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In contrast, the bulk of the continental crust is much older.

The oldest continental crustal rocks on Earth have ages in the range from about 3. Some zircon with age as great as 4. A theoretical protoplanet named "Theia" is thought to have collided with the forming Earth, and part of the material ejected into space by the collision accreted to form the Moon.

The cumulate rocks form much of the crust. The thickness of the crust ranges between about 20 and km.

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Crust on the far side of the Moon averages about 12 km thicker than that on the near side. Estimates of average thickness fall in the range from about 50 to 60 km. Most of this plagioclase-rich crust formed shortly after formation of the moon, between about 4.

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The best-characterized and most voluminous of these later additions are the mare basalts formed between about 3. Minor volcanism continued after 3.

For several hundred years afterward, with the cultural taboo of dissection, no major progress occurred in neuroscience.

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Estimates of average thickness fall in the range from about 50 to 60 km. The thickness of the crust ranges between about 20 and km. Commonly used terms for planes of orientation or planes of section in neuroanatomy are "sagittal", "transverse" or "coronal", and "axial" or "horizontal".

However, Pope Sixtus IV effectively revitalized the study of neuroanatomy by altering the papal policy and allowing human dissection. Commonly used terms for planes of orientation or planes of section in neuroanatomy are "sagittal", "transverse" or "coronal", and "axial" or "horizontal". Again in this case, the situation is different for swimming, creeping or quadrupedal prone animals than for Man, or other erect species, due to the changed position of the axis.

A mid-sagittal plane divides the body and brain into left and right halves; sagittal sections in general are parallel to this median plane, moving along the medial-lateral dimension see the image above.

The term sagittal refers etymologically to the median suture between the right and left parietal bones of the cranium, known classically as sagittal suture, because it looks roughly like an arrow by its confluence with other sutures sagitta; arrow in Latin.

Histochemistry uses knowledge about biochemical reaction properties of the chemical constituents of the brain including notably enzymes to apply selective methods of reaction to visualize where they occur in the brain and any functional or pathological changes.

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Casino slot applies importantly to molecules related to neurotransmitter production and metabolism, but applies likewise in many other directions chemoarchitecture, or chemical neuroanatomy.

Immunocytochemistry is a special case of histochemistry that uses selective antibodies against a variety of chemical epitopes of the nervous system to selectively stain particular cell types, axonal fascicles, neuropiles, glial processes or blood vessels, or specific intracytoplasmic or intranuclear proteins and other immunogenetic molecules, e.

Immunoreacted transcription factor proteins reveal genomic readout in terms of translated protein. This immensely increases the capacity of researchers to distinguish between different cell types such as neurons and glia in various regions of the nervous system.

The brain is small and simple in some species, such as the nematode worm, where the body plan is quite simple: The nematode Caenorhabditis elegans has been studied because of its importance in genetics. In the early s, Sydney Brenner chose it as a model system for studying the way that genes control development, including neuronal development.

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    Androgen insensitivity syndrome (AIS) is an intersex condition in which there is a partial or complete inability of many cells in the affected genetic male to respond to androgenic hormones. This can prevent or impair the masculinization of male genitalia in the developing genetic male (chromosomal XY) fetus, as well as the.

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Estimates for the incidence of androgen insensitivity syndrome are based on a relatively small population size, thus are known to be imprecise. Preimplantation genetic diagnosis PGD or PIGD refers to genetic profiling of embryos prior to implantation as a form of embryo profiling , and sometimes even of oocytes prior to fertilization.

When used to screen for a specific genetic sequence, its main advantage is that it avoids selective pregnancy termination, as the method makes it highly likely that a selected embryo will be free of the condition under consideration.

Recorded descriptions of the effects of AIS date back hundreds of years, although significant understanding of its underlying histopathology did not occur until the s. The first descriptions of the effects of AIS appeared in the medical literature as individual case reports or as part of a comprehensive description of intersex physicalities. In , Scottish obstetrician Sir James Young Simpson published one such description [] in an exhaustive study of intersexuality that has been credited with advancing the medical community's understanding of the subject.

An alternative system of nomenclature has been recently suggested, [] but the subject of exactly which word or words should be used in its place still one of much debate. For example, 46,XY individuals who have a female phenotype, but also have testes instead of ovaries — a group that includes all individuals with CAIS, as well as some individuals with PAIS — are classified as having "male pseudohermaphroditism", while individuals with both an ovary and a testis or at least one ovotestis are classified as having " true hermaphroditism ".

Previous definitions of "pseudohermaphroditism" relied on perceived inconsistencies between the internal and external organs; the "true" sex of an individual was determined by the internal organs, and the external organs determined the "perceived" sex of an individual.

German-Swiss pathologist Edwin Klebs is sometimes noted for using the word "pseudohermaphroditism" in his taxonomy of intersexuality in , [] although the word is clearly not his invention as is sometimes reported; the history of the word " pseudohermaphrodite " and the corresponding desire to separate "true" hermaphrodites from "false", "spurious", or "pseudo" hermaphrodites, dates back to at least , when Dutch anatomist Frederik Ruysch used it in a publication describing a subject with testes and a mostly female phenotype.

In , American gynecologist John Morris provided the first full description of what he called "testicular feminization syndrome" based on 82 cases compiled from the medical literature, including two of his own patients. A distinct name has been given to many of the various presentations of AIS, such as Reifenstein syndrome , [] Goldberg-Maxwell syndrome , [] Morris' syndrome , [] Gilbert-Dreyfus syndrome , [] Lub's syndrome , [] "incomplete testicular feminization" , [] Rosewater syndrome , [] and Aiman's syndrome Over the last 60 years, as reports of strikingly different phenotypes were reported to occur even among members of the same family, and as steady progress was made towards the understanding of the underlying molecular pathogenesis of AIS, these disorders were found to be different phenotypic expressions of one syndrome caused by molecular defects in the androgen receptor gene.

AIS is now the accepted terminology for the syndromes resulting from unresponsiveness of the target cell to the action of androgenic hormones.

The more virilized phenotypes of AIS have sometimes been described as "undervirilized male syndrome", "infertile male syndrome", "undervirilized fertile male syndrome", etc. She has given interviews about her condition [] [] and founded "Girl Comet, a non-profit diversity awareness and inspiration initiative.

In , fashion model Hanne Gaby Odiele disclosed that she was born with the intersex trait androgen insensitivity syndrome. As a child, she underwent medical procedures relating to her condition , [] which she said took place without her or her parents' informed consent.

In the Japanese horror novel Ring , by Koji Suzuki later adapted into Japanese, Korean, and American films , the central antagonist Sadako has this syndrome. From Wikipedia, the free encyclopedia. Androgen insensitivity syndrome AIS results when the androgen receptor AR pictured is not able to function as a transcription factor for androgens , which normally activate relevant genes.

Complete androgen insensitivity syndrome. Partial androgen insensitivity syndrome. Mild androgen insensitivity syndrome. Androgen enters the cell. Only certain organs in the body, such as the gonads and the adrenal glands , produce the androgen testosterone. Testosterone is converted into dihydrotestosterone , a chemically similar androgen, in cells containing the enzyme 5-alpha reductase.

Both androgens exert their influence through binding with the androgen receptor. The androgen receptor is expressed ubiquitously throughout the tissues of the human body. Before it binds with an androgen, the androgen receptor is bound to heat shock proteins. These heat shock proteins are released upon androgen binding. Androgen binding induces a stabilizing, conformational change in the androgen receptor.

The two zinc fingers of the DNA-binding domain are exposed as a result of this new conformation. Receptor phosphorylation can occur before androgen binding, although the presence of androgen promotes hyperphosphorylation. The biological ramifications of receptor phosphorylation are unknown. Nucleocytoplasmic transport is in part facilitated by an amino acid sequence on the AR called the nuclear localization signal. The AR's nuclear localization signal is primarily encoded in the hinge region of the AR gene.

Dimerization is mediated by the second nearest the 3' end zinc finger. Target genes contain or are flanked by transcriptional enhancer nucleotide sequences that interact with the first zinc finger. These areas are called androgen response elements. Type I coactivators i. Diagnosis of Complete Androgen Insensitivity Syndrome.

Diagnosis of Partial Androgen Insensitivity Syndrome. Diagnosis of Mild Androgen Insensitivity Syndrome. Frasier syndrome associated with progressive glomerulopathy Denys-Drash syndrome associated with nephropathy and Wilms tumor WAGR syndrome associated with Wilms tumor and aniridia McKusick-Kaufman syndrome associated with postaxial polydactyly Robinow syndrome associated with dwarfism Aarskog-Scott syndrome associated with facial anomalies Hand-foot-genital syndrome associated with limb malformations Popliteal pterygium syndrome associated with extensive webbing behind knees Kallmann syndrome often associated with anosmia Hypospadias not otherwise specified Cryptorchidism not otherwise specified vaginal atresia not otherwise specified.

Management of Complete Androgen Insensitivity Syndrome. Management of Partial Androgen Insensitivity Syndrome. Management of Mild Androgen Insensitivity Syndrome. The pharmacology and classification of the nuclear receptor superfamily: American Journal of Human Genetics. American Journal of Medical Genetics. The androgen receptor gene mutations database". Hung, Wellington, Becker, Kenneth L. Principles and Practice of Endocrinology and Metabolism. J Pediatr Adolesc Gynecol. Acta Obstet Gynecol Scand.

