated diseases. Periodic screening for autoantibodies would help to prevent delayed diagnosis and would improve patient's quality of life.
MeSH term(s)	Autoantibodies/immunology ; Celiac Disease/complications ; Celiac Disease/diagnosis ; Celiac Disease/diet therapy ; Celiac Disease/immunology ; Delayed Diagnosis ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/diagnosis ; Diabetes Mellitus, Type 1/immunology ; Diet, Gluten-Free ; Hepatitis, Autoimmune/complications ; Hepatitis, Autoimmune/diagnosis ; Hepatitis, Autoimmune/immunology ; Humans ; Male ; Middle Aged ; Polyendocrinopathies, Autoimmune/complications ; Polyendocrinopathies, Autoimmune/diagnosis ; Polyendocrinopathies, Autoimmune/immunology ; Protein-Energy Malnutrition/diagnosis ; Protein-Energy Malnutrition/etiology ; Thyroiditis, Autoimmune/complications ; Thyroiditis, Autoimmune/diagnosis ; Thyroiditis, Autoimmune/immunology
Chemical Substances	Autoantibodies
Language	English
Publishing date	2016-05-27
Publishing country	Mexico
Document type	Case Reports ; Journal Article
ZDB-ID	2188733-0
ISSN	1665-2681
ISSN	1665-2681
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Article: Integrating Foundational Sciences in a Clinical Context in the Post-Clerkship Curriculum.

Dahlman, Kimberly Brown / Weinger, Matthew B / Lomis, Kimberly D / Nanney, Lillian / Osheroff, Neil / Moore, Donald E / Estrada, Lourdes / Cutrer, William B

Medical science educator

2018 Volume 28, Issue 1, Page(s) 145–154

Abstract: Purpose: To design, implement, and launch courses that integrate foundational science learning and clinical application in a post-clerkship undergraduate medical school curriculum.: Method: In Academic Year (AY) 15-16, as part of a comprehensive ... ...

Abstract	Purpose: To design, implement, and launch courses that integrate foundational science learning and clinical application in a post-clerkship undergraduate medical school curriculum. Method: In Academic Year (AY) 15-16, as part of a comprehensive curricular revision, Vanderbilt University School of Medicine (VUSM) formally implemented "Integrated Science Courses" (ISCs) that combined rigorous training in the foundational sciences with meaningful clinical experiences. These courses integrated foundational sciences that could be leveraged in the clinical environment, utilized a variety of instructional modalities, and included quantitative and qualitative (competency-based milestones) student assessments. Each ISC underwent a rigorous quality improvement process that required input on foundational science content, student experience, and student performance assessment. Results: Eleven ISCs were delivered to 173 students in AY15-16, with some students taking more than one ISC. Immediately after completing each course, 93% (n=222) of ISC enrollees completed a course evaluation. Students (91%; n=201) 'agreed' or 'strongly agreed' that foundational science learning informed and enriched the clinical experiences. Furthermore, 94% (n=209) of students thought that the clinical experiences informed and enriched the foundational science learning. Ninety-four percent of the students anticipated using the foundational science knowledge acquired in future clinical training and practice. Conclusion: The teaching of foundational sciences in the clinical workplace in the post-clerkship medical curriculum is challenging and resource-intensive, yet feasible. Additional experience with the model will inform the mix of courses as well as the breadth and depth of foundational science instruction that is necessary to foster scientifically-based clinical reasoning skills in each student.
Language	English
Publishing date	2018-01-02
Publishing country	United States
Document type	Journal Article
ISSN	2156-8650
ISSN	2156-8650
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Article ; Online: Correction: Novel Hybrid Phenotype Revealed in Small Cell Lung Cancer by a Transcription Factor Network Model That Can Explain Tumor Heterogeneity.

Udyavar, Akshata R / Wooten, David J / Hoeksema, Megan / Bansal, Mukesh / Califano, Andrea / Estrada, Lourdes / Schnell, Santiago / Irish, Jonathan M / Massion, Pierre P / Quaranta, Vito

Cancer research

2019 Volume 79, Issue 5, Page(s) 1014

Language	English
Publishing date	2019-03-01
Publishing country	United States
Document type	Journal Article ; Published Erratum
ZDB-ID	1432-1
ISSN	1538-7445 ; 0008-5472
ISSN (online)	1538-7445
ISSN	0008-5472
DOI	10.1158/0008-5472.CAN-19-0069
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Article ; Online: Epidemiology, Outcomes, and Associated Factors of Coronavirus Disease 2019 (COVID-19) Reverse Transcriptase Polymerase Chain Reaction-Confirmed Cases in the San Pedro Sula Metropolitan Area, Honduras.