Retrieved on October 1, The ethics of PGD for intersex conditions". Organisation Intersex International Australia. Retrieved 28 September The diagnosis and treatment of endocrine disorders in childhood and adolescence. Charles C Thomas, , pp. Midwifery, obstetrics and the rise of gynaecology: Des monstres et prodiges.

Chez Franc d'Amour The controversy over "disorders of sex development " ". Handbuch der pathologischen anatomie. Acta eruditorum anno mdccix. Carl Gerold ; Allgemeine Literatur-Zeitung Issues Stuttgart et Augsbourg , p.

Proc Am Fed Clin Res. Fellows who work outside the program must raise their own funds. We do not believe that such a philosophy is in the best interest of fellows. As noted earlier, the average fellow requires about 5 years of research training before full independence is achieved.

After the formal three year fellowship, trainees become Instructors in Pediatrics at Harvard Medical School. During this extended and protected training period, a focus on research continues, although many fellows begin their roles as attending physicians on the clinical service in a limited capacity. We believe this is a crucial point and that our program must support a fellow who seeks a research career until the fellow becomes independent or a clear path to a tenure track position is identified.

We have had fellows whose first projects did not go well but who subsequently were successful. The need to support such individuals for an extended period is one of the principal functions of our training program, and we make every effort to support fellows in our program during this extended training period or until they successfully compete for initial training grants e. Our approach provides an additional buffer zone for fledgling investigators to become firmly established before leaving "the nest", and we believe it contributes to the success of our program.

There are currently eight fellows on the committee, including two upper year fellows who run the meeting and two representatives from each fellow class.

This committee meets monthly to discuss current issues related to the clinical rotations for first-year fellows as well as issues related to career development and overall well-being of all fellows. It was founded by Dr.

Diamond, who is often said to have been the father of Pediatric Hematology, and by Dr. Sidney Farber, who originated cancer chemotherapy. The modern program dates from when Dr. Diamond as Division Chief. Under his direction the program expanded from a faculty of 3 and 1, net square feet nsf of research space to a faculty of 21 and 12, nsf.

During that time, the division also greatly expanded its clinical activities. Farber in , Dr. Soon thereafter, a bone marrow transplant BMT program was begun. Nathan assumed the role of Chairman of the Department of Pediatrics and Drs. Lux and Steven J. Burakoff were appointed to direct the combined program. Burakoff moved to New York University in and was replaced by Dr.

Lux, who has retired from his position after 23 years of service. All outpatient clinical activities for pediatric oncology, stem cell transplantation and bone marrow failure are housed in the DFCI Jimmy Fund Clinic. All inpatient clinical activities take place at BCH. Ambulatory clinical hematology takes place at BCH.

The program has continued to grow under Drs. In particular, research space expanded following the addition of a new wing of the Enders research building in and the move to new space in the DFCI in both and A new research building Karp Building at BCH that opened in November allowed the program to expand to approximately 44, nsf. These programs are integral parts of this training. Williams brings new expertise in translational research, particularly focused on stem cell biology and genetic therapies.

Williams is an internationally recognized researcher, with major interests in the study of blood stem cell biology, blood formation, leukemia, and the treatment of genetic blood disorders using gene therapy. He has won numerous prestigious awards for his research, including the Dameshek Award for outstanding research in hematology and the E.

During his fellowship research at the Whitehead Institute he developed techniques for introducing genes into hematopoietic stem and progenitor cells using retroviruses that are still used in gene therapy today. Williams has a strong interest in translational research. He co-discovered Interleukin NeumegaTM. He discovered the utility of fibronectin RetronectinTM to facilitate viral vector medicated stem cell gene transduction and is leading gene therapy trials in patients with several genetic diseases.

He has a specific clinical focus on bone marrow failure syndromes and aplastic anemia. He is the principal investigator sponsor of five current gene therapy trials. Mack is an enthusiastic teacher, and is known for her patience and thoughtfulness in her interactions with patients and fellows.

In this role, she is tasked with supporting fellows and junior faculty in clinical research. Orkin is a world-renowned researcher who has made extraordinary contributions to our understanding of the molecular basis of thalassemia, and the mechanisms that regulate the lineage specification and differentiation of hematopoietic stem cells in their transitions to blood cells, the biology of stem cells, and the molecular mechanisms responsible for cancer.

Orkin pioneered positional cloning when he cloned the gene responsible for X-linked chronic granulomatous disease. These and other seminal contributions have been recognized by his election to the National Academy of Sciences and the American Academy of Arts and Sciences, by his selection to be the President of the American Society of Clinical Investigation, and by receipt of numerous prizes, including the Dameshek, E. Kesselheim attended college at the University of Wisconsin and then completed her MD degree at the University of Pennsylvania.

While at Penn, she earned a Masters degree in medical ethics. Kesselheim developed and implemented an ethics curriculum for residents and engaged in research about how pediatricians learn ethics during their training. As a fellow in pediatric hematology-oncology, Dr.

Kesselheim completed coursework to earn a Masters degree in Education from Harvard. As an educator, she designs curricula and assessment instruments related to humanism, ethics, and professionalism. Her research continues to focus on the methods and outcomes of physician education in these same domains of education.

Kesselheim oversees the formal teaching curriculum and leads initiatives on evaluation and feedback for the fellowship in pediatric hematology-oncology. She also directs educational experiences for medical students, residents, and faculty. Daley, Golub, Orkin, Zon and Pellman. The duration of rotations vary from weeks. He or she is responsible for running morning work rounds and evening sign-out rounds, for coordinating the relationship between the attending and the ward service, and for supervising two PL-2 residents in all aspects of the medical and oncologic management of the patients on this service there is no PL3 resident on this service.

The residents take call every fourth night, shared with the solid tumor residents. The fellow makes morning rounds daily with the attending, residents, nurse practitioner, and nurses, at which time medical problems are discussed, oncologic and medical therapy is planned, and support services psychotherapy, social services, pain control, etc are organized.

The fellow is responsible for all aspects of the oncologic care of the patients on the service including chemotherapy orders, monitoring for chemotherapy complications and patient procedures.

The fellow is also responsible for education of residents and conducts sign-out rounds in the evenings. In addition, the fellow on the Hematologic Malignancy Service provides consultative care of hematologic malignancy patients in the intensive care unit and on other inpatient services throughout the hospital and performs evaluations of new patients with suspected hematologic malignancies.

The fellow also supervises solid tumor patients who are primarily cared for by other services, including surgical oncology patients and patients in the intensive care unit.

The fellow also has the opportunity to join in the consultation for patients coming from other centers with complicated oncologic issues. The fellow usually supervises one medical student.

In addition, Children's Hospital second year pediatric residents have this rotation as an elective. As on the other services, daily work rounds, attending rounds and sign-out rounds are made. A major part of this rotation is learning 11 blood morphology both with the Hematology Attending and with the Hematopathology faculty. The hematology fellow is also responsible for hematology patients seen in the emergency room, and for cross-covering the ambulatory hematology fellow when he or she is in oncology Jimmy Fund clinic.

The fellow also participates in a short course in laboratory hematology and transfusion medicine, and helps to handle outside calls to the hematology service. The majority of children admitted are Hematopoietic Stem Cell Transplant patients, but Oncology and other immunocompromised patients can also be admitted to the unit. There are two separate patient teams — A and B. The fellow also is present when possible. Patients whose acuity is such that they require additional support are transferred to the ICU on 7South Team 1 which has been designed to provide specialized care for SCT patients.

While on the Neuro-oncology service, fellows are responsible for evaluations of new Neurooncology patients, participating in second opinions and the Brain Tumor Clinic, and participating in the care of all Neuro-oncology inpatients. The fellow may work with a dedicated Neuro-oncology fellow. In addition to clinical responsibilities, conferences with an emphasis on Neuro-oncology are held throughout the week. The elective fellow can chose between a variety of pre-arranged electives which include pathology, surgical oncology, palliative care, radiation oncology, late effects of chemotherapy and the pain management service or can arrange their own elective experience.

The fellow on elective continues to attend his or her hematology and oncology clinics. This clinic meets all day, five days per week. Each fellow accrues about 20 new oncology patients and approximately 5 stem cell transplant patients in this clinic and serves as their primary physician.

In general, the fellow spends about 6 hours per week in this clinic. Each clinic includes a conference where all patients are discussed with a team of attending physicians. This clinic has five half-day sessions per week. Fellows follow their hematology patients in one of these clinic sessions.

Fellows from all years take phone calls for the Hematology, Oncology and Stem Cell Transplant services overnight, including both in-hospital and outside calls. In some circumstances for example, a new patient with leukemia , fellows may be asked to return to the hospital from home. On the weekends, fellows cover all services. One fellow takes in-house call for the BMT service on Friday night, and a separate fellow is on call during the daytime on Saturday and Sunday.

The Hematology and Oncology services are covered by one fellow from Friday 5pm until Sunday 5pm. On Sunday night a different fellow assumes call, covering the Hematology and Oncology services from home from 5pm to 8am. Fellows are expected to attend conferences that are specific to a service during their rotations on that service and are invited to attend at other times. New patients presented and discussed. Academic presentations, focused on aplastic anemia, myelodysplasia, bone marrow failure.

Active patients with musculoskeletal tumors are presented, and diagnostic and management issues discussed. Fellows are urged to participate if one of their patients is attending the clinic that day. Many upper year fellows also attend. Current articles from the hematology literature are reviewed with a formal fellow-driven presentation.

Fellows are encouraged to attend. The following topics represent the conference themes: For all first year fellows. Includes a series of sessions at the beginning of the year on the analysis of peripheral blood and bone marrow slides. Teaching sessions are led by expert faculty. Fellows attend weekly on their assigned day for outpatient oncology clinic. Third year fellows are responsible for running the conference on their clinic day, providing education and ensuring that discussions are interesting and informative.

Involvement of clinicians and researchers in discussions over thrombosis and hemostasis issues, with a view of fostering collaborative research. In general, all first year fellows attend and present approximately three times per year.

Upper-year fellows and oncology staff also attend. The fellow meets with the mentor about every three months to discuss any issues that may arise during that time. In addition, the mentor receives copies of the performance reviews done by the attending at the end of each rotation. Should problems be detected, the clinical mentor will work with the fellow and the rest of the clinical staff as appropriate to address the issues.

About 60 percent of our fellows choose to do laboratory 15 research and 40 percent choose clinical investigation. We strongly support both pathways. Most fellows remain with the same research mentor until the fellow assumes independent faculty status i.

Although the NIH only allows a maximum of three years postdoctoral research support on NIH Training Grants T32s , we have in the past and will continue to try and support fellows for as long as necessary for them to attain independence.

This support is obtained through vigorous pursuit of competitive federal and nonfederal fellowships, supplemented by institutional resources. During that year, the fellow's stipend is derived from institutional funds. Once this year is completed, the fellow enters a nearly full time research training program supported by two institutional training grants a total of 18 slots.

Clinical work is limited to an average of one clinic day per week. A comprehensive program of cross coverage has been instituted to insure that, to the extent possible, a fellow's research work is not hampered by clinical responsibilities on days other than the assigned clinic day. We provide listings of many laboratory and clinical researchers in the Boston area and ask the fellows to read about specific research areas and begin to identify potential mentors.

The meetings occur early in the first year. This process continues throughout the first half of the year, with the goal that all fellows will have secured a research position by January.

Fellows are able to work with any of the thousands of experienced researchers in the Boston area, as long as the outside research sponsor is acceptable to an oversight committee composed of Drs. Orkin and Pellman laboratory research and Sallan and Frazier clinical research. We view outside research experiences as particularly valuable since, if fellows rejoin the program as faculty, they bring new skills and areas of research.

Clinical Research and Global Health. Fellows who are interested in these training tracks will benefit from a formal research curriculum and mentorship from leading experts in these areas. Fellows in this track will accomplish these key signposts of clinical research expertise: Expertise in a specific area of interest in a disease, a therapeutic modality, or in relevant fields of risk reduction, outcomes research or cancer control that will lead to national recognition.

A portfolio of research that demonstrates competency in various aspects of clinical research. Clinically-based research within the Program occurs on two tracks, which are not necessarily mutually exclusive but do require different expertise.

One track is for fellows interested in clinical-translational research with the ultimate goal of designing clinical trials. Other fellows in the Program pursue health-services research, focusing on outcomes and policy. The expertise of our faculty currently supports research in clinical trial design and evaluation, bioethics, medical education, improvement of patient-parent-physician communication, risk stratification, evaluation and mitigation of late effects, and optimization of palliative care.

Research in these areas can either be focused within the United States, or in low and middle income countries through our Global Health Program. CTIP includes protocol specialists, who are available to advise on the development and submission of protocols; statisticians with expertise in study design, data collection and evaluation; clinical research associates; and clinical research nurses.

Every clinical fellow is supported throughout their research experience by this readily-available expert team. Fellows choose a research mentor during the first year of fellowship. For fellows who come without substantial research methods training, the core didactic training is the Clinical Effectiveness Program at Harvard School of Public Health HSPH which is typically taken the summer after the first or second year of fellowship training.

Tuition for this course is fully funded by the training program. This intensive 7-week, 15 credit program includes core courses in epidemiology and biostatistics as well as 2 electives. One important goal of the summer course is to develop a complete clinical research proposal, including background, objectives, methods, statistical analysis, with input from both the clinical research mentor as well as the HSPH faculty.

This project will serve as the blueprint for at least one of the projects the fellow intends to complete during the subsequent year s of fellowship. This is a suggested schedule to be used as basis for discussion between fellow and mentor during regular meetings and to be reviewed by the Scientific Oversight Committee at their annual review of the fellow. Each fellow should have at least two research projects. The goal of Project 1 should be to allow the fellow to become immersed in the research field of interest, to learn some of the pragmatic skills of clinical research, such as how to write an IRB application, as well as to hone methodological skills.

By late winter, the fellow should have accomplished enough work to be able to write an abstract on that work to be submitted to a national meeting.

The analysis should be complete by fall of the 3rd year and a final paper produced by end of the 3rd year. Because the conceptualization on Project 1 will have entailed a very thorough review of the existing literature, a review article should be written by the fellow, summarizing the background information of Project 1, by the end of the 2nd year. Current training programs include: In addition, the Dana-Farber offers two courses for fellows and junior faculty.

The first course, recommended for all fellows in any type of clinical research, is a general overview of clinical research with special skill-building lectures, for instance on how to write a research paper, given by the editor of the Journal of Clinical Oncology.

This course is taken once a week during the second half of the second year and is a joint class with the medical oncology fellows. The second course is required for all fellows and junior faculty who intend to be the Principal Investigator on a clinical therapeutic trial.

This course delves more deeply into methodology of clinical trial design, and the Participants during the course actually develop and receive iterative critique on a clinical protocol of their own design. Finally, some fellows interested in clinical trials choose to participate in our fellowship program with Novartis, described separately.

This one-year program offers fellows the opportunity to participate in early phase clinical trials at Novartis as preparation for ongoing investigation in the future. The Division also sponsors a weekly research seminar at which senior and junior faculty and fellows present their work on a rotating basis. Fellows working towards a career in clinical research are encouraged to apply for grant funding, either from a private foundation or for a National Institute of Health Career Development award K series near the end of their fellowship.

In addition to support from their mentor, fellows receive comprehensive support and guidance throughout the grant application process. Program goal Trains fellows or junior faculty to become independent health services researchers; focused on creating new knowledge and strategies to improve access, quality, outcomes, and costeffectiveness in pediatric health care. Structured seminars, intensive mentorship, and cross-disciplinary collaboration.

Emphasis on clinical effectiveness and outcomes research, translation of evidence into practice and policy, analysis of large databases, and cost effectiveness of care. Trainees may have concurrent subspecialty fellowship appointment. Extensive didactic curriculum at HSPH and HMS, including summer Clinical Effectiveness Program, longitudinal seminar series, physiological investigation tools, clinical trials methods, genetics, pharmacoepidemiology, and bioinformatics.

Many additional courses throughout Harvard University are available to fellows on an auditor basis. For fellows interested in global health a 4-year fellowship is offered. Currently the sites that are available to fellows include any of the member institutions of AHOPCA Asociacion de Hemato-Oncologia Pediatrica de Centroamerica y Republica Dominicana , a pediatric oncology association that has a designated pediatric oncology facility in every country in Central America and the Dominican Republic.

Other projects include the collaboration with Partners-in-Health in the development of pediatric cancer and hematology programs in Rwanda and Haiti, the development of a sickle cell program in Liberia, and a retinoblastoma program in Davao, Philippines. Fellows will spend a minimum of one month and up to three months per year at one of these sites during their second, third and fourth year of their fellowship training. Since this requires additional time to be spent off-site during the fellowship we extend training to four years for most fellows.

Ongoing collaboration when the fellow is not in residence at the site will be facilitated with interactive information technology, such as the Cure4Kids website. The overarching project for the summer course is to develop a complete clinical research proposal, including background, objectives, methods, statistical analysis, with input from both the clinical research mentor as well as the HSPH faculty.

This project will serve as the blueprint for the project the fellow will work on at the international site. During this fellowship, not more than one fellow per year may be identified by a selective process to work in the Novartis Oncology Translational Research Program in Cambridge. Selected fellows will participate in an experiential education program that provides practical learning and clinical research experience. Fellows interested in this program will meet with team leaders at Novartis to discuss potential projects.

The remainder of each week will be spent working in Oncology Translational Research at Novartis. The length of training varies widely from individual to individual but is almost always longer than the traditional 2 to 3 years of research training associated with MD fellowships.

Trainees pursuing clinical projects require broad training in experimental design, biostatistics, epidemiology, pharmacokinetics, and clinical trials. This emphasis is linked to Dr. The training program is individualized for each trainee since trainees come to the program with very different goals and experiences in research. Though most MD trainees choose to do their clinical work first, a few prefer to begin in the laboratory to avoid clinical distractions.

Williams himself is an example of this 22 II. While not a Ph. The clinical work itself is varied, depending on experience. Those with previous training in internal medicine take different rotations from those with a pediatrics background, etc. We also foster training of individuals whose interests lie astride or between disciplines. We encourage such hybrid individuals and the training of internists or graduates of combined medicine-pediatrics residencies within the division because we believe they enrich the program with new views and experiences.

The general philosophy is that training monies are available solely to support the needs of the trainees and not the needs of the division.

In our experience this view is not universal. Fellows typically present their work at lab meetings and once or twice per year at floor-wide research meetings. In addition, fellows frequently present their work at national meetings. Introduction to Statistical Genetics CRP Education core , and an overview of Clinical Pharmacology could also be valuable for the translationally oriented fellow.

Abundant formal courses are available in the Harvard Medical School area. All fellows must take a course in bioethics: Laboratory 23 researchers also take a course in radionuclides for researchers, and a course in the care and handling of laboratory animals. All fellows are encouraged to attend scientific meetings and, when appropriate, to present their research.