Zuniga-Moya, Julio C / Norwood, Dalton Argean / Romero Reyes, Luis Enrique / Barrueto Saavedra, Emilio / Diaz, Roxana / Fajardo, Wendy Carolina / Pineda, Allan / Torres, Diana / Barahona, Rodolfo / Leiva, Said Omar / Hernandez, Pastora X / Silva, Hector / Leiva, Carlos Raul / Estrada, Lourdes / Barahona-Campos, Alma / Gordon, Aubree

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2020 Volume 72, Issue 10, Page(s) e476–e483

Abstract: Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused substantial morbidity and mortality worldwide. Few reports exist in Latin America, a current epicenter of transmission. Here, we aim to describe the ... ...

Abstract	Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused substantial morbidity and mortality worldwide. Few reports exist in Latin America, a current epicenter of transmission. Here, we aim to describe the epidemiology and outcomes associated with coronavirus disease 2019 (COVID-19) in Honduras. Methods: Baseline clinical and epidemiological information of SARS-CoV-2 reverse transcriptase polymerase chain reaction-confirmed cases detected between 17 March-4 May in the San Pedro Sula Metropolitan area was collected; for hospitalized cases, clinical data were abstracted. Logistic regression models were fit to determine the factors associated with hospitalization. Results: We identified 877 COVID-19 cases, of which 25% (n = 220) were hospitalized. The 19-44-year age group (57.8%) and males (61.3%) were predominant in overall COVID-19 cases. Of the cases, 34% (n = 299) had at least 1 preexisting medical condition. Individuals aged 45-69 years (adjusted odds ratio [aOR] = 4.05; 95% confidence interval [CI], 2.85-5.76) or ≥70 years (aOR = 9.12; 95% CI, 5.24-15.86), of male sex (aOR = 1.72; 95% CI, 1.21-2.44), and those with a preexisting condition (aOR = 2.12; 95% CI, 1.43-3.14) had higher odds of hospitalization. Of inpatients, 50% were hospitalized more than 7 days. The median length of hospitalization was 13 days (interquartile range [IQR], 8-29) among individuals aged 19-44 years, and 17 days (IQR, 11-24.6) among those aged 45-69. Of the fatal cases, 42% occurred among adults under 60 years old. Conclusions: Our findings show that a high proportion of COVID-19 cases in Honduras occurred among younger adults, who also constituted a significant proportion of severe and fatal cases. Preexisting conditions were associated with severe outcomes independently from age and were highly prevalent in Honduran COVID-19 cases.
MeSH term(s)	Adult ; Aged ; COVID-19 ; Honduras/epidemiology ; Hospitalization ; Humans ; Male ; Middle Aged ; Pandemics ; Reverse Transcriptase Polymerase Chain Reaction ; SARS-CoV-2 ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-08-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa1188
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Zs.A 1505: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Altered TGF-α/β signaling drives cooperation between breast cancer cell populations.

Franco, Omar E / Tyson, Darren R / Konvinse, Katherine C / Udyavar, Akshata R / Estrada, Lourdes / Quaranta, Vito / Crawford, Susan E / Hayward, Simon W

FASEB journal : official publication of the Federation of American Societies for Experimental Biology

2016 Volume 30, Issue 10, Page(s) 3441–3452

Abstract: The role of tumor heterogeneity in regulating disease progression is poorly understood. We hypothesized that interactions between subpopulations of cancer cells can affect the progression of tumors selecting for a more aggressive phenotype. We developed ... ...