Careful attention is given to preparation for such presentations. Talks are carefully rehearsed and posters are examined by senior staff and specific feedback is given. These sessions are of great value in helping fellows learn how to communicate science. The laboratory research mentoring program is supervised by Drs. David Pellman and Stuart Orkin and the clinical research mentoring by Drs.

Stephen Sallan and Lindsay Frazier. Fellows meet with their committees twice per year and present their research and future plans. Mentors are invited to attend. The committee offers advice on problems the fellow has encountered, suggestions for new research directions, and opinions about the most promising leads to pursue.

The committee also advises the fellow about funding opportunities and grant writing; and otherwise assists the fellow in any way possible. Research interests can be broadly subdivided into 37 laboratory research and 21 clinical research project areas. Letai, Look, and Walensky 2. Adhesion, Migration, Cell Shape: Pellman, Springer, von Andrian, Wagner, and Williams 3.

Cancer Cell and Molecular Biology: Cancer Cytogenetics and Fusion Oncogenes: Alt, Garraway, Hahn, and Look 5. Cell and Molecular Biology: Cellular and Thiamine Metabolism: Bradner, Danial and Walensky 8.

Bradner, Orkin and Roberts Daley, Look, Orkin, Segal, and Zon Fanconi Anemia and Bone Marrow Failure: Daley, Ebert, Orkin, Roberts, and Zon Gene Transfer and Gene Therapy: Immunology and Innate Immunity: Alt, Haining, Lieberman, Pai, and Ritz Immunology and stem cell transplantation: Iron Metabolism, Iron Overload: Fleming, Neufeld, and Pai Benz, Brugnara, Hartwig, and Lux Kieran, Look, Segal, and Stiles Cantor, Frelinger, Hartwig, Hoffmeister and Michelson Golub, Gregory, Lieberman, and Orkin 25 Frelinger, Heeney, Michelson, and Neufeld 2.

Bone Marrow Failure, Fanconi Anemia: Garraway, Golub, Janeway, and Stegmaier 4. Cancer Prevention and Cancer Epidemiology: Cancer Therapy, Small Molecules, Translational: Daley, Dubois, Lieberman, Stegmaier, and Williams 6. End-of-Life and Palliative Care: Grier, Mack, Ullrich, and Wolfe 8. Frazier, Lehmann, and Kieran Daley, Sallan, Silverman, and Stegmaier Fleming, Heeney, Nathan and Neufeld Grace and Neufeld Ebert, Fleming, Hoffman, and Williams Diller, George, and Shusterman Neuro-oncology and Phase I trials: Diller, Frazier, Mack, and Wolfe Brugnara and Heeney Diller and Vrooman The fellow's salary is supported by clinical funds during the clinical year of training.

One training grant is available to support fellows during their research years. Fellows can receive up to three years of support from the training grants, but many choose to apply for other fellowships, especially "K-awards" K08, K23, etc , after one or two years of research because of the higher stipend they offer. We have specific faculty mentorship focused on assisting fellows developing their first NIH and other grants. The following items are eligible for reimbursement: Fellows are also eligible for additional benefits, which are mostly available at reduced rates: Another way to look at the program is to analyze our success at achieving our major objective, which is to train leaders of American hematology and oncology.

To evaluate our success in preparing fellows for leadership positions, we have recently examined the cohort who began training between and More recent fellows are still completing their training or are early in their academic careers. For those of our graduates who began the program between and Of those in the program from to , many are still young and have not yet reached their full potential. No other pediatric program, in any specialty, has such a record of accomplished alumni.

George Buchanan and Eli Schwartz and Dr. Holcombe Grier is the immediate Past- President. Five alumni, one former mentoring faculty and one current mentoring faculty were awarded the prestigious William Dameshek Prize for Research in Hematology and six have received the equally prestigious E. Donnall Thomas Prize for Research in Hematology. Both recognize outstanding accomplishments in hematology research. More than ten alumni have received the distinguished E.

Mead-Johnson Award for Research in Pediatrics, which is the highest research award in that specialty. Seven have received the Henry M. Stratton Medal, given each year in recognition of a distinguished career in American hematology, and David Nathan was also the recipient of the Wallace H. Coulter Award for lifetime achievement in Hematology. Dean, Duke University School of Medicine. Ex-Chief, Hematology Section, Dept. Director, Israel Red Cross General Hospital, Harvard Chief, of Transfusion Service, Chief, Div.

Inpatient 6E service is an 8 bed hematology ward. New patient evaluations and follow-ups take place in the Jimmy Fund Clinic. The SCT group consists of 14 attending physicians, 1 physician's assistant, 3 nurse practitioners, 1 program administrator, and 2 transplant coordinators. For more information on the ERAS system please visit the following: You will be directed to search for the program name.

Our program name is: Please make sure that you click on that link. If not, you will be redirected to a different application. All applicants must supply at least three letters. If your application is not received by the deadline mentioned below, your application will be marked incomplete and will not be accepted.

We strongly recommend that you submit your application by December However, we accept applications until March 1, assuming it is possible to schedule an interview between that date and the date of our selection committee meeting. If you need further information please contact: We cannot accept applicants who are not registered with the NRMP. The NRMP phone number and web address are and http: Such decisions are made on a caseby-case basis.

The deadline for applications is March 15; however, we strongly encourage you to apply before the end of December since we begin to sort applications and issue invitations for interviews at that time.

We do not issue all interview invitations at the same time because some candidates decide to apply later than others and we do not want to exclude them from consideration. Trishna Rana arranges all interviews and will gladly help with any other problems.

Applicants are also welcome to contact Dr. Receive applications mostly December - March Early December: Interviews on selected days Late April: Rank order list deadline Mid-May: Those seeking an exemption must apply by February 1, It is the training directors' intention that exemptions will only be granted in rare circumstances. Please contact us if you feel an exemption is appropriate in your case or for any other questions. However, three single year clinical training programs are available within the division: Pediatric palliative care for those who have completed a general pediatrics residency, contact Dr.

Additional information about this fellowship is available on the Pediatric Advanced Care Team's web page: The components of the program include time on the inpatient service as a coattending with a senior member of the transplant team, new patient evaluations, attending chronic GVHD clinic, working in the cell manipulation and apheresis facilities and a clinical research project for meeting submission and eventual publication.

Immensely diverse and vibrant, Boston is a city of some twenty neighborhoods with Cambridge and Brookline as bordering communities. Sites of pivotal battles at Bunker Hill, and in Lexington and Concord, are also national monuments and nearly every town has an historical society. Old Sturbridge Village is an authentic recreation of a colonial village, with historic housing and costumed inhabitant.

It is located in Sturbridge, an hour west of Boston. And touristy Salem, home of the infamous witch trials, lies to the north. More distant towns are served by commuter rail. The Longwood Medical area is centered within blocks of two different Green line routes.

There is also an extensive bus system, including a shuttle bus from Harvard University to the Medical School. Parking is expensive in the Longwood area, but fellows who drive can park in cheaper outlying lots and use shuttle buses. Fellows can park in the patient lot across from Children's for free at nights and on weekends.

Residents who leave the hospital late at night can also obtain free taxi vouchers. The Boston Symphony is world-renowned, as is the Boston Pops, but there are several other professional symphonies and innumerable civic and college orchestras. In fact, the medical area has its own orchestra, the Longwood Symphony, composed mostly of physicians, that is very high quality. There are also many outstanding amateur choral groups: Kennedy Library and Museum are also outstanding.

Plus, Boston is a frequent venue for pre-Broadway tryouts and touring national companies. The Revolution soccer are also among the top teams each year. Harvard University offers facilities for indoor and outdoor tennis, swimming and diving, ice skating, jogging, squash, basketball, baseball, field hockey, lacrosse, rugby, volleyball, rowing, and sailing, plus others, and extensive exercise and weight training. The Medical School has a gymnasium, squash courts, cardiovascular and strength training equipment and an outdoor tennis court.

Groups like the Boston Ski and Sports Club organize year round sports leagues, as well as sporting trips. Boston is a great running and biking city. There are numerous bikeways, particularly along the Charles River and through the 'Emerald Necklace' string of parks, which lies just 3 blocks from the Longwood area.

The same routes are popular for running. For serious runners, the famous Boston Marathon occurs each spring on Patriots Day, which is a local holiday, allowing those who wish to run, to participate. Many housestaff, fellows and faculty do. Golfers have many opportunities in the Boston area.

To compensate, the program offers higher than average salaries. Real estate information is available from a number of sources including the Boston Globe. The Great Schools website contains considerable information about individual schools www.

KIDS Boston is a great city for kids because there are so many things to see and do in the city and nearby, and because the transportation system is safe and extensive.

The Children's Museum and the Museum of Science are each among the best in the country. The nearly free Community Boating Program is also outstanding. A good list of activities for kids can be found at Boston Discovery Guide http: The latter site also contains useful information about Boston suburban communities.

Unlike many cities, much of the waterfront is recreational space. The harbor offers boating of all kinds, fishing, and a number of community beaches. There is a Harborwalk with many parks and other venues. The Harbor Islands are part of the National Park system and are accessible by ferry for day trips and picnicking.

Every July 4th, the Esplanade is packed with crowds for a spectacular Boston Pops concert and fireworks show.

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Recorded descriptions of the effects of AIS date back hundreds of years, although significant understanding of its underlying histopathology did not occur until the s. The first descriptions of the effects of AIS appeared in the medical literature as individual case reports or as part of a comprehensive description of intersex physicalities. In , Scottish obstetrician Sir James Young Simpson published one such description [] in an exhaustive study of intersexuality that has been credited with advancing the medical community's understanding of the subject.

An alternative system of nomenclature has been recently suggested, [] but the subject of exactly which word or words should be used in its place still one of much debate. For example, 46,XY individuals who have a female phenotype, but also have testes instead of ovaries — a group that includes all individuals with CAIS, as well as some individuals with PAIS — are classified as having "male pseudohermaphroditism", while individuals with both an ovary and a testis or at least one ovotestis are classified as having " true hermaphroditism ".

Previous definitions of "pseudohermaphroditism" relied on perceived inconsistencies between the internal and external organs; the "true" sex of an individual was determined by the internal organs, and the external organs determined the "perceived" sex of an individual.

German-Swiss pathologist Edwin Klebs is sometimes noted for using the word "pseudohermaphroditism" in his taxonomy of intersexuality in , [] although the word is clearly not his invention as is sometimes reported; the history of the word " pseudohermaphrodite " and the corresponding desire to separate "true" hermaphrodites from "false", "spurious", or "pseudo" hermaphrodites, dates back to at least , when Dutch anatomist Frederik Ruysch used it in a publication describing a subject with testes and a mostly female phenotype.

In , American gynecologist John Morris provided the first full description of what he called "testicular feminization syndrome" based on 82 cases compiled from the medical literature, including two of his own patients.

A distinct name has been given to many of the various presentations of AIS, such as Reifenstein syndrome , [] Goldberg-Maxwell syndrome , [] Morris' syndrome , [] Gilbert-Dreyfus syndrome , [] Lub's syndrome , [] "incomplete testicular feminization" , [] Rosewater syndrome , [] and Aiman's syndrome Over the last 60 years, as reports of strikingly different phenotypes were reported to occur even among members of the same family, and as steady progress was made towards the understanding of the underlying molecular pathogenesis of AIS, these disorders were found to be different phenotypic expressions of one syndrome caused by molecular defects in the androgen receptor gene.

AIS is now the accepted terminology for the syndromes resulting from unresponsiveness of the target cell to the action of androgenic hormones.

The more virilized phenotypes of AIS have sometimes been described as "undervirilized male syndrome", "infertile male syndrome", "undervirilized fertile male syndrome", etc. She has given interviews about her condition [] [] and founded "Girl Comet, a non-profit diversity awareness and inspiration initiative.

In , fashion model Hanne Gaby Odiele disclosed that she was born with the intersex trait androgen insensitivity syndrome. As a child, she underwent medical procedures relating to her condition , [] which she said took place without her or her parents' informed consent. In the Japanese horror novel Ring , by Koji Suzuki later adapted into Japanese, Korean, and American films , the central antagonist Sadako has this syndrome. From Wikipedia, the free encyclopedia.

Androgen insensitivity syndrome AIS results when the androgen receptor AR pictured is not able to function as a transcription factor for androgens , which normally activate relevant genes.

Complete androgen insensitivity syndrome. Partial androgen insensitivity syndrome. Mild androgen insensitivity syndrome. Androgen enters the cell. Only certain organs in the body, such as the gonads and the adrenal glands , produce the androgen testosterone. Testosterone is converted into dihydrotestosterone , a chemically similar androgen, in cells containing the enzyme 5-alpha reductase. Both androgens exert their influence through binding with the androgen receptor.

The androgen receptor is expressed ubiquitously throughout the tissues of the human body. Before it binds with an androgen, the androgen receptor is bound to heat shock proteins. These heat shock proteins are released upon androgen binding. Androgen binding induces a stabilizing, conformational change in the androgen receptor.

The two zinc fingers of the DNA-binding domain are exposed as a result of this new conformation. Receptor phosphorylation can occur before androgen binding, although the presence of androgen promotes hyperphosphorylation. The biological ramifications of receptor phosphorylation are unknown. Nucleocytoplasmic transport is in part facilitated by an amino acid sequence on the AR called the nuclear localization signal.

The AR's nuclear localization signal is primarily encoded in the hinge region of the AR gene. Dimerization is mediated by the second nearest the 3' end zinc finger.

Target genes contain or are flanked by transcriptional enhancer nucleotide sequences that interact with the first zinc finger. These areas are called androgen response elements. Type I coactivators i. Diagnosis of Complete Androgen Insensitivity Syndrome. Diagnosis of Partial Androgen Insensitivity Syndrome. Diagnosis of Mild Androgen Insensitivity Syndrome. Frasier syndrome associated with progressive glomerulopathy Denys-Drash syndrome associated with nephropathy and Wilms tumor WAGR syndrome associated with Wilms tumor and aniridia McKusick-Kaufman syndrome associated with postaxial polydactyly Robinow syndrome associated with dwarfism Aarskog-Scott syndrome associated with facial anomalies Hand-foot-genital syndrome associated with limb malformations Popliteal pterygium syndrome associated with extensive webbing behind knees Kallmann syndrome often associated with anosmia Hypospadias not otherwise specified Cryptorchidism not otherwise specified vaginal atresia not otherwise specified.

Management of Complete Androgen Insensitivity Syndrome. Management of Partial Androgen Insensitivity Syndrome. Management of Mild Androgen Insensitivity Syndrome. The pharmacology and classification of the nuclear receptor superfamily: American Journal of Human Genetics. American Journal of Medical Genetics. The androgen receptor gene mutations database". Hung, Wellington, Becker, Kenneth L.

Principles and Practice of Endocrinology and Metabolism. J Pediatr Adolesc Gynecol. Acta Obstet Gynecol Scand. Retrieved on October 1, The ethics of PGD for intersex conditions". Organisation Intersex International Australia. Retrieved 28 September The diagnosis and treatment of endocrine disorders in childhood and adolescence. Charles C Thomas, , pp.

Midwifery, obstetrics and the rise of gynaecology: Des monstres et prodiges. Chez Franc d'Amour The controversy over "disorders of sex development " ". Handbuch der pathologischen anatomie. Acta eruditorum anno mdccix. Carl Gerold ; Allgemeine Literatur-Zeitung Issues Stuttgart et Augsbourg , p.

Proc Am Fed Clin Res. Annals of Internal Medicine. Genetic polymorphisms and susceptibility to disease. Retrieved 23 January Academic presentations, focused on aplastic anemia, myelodysplasia, bone marrow failure.

Active patients with musculoskeletal tumors are presented, and diagnostic and management issues discussed. Fellows are urged to participate if one of their patients is attending the clinic that day. Many upper year fellows also attend. Current articles from the hematology literature are reviewed with a formal fellow-driven presentation. Fellows are encouraged to attend.

The following topics represent the conference themes: For all first year fellows. Includes a series of sessions at the beginning of the year on the analysis of peripheral blood and bone marrow slides. Teaching sessions are led by expert faculty.

Fellows attend weekly on their assigned day for outpatient oncology clinic. Third year fellows are responsible for running the conference on their clinic day, providing education and ensuring that discussions are interesting and informative. Involvement of clinicians and researchers in discussions over thrombosis and hemostasis issues, with a view of fostering collaborative research.

In general, all first year fellows attend and present approximately three times per year. Upper-year fellows and oncology staff also attend. The fellow meets with the mentor about every three months to discuss any issues that may arise during that time.

In addition, the mentor receives copies of the performance reviews done by the attending at the end of each rotation. Should problems be detected, the clinical mentor will work with the fellow and the rest of the clinical staff as appropriate to address the issues. About 60 percent of our fellows choose to do laboratory 15 research and 40 percent choose clinical investigation. We strongly support both pathways. Most fellows remain with the same research mentor until the fellow assumes independent faculty status i.

Although the NIH only allows a maximum of three years postdoctoral research support on NIH Training Grants T32s , we have in the past and will continue to try and support fellows for as long as necessary for them to attain independence.

This support is obtained through vigorous pursuit of competitive federal and nonfederal fellowships, supplemented by institutional resources. During that year, the fellow's stipend is derived from institutional funds. Once this year is completed, the fellow enters a nearly full time research training program supported by two institutional training grants a total of 18 slots.

Clinical work is limited to an average of one clinic day per week. A comprehensive program of cross coverage has been instituted to insure that, to the extent possible, a fellow's research work is not hampered by clinical responsibilities on days other than the assigned clinic day. We provide listings of many laboratory and clinical researchers in the Boston area and ask the fellows to read about specific research areas and begin to identify potential mentors.

The meetings occur early in the first year. This process continues throughout the first half of the year, with the goal that all fellows will have secured a research position by January.

Fellows are able to work with any of the thousands of experienced researchers in the Boston area, as long as the outside research sponsor is acceptable to an oversight committee composed of Drs.

Orkin and Pellman laboratory research and Sallan and Frazier clinical research. We view outside research experiences as particularly valuable since, if fellows rejoin the program as faculty, they bring new skills and areas of research. Clinical Research and Global Health. Fellows who are interested in these training tracks will benefit from a formal research curriculum and mentorship from leading experts in these areas. Fellows in this track will accomplish these key signposts of clinical research expertise: Expertise in a specific area of interest in a disease, a therapeutic modality, or in relevant fields of risk reduction, outcomes research or cancer control that will lead to national recognition.

A portfolio of research that demonstrates competency in various aspects of clinical research. Clinically-based research within the Program occurs on two tracks, which are not necessarily mutually exclusive but do require different expertise. One track is for fellows interested in clinical-translational research with the ultimate goal of designing clinical trials.