Abstract	The role of tumor heterogeneity in regulating disease progression is poorly understood. We hypothesized that interactions between subpopulations of cancer cells can affect the progression of tumors selecting for a more aggressive phenotype. We developed an in vivo assay based on the immortalized nontumorigenic breast cell line MCF10A and its Ras-transformed derivatives AT1 (mildly tumorigenic) and CA1d (highly tumorigenic). CA1d cells outcompeted MCF10A, forming invasive tumors. AT1 grafts were approximately 1% the size of CA1d tumors when initiated using identical cell numbers. In contrast, CA1d/AT1 mixed tumors were larger than tumors composed of AT1 alone (100-fold) or CA1d (3-fold), suggesting cooperation in tumor growth. One of the mechanisms whereby CA1d and AT1 were found to cooperate was by modulation of TGF-α and TGF-β signaling. Both of these molecules were sufficient to induce changes in AT1 proliferative potential in vitro. Reisolation of AT1 tumor-derived (AT1
MeSH term(s)	Animals ; Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Cell Line, Tumor ; Cell Movement/drug effects ; Cell Movement/physiology ; Cell Transformation, Neoplastic/metabolism ; Epithelium/metabolism ; Epithelium/pathology ; Humans ; Mice, SCID ; Signal Transduction ; Transforming Growth Factor alpha/metabolism ; Transforming Growth Factor beta/metabolism
Chemical Substances	Transforming Growth Factor alpha ; Transforming Growth Factor beta
Language	English
Publishing date	2016-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	639186-2
ISSN	1530-6860 ; 0892-6638
ISSN (online)	1530-6860
ISSN	0892-6638
DOI	10.1096/fj.201500187RR
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Zs.A 2266: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: A novel circular invasion assay mimics in vivo invasive behavior of cancer cell lines and distinguishes single-cell motility in vitro

Estrada Lourdes / Guess Cherise / Kam Yoonseok / Weidow Brandy / Quaranta Vito

BMC Cancer, Vol 8, Iss 1, p

2008 Volume 198

Abstract: Abstract Background Classical in vitro wound-healing assays and other techniques designed to study cell migration and invasion have been used for many years to elucidate the various mechanisms associated with metastasis. However, many of these methods ... ...

Abstract	Abstract Background Classical in vitro wound-healing assays and other techniques designed to study cell migration and invasion have been used for many years to elucidate the various mechanisms associated with metastasis. However, many of these methods are limited in their ability to achieve reproducible, quantitative results that translate well in vivo . Such techniques are also commonly unable to elucidate single-cell motility mechanisms, an important factor to be considered when studying dissemination. Therefore, we developed and applied a novel in vitro circular invasion assay (CIA) in order to bridge the translational gap between in vitro and in vivo findings, and to distinguish between different modes of invasion. Method Our method is a modified version of a standard circular wound-healing assay with an added matrix barrier component (Matrigel™), which better mimics those physiological conditions present in vivo . We examined 3 cancer cell lines (MCF-7, SCOV-3, and MDA-MB-231), each with a different established degree of aggressiveness, to test our assay's ability to detect diverse levels of invasiveness. Percent wound closure (or invasion) was measured using time-lapse microscopy and advanced image analysis techniques. We also applied the CIA technique to DLD-1 cells in the presence of lysophosphatidic acid (LPA), a bioactive lipid that was recently shown to stimulate cancer cell colony dispersal into single migratory cells, in order to validate our method's ability to detect collective and individual motility. Results CIA method was found to be highly reproducible, with negligible levels of variance measured. It successfully detected the anticipated low, moderate, and high levels of invasion that correspond to in vivo findings for cell lines tested. It also captured that DLD-1 cells exhibit individual migration upon LPA stimulation, and collective behavior in its absence. Conclusion Given its ability to both determine pseudo-realistic invasive cell behavior in vitro and capture subtle differences in cell motility, we propose that our CIA method may shed some light on the cellular mechanisms underlying cancer invasion and deserves inclusion in further studies. The broad implication of this work is the development of a reproducible, quantifiable, high-resolution method that can be applied to various models, to include an unlimited number of parameters and/or agents that may influence invasion.
Keywords	Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Oncology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	610
Language	English
Publishing date	2008-07-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
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Article: CDX2 expression can predict response to neoadjuvant therapy in gastric carcinoma.

Fernández Aceñero, María Jesús / Sánchez de Molina, María Luisa / Caso, Ana / Vorwald, Peter / Olmo, Damián García / Palomar, Jorge / Estrada, Lourdes / Díaz Del Arco, Cristina

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie

2018 Volume 58, Issue 4, Page(s) 1275–1278

Abstract: Purpose: Caudal-related homeobox transcription factor 2 (CDX2) has recently been proposed as a prognostic factor for gastric carcinoma. However and to the best of our knowledge, no previous report has analyzed CDX2 expression in patients with gastric ... ...