Other fellows in the Program pursue health-services research, focusing on outcomes and policy. The expertise of our faculty currently supports research in clinical trial design and evaluation, bioethics, medical education, improvement of patient-parent-physician communication, risk stratification, evaluation and mitigation of late effects, and optimization of palliative care.

Research in these areas can either be focused within the United States, or in low and middle income countries through our Global Health Program. CTIP includes protocol specialists, who are available to advise on the development and submission of protocols; statisticians with expertise in study design, data collection and evaluation; clinical research associates; and clinical research nurses.

Every clinical fellow is supported throughout their research experience by this readily-available expert team. Fellows choose a research mentor during the first year of fellowship. For fellows who come without substantial research methods training, the core didactic training is the Clinical Effectiveness Program at Harvard School of Public Health HSPH which is typically taken the summer after the first or second year of fellowship training. Tuition for this course is fully funded by the training program.

This intensive 7-week, 15 credit program includes core courses in epidemiology and biostatistics as well as 2 electives. One important goal of the summer course is to develop a complete clinical research proposal, including background, objectives, methods, statistical analysis, with input from both the clinical research mentor as well as the HSPH faculty.

This project will serve as the blueprint for at least one of the projects the fellow intends to complete during the subsequent year s of fellowship. This is a suggested schedule to be used as basis for discussion between fellow and mentor during regular meetings and to be reviewed by the Scientific Oversight Committee at their annual review of the fellow.

Each fellow should have at least two research projects. The goal of Project 1 should be to allow the fellow to become immersed in the research field of interest, to learn some of the pragmatic skills of clinical research, such as how to write an IRB application, as well as to hone methodological skills.

By late winter, the fellow should have accomplished enough work to be able to write an abstract on that work to be submitted to a national meeting. The analysis should be complete by fall of the 3rd year and a final paper produced by end of the 3rd year.

Because the conceptualization on Project 1 will have entailed a very thorough review of the existing literature, a review article should be written by the fellow, summarizing the background information of Project 1, by the end of the 2nd year. Current training programs include: In addition, the Dana-Farber offers two courses for fellows and junior faculty. The first course, recommended for all fellows in any type of clinical research, is a general overview of clinical research with special skill-building lectures, for instance on how to write a research paper, given by the editor of the Journal of Clinical Oncology.

This course is taken once a week during the second half of the second year and is a joint class with the medical oncology fellows. The second course is required for all fellows and junior faculty who intend to be the Principal Investigator on a clinical therapeutic trial.

This course delves more deeply into methodology of clinical trial design, and the Participants during the course actually develop and receive iterative critique on a clinical protocol of their own design. Finally, some fellows interested in clinical trials choose to participate in our fellowship program with Novartis, described separately.

This one-year program offers fellows the opportunity to participate in early phase clinical trials at Novartis as preparation for ongoing investigation in the future. The Division also sponsors a weekly research seminar at which senior and junior faculty and fellows present their work on a rotating basis. Fellows working towards a career in clinical research are encouraged to apply for grant funding, either from a private foundation or for a National Institute of Health Career Development award K series near the end of their fellowship.

In addition to support from their mentor, fellows receive comprehensive support and guidance throughout the grant application process. Program goal Trains fellows or junior faculty to become independent health services researchers; focused on creating new knowledge and strategies to improve access, quality, outcomes, and costeffectiveness in pediatric health care.

Structured seminars, intensive mentorship, and cross-disciplinary collaboration. Emphasis on clinical effectiveness and outcomes research, translation of evidence into practice and policy, analysis of large databases, and cost effectiveness of care. Trainees may have concurrent subspecialty fellowship appointment. Extensive didactic curriculum at HSPH and HMS, including summer Clinical Effectiveness Program, longitudinal seminar series, physiological investigation tools, clinical trials methods, genetics, pharmacoepidemiology, and bioinformatics.

Many additional courses throughout Harvard University are available to fellows on an auditor basis. For fellows interested in global health a 4-year fellowship is offered. Currently the sites that are available to fellows include any of the member institutions of AHOPCA Asociacion de Hemato-Oncologia Pediatrica de Centroamerica y Republica Dominicana , a pediatric oncology association that has a designated pediatric oncology facility in every country in Central America and the Dominican Republic.

Other projects include the collaboration with Partners-in-Health in the development of pediatric cancer and hematology programs in Rwanda and Haiti, the development of a sickle cell program in Liberia, and a retinoblastoma program in Davao, Philippines.

Fellows will spend a minimum of one month and up to three months per year at one of these sites during their second, third and fourth year of their fellowship training. Since this requires additional time to be spent off-site during the fellowship we extend training to four years for most fellows.

Ongoing collaboration when the fellow is not in residence at the site will be facilitated with interactive information technology, such as the Cure4Kids website. The overarching project for the summer course is to develop a complete clinical research proposal, including background, objectives, methods, statistical analysis, with input from both the clinical research mentor as well as the HSPH faculty. This project will serve as the blueprint for the project the fellow will work on at the international site.

During this fellowship, not more than one fellow per year may be identified by a selective process to work in the Novartis Oncology Translational Research Program in Cambridge. Selected fellows will participate in an experiential education program that provides practical learning and clinical research experience.

Fellows interested in this program will meet with team leaders at Novartis to discuss potential projects. The remainder of each week will be spent working in Oncology Translational Research at Novartis. The length of training varies widely from individual to individual but is almost always longer than the traditional 2 to 3 years of research training associated with MD fellowships. Trainees pursuing clinical projects require broad training in experimental design, biostatistics, epidemiology, pharmacokinetics, and clinical trials.

This emphasis is linked to Dr. The training program is individualized for each trainee since trainees come to the program with very different goals and experiences in research. Though most MD trainees choose to do their clinical work first, a few prefer to begin in the laboratory to avoid clinical distractions. Williams himself is an example of this 22 II. While not a Ph. The clinical work itself is varied, depending on experience.

Those with previous training in internal medicine take different rotations from those with a pediatrics background, etc. We also foster training of individuals whose interests lie astride or between disciplines. We encourage such hybrid individuals and the training of internists or graduates of combined medicine-pediatrics residencies within the division because we believe they enrich the program with new views and experiences.

The general philosophy is that training monies are available solely to support the needs of the trainees and not the needs of the division. In our experience this view is not universal.

Fellows typically present their work at lab meetings and once or twice per year at floor-wide research meetings. In addition, fellows frequently present their work at national meetings. Introduction to Statistical Genetics CRP Education core , and an overview of Clinical Pharmacology could also be valuable for the translationally oriented fellow. Abundant formal courses are available in the Harvard Medical School area. All fellows must take a course in bioethics: Laboratory 23 researchers also take a course in radionuclides for researchers, and a course in the care and handling of laboratory animals.

All fellows are encouraged to attend scientific meetings and, when appropriate, to present their research. Careful attention is given to preparation for such presentations. Talks are carefully rehearsed and posters are examined by senior staff and specific feedback is given. These sessions are of great value in helping fellows learn how to communicate science.

The laboratory research mentoring program is supervised by Drs. David Pellman and Stuart Orkin and the clinical research mentoring by Drs.

Stephen Sallan and Lindsay Frazier. Fellows meet with their committees twice per year and present their research and future plans. Mentors are invited to attend. The committee offers advice on problems the fellow has encountered, suggestions for new research directions, and opinions about the most promising leads to pursue.

The committee also advises the fellow about funding opportunities and grant writing; and otherwise assists the fellow in any way possible. Research interests can be broadly subdivided into 37 laboratory research and 21 clinical research project areas. Letai, Look, and Walensky 2.

Adhesion, Migration, Cell Shape: Pellman, Springer, von Andrian, Wagner, and Williams 3. Cancer Cell and Molecular Biology: Cancer Cytogenetics and Fusion Oncogenes: Alt, Garraway, Hahn, and Look 5.

Cell and Molecular Biology: Cellular and Thiamine Metabolism: Bradner, Danial and Walensky 8. Bradner, Orkin and Roberts Daley, Look, Orkin, Segal, and Zon Fanconi Anemia and Bone Marrow Failure: Daley, Ebert, Orkin, Roberts, and Zon Gene Transfer and Gene Therapy: Immunology and Innate Immunity: Alt, Haining, Lieberman, Pai, and Ritz Immunology and stem cell transplantation: Iron Metabolism, Iron Overload: Fleming, Neufeld, and Pai Benz, Brugnara, Hartwig, and Lux Kieran, Look, Segal, and Stiles Cantor, Frelinger, Hartwig, Hoffmeister and Michelson Golub, Gregory, Lieberman, and Orkin 25 Frelinger, Heeney, Michelson, and Neufeld 2.

Bone Marrow Failure, Fanconi Anemia: Garraway, Golub, Janeway, and Stegmaier 4. Cancer Prevention and Cancer Epidemiology: Cancer Therapy, Small Molecules, Translational: Daley, Dubois, Lieberman, Stegmaier, and Williams 6.

End-of-Life and Palliative Care: Grier, Mack, Ullrich, and Wolfe 8. Frazier, Lehmann, and Kieran Daley, Sallan, Silverman, and Stegmaier Fleming, Heeney, Nathan and Neufeld Grace and Neufeld Ebert, Fleming, Hoffman, and Williams Diller, George, and Shusterman Neuro-oncology and Phase I trials: Diller, Frazier, Mack, and Wolfe Brugnara and Heeney Diller and Vrooman The fellow's salary is supported by clinical funds during the clinical year of training. One training grant is available to support fellows during their research years.