Abstract	Purpose: Caudal-related homeobox transcription factor 2 (CDX2) has recently been proposed as a prognostic factor for gastric carcinoma. However and to the best of our knowledge, no previous report has analyzed CDX2 expression in patients with gastric adenocarcinoma receiving neoadjuvant therapy (NAT). Patients, materials and methods: This is a retrospective cohort study to analyze the potential role of CDX2 expression to predict response to NAT and prognosis. This study has enrolled 57 patients receiving chemotherapy for locally advanced gastric carcinoma. Results: 59.6% of the patients were men; mean age was 64.96 years. Only 8% of the patients showed a complete response to therapy, 10% had grade 1, 28% grade 2, and 54% grade 3 regression, respectively, according to modified Ryan's criteria. On follow-up, 38.6% of the patients showed recurrence of disease (50% distant metastasis) and 28.1% eventually died of it. Twenty-three (40.4%) patients showed intense CDX2 expression. We found a statistically significant association between CDX2 expression and poor regression with NAT, but we found no association with outcome. Discussion: Our study indicates that CDX2 expression can predict lack of response to NAT. Our results have not confirmed the association with prognosis shown in previous reports. Conclusions: Despite these preliminary results, furthermore studies are necessary to define the potential use of CDX2 in gastric carcinoma.
MeSH term(s)	Aged ; CDX2 Transcription Factor/biosynthesis ; CDX2 Transcription Factor/genetics ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/genetics ; Stomach Neoplasms/metabolism ; Stomach Neoplasms/pathology
Chemical Substances	CDX2 Transcription Factor ; CDX2 protein, human
Language	English
Publishing date	2018-03-16
Publishing country	Romania
Document type	Journal Article
ZDB-ID	1062519-7
ISSN	2066-8279 ; 1220-0522 ; 0035-4007
ISSN (online)	2066-8279
ISSN	1220-0522 ; 0035-4007
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Article ; Online: Nest expansion assay

Estrada Lourdes / Weidow Brandy / Karperien Audrey / Kam Yoonseok / Anderson Alexander R / Quaranta Vito

BMC Research Notes, Vol 2, Iss 1, p

a cancer systems biology approach to in vitro invasion measurements

2009 Volume 130

Abstract: Abstract Background Traditional in vitro cell invasion assays focus on measuring one cell parameter at a time and are often less than ideal in terms of reproducibility and quantification. Further, many techniques are not suitable for quantifying the ... ...

Abstract	Abstract Background Traditional in vitro cell invasion assays focus on measuring one cell parameter at a time and are often less than ideal in terms of reproducibility and quantification. Further, many techniques are not suitable for quantifying the advancing margin of collectively migrating cells, arguably the most important area of activity during tumor invasion. We have developed and applied a highly quantitative, standardized, reproducible Nest Expansion Assay (NEA) to measure cancer cell invasion in vitro , which builds upon established wound-healing techniques. This assay involves creating uniform circular "nests" of cells within a monolayer of cells using a stabilized, silicone-tipped drill press, and quantifying the margin expansion into an overlaid extracellular matrix (ECM)-like component using computer-assisted applications. Findings The NEA was applied to two human-derived breast cell lines, MCF10A and MCF10A-CA1d, which exhibit opposite degrees of tumorigenicity and invasion in vivo . Assays were performed to incorporate various microenvironmental conditions, in order to test their influence on cell behavior and measures. Two types of computer-driven image analysis were performed using Java's freely available ImageJ software and its FracLac plugin to capture nest expansion and fractal dimension, respectively – which are both taken as indicators of invasiveness. Both analyses confirmed that the NEA is highly reproducible, and that the ECM component is key in defining invasive cell behavior. Interestingly, both analyses also detected significant differences between non-invasive and invasive cell lines, across various microenvironments, and over time. Conclusion The spatial nature of the NEA makes its outcome susceptible to the global influence of many cellular parameters at once (e.g., motility, protease secretion, cell-cell adhesion). We propose the NEA as a mid-throughput technique for screening and simultaneous examination of factors contributing to cancer cell invasion, particularly suitable for ...
Keywords	Medicine ; R ; Biology (General) ; QH301-705.5 ; Science (General) ; Q1-390
Subject code	500
Language	English
Publishing date	2009-07-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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