Fellows can receive up to three years of support from the training grants, but many choose to apply for other fellowships, especially "K-awards" K08, K23, etc , after one or two years of research because of the higher stipend they offer.

We have specific faculty mentorship focused on assisting fellows developing their first NIH and other grants. The following items are eligible for reimbursement: Fellows are also eligible for additional benefits, which are mostly available at reduced rates: Another way to look at the program is to analyze our success at achieving our major objective, which is to train leaders of American hematology and oncology.

To evaluate our success in preparing fellows for leadership positions, we have recently examined the cohort who began training between and More recent fellows are still completing their training or are early in their academic careers. For those of our graduates who began the program between and Of those in the program from to , many are still young and have not yet reached their full potential.

No other pediatric program, in any specialty, has such a record of accomplished alumni. George Buchanan and Eli Schwartz and Dr. Holcombe Grier is the immediate Past- President. Five alumni, one former mentoring faculty and one current mentoring faculty were awarded the prestigious William Dameshek Prize for Research in Hematology and six have received the equally prestigious E.

Donnall Thomas Prize for Research in Hematology. Both recognize outstanding accomplishments in hematology research.

More than ten alumni have received the distinguished E. Mead-Johnson Award for Research in Pediatrics, which is the highest research award in that specialty. Seven have received the Henry M. Stratton Medal, given each year in recognition of a distinguished career in American hematology, and David Nathan was also the recipient of the Wallace H. Coulter Award for lifetime achievement in Hematology. Dean, Duke University School of Medicine.

Ex-Chief, Hematology Section, Dept. Director, Israel Red Cross General Hospital, Harvard Chief, of Transfusion Service, Chief, Div. Inpatient 6E service is an 8 bed hematology ward. New patient evaluations and follow-ups take place in the Jimmy Fund Clinic. The SCT group consists of 14 attending physicians, 1 physician's assistant, 3 nurse practitioners, 1 program administrator, and 2 transplant coordinators.

For more information on the ERAS system please visit the following: You will be directed to search for the program name. Our program name is: Please make sure that you click on that link. If not, you will be redirected to a different application. All applicants must supply at least three letters.

If your application is not received by the deadline mentioned below, your application will be marked incomplete and will not be accepted. We strongly recommend that you submit your application by December However, we accept applications until March 1, assuming it is possible to schedule an interview between that date and the date of our selection committee meeting.

If you need further information please contact: We cannot accept applicants who are not registered with the NRMP. The NRMP phone number and web address are and http: Such decisions are made on a caseby-case basis. The deadline for applications is March 15; however, we strongly encourage you to apply before the end of December since we begin to sort applications and issue invitations for interviews at that time.

We do not issue all interview invitations at the same time because some candidates decide to apply later than others and we do not want to exclude them from consideration. Trishna Rana arranges all interviews and will gladly help with any other problems. Applicants are also welcome to contact Dr. Receive applications mostly December - March Early December: Interviews on selected days Late April: Rank order list deadline Mid-May: Those seeking an exemption must apply by February 1, It is the training directors' intention that exemptions will only be granted in rare circumstances.

Please contact us if you feel an exemption is appropriate in your case or for any other questions. However, three single year clinical training programs are available within the division: Pediatric palliative care for those who have completed a general pediatrics residency, contact Dr. Additional information about this fellowship is available on the Pediatric Advanced Care Team's web page: The components of the program include time on the inpatient service as a coattending with a senior member of the transplant team, new patient evaluations, attending chronic GVHD clinic, working in the cell manipulation and apheresis facilities and a clinical research project for meeting submission and eventual publication.

Immensely diverse and vibrant, Boston is a city of some twenty neighborhoods with Cambridge and Brookline as bordering communities. Sites of pivotal battles at Bunker Hill, and in Lexington and Concord, are also national monuments and nearly every town has an historical society.

Old Sturbridge Village is an authentic recreation of a colonial village, with historic housing and costumed inhabitant. It is located in Sturbridge, an hour west of Boston. And touristy Salem, home of the infamous witch trials, lies to the north. More distant towns are served by commuter rail. The Longwood Medical area is centered within blocks of two different Green line routes.

There is also an extensive bus system, including a shuttle bus from Harvard University to the Medical School. Parking is expensive in the Longwood area, but fellows who drive can park in cheaper outlying lots and use shuttle buses.

Fellows can park in the patient lot across from Children's for free at nights and on weekends. Residents who leave the hospital late at night can also obtain free taxi vouchers. The Boston Symphony is world-renowned, as is the Boston Pops, but there are several other professional symphonies and innumerable civic and college orchestras. In fact, the medical area has its own orchestra, the Longwood Symphony, composed mostly of physicians, that is very high quality.

There are also many outstanding amateur choral groups: Kennedy Library and Museum are also outstanding. Plus, Boston is a frequent venue for pre-Broadway tryouts and touring national companies. The Revolution soccer are also among the top teams each year. Harvard University offers facilities for indoor and outdoor tennis, swimming and diving, ice skating, jogging, squash, basketball, baseball, field hockey, lacrosse, rugby, volleyball, rowing, and sailing, plus others, and extensive exercise and weight training.

The Medical School has a gymnasium, squash courts, cardiovascular and strength training equipment and an outdoor tennis court. Groups like the Boston Ski and Sports Club organize year round sports leagues, as well as sporting trips. Boston is a great running and biking city. There are numerous bikeways, particularly along the Charles River and through the 'Emerald Necklace' string of parks, which lies just 3 blocks from the Longwood area. The same routes are popular for running. For serious runners, the famous Boston Marathon occurs each spring on Patriots Day, which is a local holiday, allowing those who wish to run, to participate.

Many housestaff, fellows and faculty do. Golfers have many opportunities in the Boston area. To compensate, the program offers higher than average salaries. Real estate information is available from a number of sources including the Boston Globe.

The Great Schools website contains considerable information about individual schools www. KIDS Boston is a great city for kids because there are so many things to see and do in the city and nearby, and because the transportation system is safe and extensive. The Children's Museum and the Museum of Science are each among the best in the country. The nearly free Community Boating Program is also outstanding. A good list of activities for kids can be found at Boston Discovery Guide http: The latter site also contains useful information about Boston suburban communities.

Unlike many cities, much of the waterfront is recreational space. The harbor offers boating of all kinds, fishing, and a number of community beaches. There is a Harborwalk with many parks and other venues. The Harbor Islands are part of the National Park system and are accessible by ferry for day trips and picnicking. Every July 4th, the Esplanade is packed with crowds for a spectacular Boston Pops concert and fireworks show.

The Charles River is also known for its rowing and sculling. The famous Head of the Charles regatta, the world's largest 2-day rowing event, is held every year in October. No other major city has such a high proportion of students.

Their youthful energy invigorates the city's restaurant and nightlife, from bar hopping in Faneuil Hall or the Back Bay, to the live music scene at the House of Blues on Landsdowne or in the cafes and coffeehouses.

Live music 44 includes Latin, jazz, blues, gospel, folk and classical. Boston is a great restaurant town. There are many outstanding restaurants and enormous variety. Beacon Hill dates from the 18th century and features cobblestone streets, gaslights and brick front Georgian townhouses. Back Bay was built a century later by the Boston elite and contains gorgeous Victorian townhouses with wide streets and small front gardens. It also includes the fanciest shopping area in Boston, along lower Newbury and Boylston streets plus the Prudential Center and Copley Place shopping centers.

The old North End, which dates from Colonial times, still retains much of its strong Italian heritage. Georgian homes in Beacon Hill neighborhood The South End is a vibrant newly restored, cosmopolitan district and includes the Theater District and many of the best restaurants.

Bay Village is a charming historic part of the South End. The Harbor area is also newly renovated. Many wharves have been recycled as high-end condominiums. Chinatown is Boston's center for the Asian community. The Fenway area, which is closest to the hospitals and includes Fenway Ball Park, has a particularly high concentration of student housing, cultural organizations and parkland.

These are described in more detail at the Boston Neighborhoods website http: Some house staff and fellows have recently purchased homes in parts of Jamaica Plain, West Roxbury and Dedham, which are reasonably close to the Longwood Medical Area. Brookline is a very high quality suburb that begins just 3 blocks west of the Longwood Medical Area.

It has superb schools and shops and multiple subway lines. Although homes in Brookline are extraordinarily expensive, condominiums and apartments are more reasonably priced, and many residents and fellows live there.

Many house staff and fellows enjoy the intellectual ferment of Cambridge and live in the residential areas near Harvard Square. There is a regular shuttle bus from Harvard Square to Harvard Medical School and good subway connections.

As such it differs greatly from the more homogeneous towns in many other parts of the country, because each of the Greater Boston communities has its own character, government and school system. The range of variation is quite remarkable. Marblehead is centered on sailing, Lincoln and Hamilton on horseback riding, Lexington and Concord on colonial history, and so on. Beaches on the outer arm of the Cape and north of the Cape tend to have colder water than beaches on the south coast of the Cape, on Martha's Vineyard and Nantucket, and lining Long Island Sound, which are brushed by fringes of the Gulf Stream.

It offers a wide variety of attractions. From quaint, historic old towns like Sandwich, founded in , or charming, gray-shingled Chatham, to the Cape Cod National Seashore, with its 40 miles of ocean beaches, dunes, salt marshes and pine barrens, to free-living, freethinking Provincetown at the tip of the Cape.

There is a ferry to Provincetown from Boston. Nantucket Town is historic and charming, with cobblestone streets and 18th century homes. Outside the town one finds an otherworldly landscape of ponds, thickets, moors and heath.

There are 80 miles of gorgeous beaches, great biking trails and the village of Siaconset 46 'Sconset with its privet hedges and rose-covered trellises. Martha's Vineyard is more varied and more Victorian, but also charming.

It includes Rockport, a charming artist's colony, and the bizarre Hammond Castle. This charming early Colonial era town with narrow streets has over preRevolutionary War homes and overlooks a spectacular harbor filled with boats. Called the Yachting Capital of America, Marblehead was the birthplace of the American Navy and retains its sailing focus.

The exceptional collection of impressionist paintings alone makes the Clark worth a visit. Six Flags also has an excellent water park, but the closest big water park is Water Country in New Hampshire. Right in the city is the famous ring of connected parks called the Emerald Necklace, which includes the Arnold Arboretum.

A short drive will get you a relaxing weekend in the Berkshire Mountains of Western Massachusetts, or to hiking and biking in 47 The Fenway, part of the Emerald Necklace system of parks, lies just 3-blocks from Children's the White Mountains of New Hampshire.

A free day from the hospital could mean escaping to scenic Vermont, or to miles of rugged coastline in Maine or to the beaches of Cape Cod. Take a ferry ride to the islands of Martha's Vineyard or Nantucket.

And, New York City is only four-hour drive from Boston. The following guides are good places to start looking: The mansions, like the Vanderbilt's opulent 'The Breakers' or 'Rosecliff', of Great Gatsby fame, are worth the trip, as is the Ocean Drive along Newport's spectacular rocky shore.

There is also an aquarium and, nearby, two of the world's largest casinos: Foxwoods and Mohegan Sun. Acadia has the highest mountains on the ocean north of Rio de Janeiro and the only fiord in the Americas.

The scenery is Bass Harbor Light on the Maine coast spectacular and is amplified by an extraordinary variety of outdoor activities hiking, biking, rock climbing, canoeing, sea kayaking, sailing, deep sea fishing, and whale watching , along with outstanding restaurants, art galleries and opportunities for antiquing.

Indeed many in northern Maine are wilderness lakes, only accessible by floatplane or logging road. Nearer Boston, Lake Winnipesaukee in mid-New Hampshire is a recreational paradise, especially along its western shore.

Sebago Lake in southern Maine is also a popular resort area. The White Mountains in New Hampshire are among the very best with 48 peaks above ft and many dozens of hikes.

Acadia National Park is another extraordinary place for hiking. The miles of hiking trails were mostly built in the early 20th century and vary from gentle woodland and oceanside walks to exhilarating cliff climbs along ledges assisted by iron ladders and steps cut into the rocks. Mt Monadnock is another excellent spot for hiking.

The solitary mountain is located just over the Massachusetts-New Hampshire border, about an hour from Boston, and has excellent views. The surrounding region is charming and contains numerous prototypical New England villages. Biking is also excellent in New England, both mountain biking and trail riding, including numerous rides in the Beehive Trail in Maine's Acadia National Park Boston area.

Acadia National Park has 50 miles of beautiful, fine gravel carriage roads, which wind among the lakes and mountains, with fabulous views and some exciting ups and downs.

They were built at great expense by John D. The trails are listed in the Top 10 biking trails in the US. For those who desire more adventurous canoeing or kayaking, the New England Division of the American Canoeing Association offers cruises and instruction and times of recreational water releases from dams.

The enormous numbers of lakes in the northern Maine Wilderness offer exceptional opportunities for extended fishing, camping and canoeing trips. One of the most famous is the trip down the Allagash Wilderness Waterway. The snow conditions are less predictably excellent than in the West, but the resorts are more accessible to those wanting day trips.

The Blue Hills is a small area just south of the city and offers night skiing. Sugarloaf, a terrific mountain in Maine, is even a bit further. Virtually all New England ski areas also cater to snow boarders. For cross-country skiing, it's hard to beat the trail system in Jackson, NH, which is also about hrs away. Imagine a whole New England Village dedicated to Nordic skiing, with a white-steepled church, covered bridges, rivers with cascading waterfalls, sundry eateries, charming country inns and miles of cross country ski trails.

For crosscountry skiing close to Boston, the Weston Ski Track is recommended. Salt-water fishing is especially popular, and colleagues with boats and experience are available within the program to introduce interested individuals to the sport. Boston Harbor has been completely cleaned up beginning in the s with the installation of the massive Deer Island water treatment plant, and its waters are now pristine. Striped bass migrate North to Boston harbor in early May, and the 39 Boston Harbor Islands provide ideal structure and a very picturesque venue for striped bass fishing.

In August and September, medium sized blue fin tuna 30 to Faculty member Tom Look with a striped bass caught lbs move into Cape Cod Bay near Boston, in Boston Harbor on a fly rod and feed actively on the surface, becoming prime targets for light tackle fly and spin fishing anglers. Tuna travel with whales, providing interesting whale watching opportunities on Stellwagen bank while searching for the elusive schools of tuna.

Bluefish arrive around the same time as the tuna, and provide exciting surface action as they feed on schools of baitfish in Boston Harbor.

Summer is the prime season for saltwater fishing in Boston, but for the dedicated fisherman or woman, large cod fish up to 50 lbs.

All fish species are safe to eat due to the successful harbor clean up. Fresh water fishing is also popular. Fly-fishing for trout in New England streams is also popular. And, for the hardy there is ice fishing in the winter.

Many area farms provide boarding and lessons. To train fellows to care for patients undergoing stem cell transplantation. To develop physician leaders for a career in academic medicine through research training and scholarly work in the field II.

General issues in the fellowship a. Fellows must be grounded in the principles and methods of evidence-based medicine i. Have the ability to manage a difficult clinical problem using the primary medical literature. Should have a general knowledge of the statistical evaluation of clinical trials.

Learn the molecular basis of hematologic and oncologic diseases and develop the ability to apply this knowledge to the diagnosis and management of patients. Year specific goals i.

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The two zinc fingers of the DNA-binding domain are exposed as a result of this new conformation. Receptor phosphorylation can occur before androgen binding, although the presence of androgen promotes hyperphosphorylation. The biological ramifications of receptor phosphorylation are unknown. Nucleocytoplasmic transport is in part facilitated by an amino acid sequence on the AR called the nuclear localization signal. The AR's nuclear localization signal is primarily encoded in the hinge region of the AR gene.

Dimerization is mediated by the second nearest the 3' end zinc finger. Target genes contain or are flanked by transcriptional enhancer nucleotide sequences that interact with the first zinc finger. These areas are called androgen response elements. Type I coactivators i. Diagnosis of Complete Androgen Insensitivity Syndrome.

Diagnosis of Partial Androgen Insensitivity Syndrome. Diagnosis of Mild Androgen Insensitivity Syndrome. Frasier syndrome associated with progressive glomerulopathy Denys-Drash syndrome associated with nephropathy and Wilms tumor WAGR syndrome associated with Wilms tumor and aniridia McKusick-Kaufman syndrome associated with postaxial polydactyly Robinow syndrome associated with dwarfism Aarskog-Scott syndrome associated with facial anomalies Hand-foot-genital syndrome associated with limb malformations Popliteal pterygium syndrome associated with extensive webbing behind knees Kallmann syndrome often associated with anosmia Hypospadias not otherwise specified Cryptorchidism not otherwise specified vaginal atresia not otherwise specified.

Management of Complete Androgen Insensitivity Syndrome. Management of Partial Androgen Insensitivity Syndrome. Management of Mild Androgen Insensitivity Syndrome. The pharmacology and classification of the nuclear receptor superfamily: American Journal of Human Genetics. American Journal of Medical Genetics.

The androgen receptor gene mutations database". Hung, Wellington, Becker, Kenneth L. Principles and Practice of Endocrinology and Metabolism. J Pediatr Adolesc Gynecol. Acta Obstet Gynecol Scand. Retrieved on October 1, The ethics of PGD for intersex conditions".

Organisation Intersex International Australia. Retrieved 28 September The diagnosis and treatment of endocrine disorders in childhood and adolescence. Charles C Thomas, , pp. Midwifery, obstetrics and the rise of gynaecology: Des monstres et prodiges. Chez Franc d'Amour The controversy over "disorders of sex development " ".

Handbuch der pathologischen anatomie. Acta eruditorum anno mdccix. Carl Gerold ; Allgemeine Literatur-Zeitung Issues Stuttgart et Augsbourg , p. Proc Am Fed Clin Res.

Annals of Internal Medicine. Genetic polymorphisms and susceptibility to disease. Retrieved 23 January Intersex civil society organizations. Diseases of the endocrine system E00—E35 , — Hypoglycemia beta cell Hyperinsulinism G cell Zollinger—Ellison syndrome.

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Haemophilia A Haemophilia B X-linked sideroblastic anemia. Ornithine transcarbamylase deficiency Oculocerebrorenal syndrome Dyslipidemia: Hunter syndrome Purine—pyrimidine metabolism: Color blindness red and green, but not blue Ocular albinism 1 Norrie disease Choroideremia Other: Dyskeratosis congenita Hypohidrotic ectodermal dysplasia EDA X-linked ichthyosis X-linked endothelial corneal dystrophy. Alport syndrome Dent's disease X-linked nephrogenic diabetes insipidus.

Genetic disorder , protein biosynthesis: Feingold syndrome Saethre—Chotzen syndrome. Barakat syndrome Tricho—rhino—phalangeal syndrome. Autoimmune polyendocrine syndrome type 1. Holt—Oram syndrome Li—Fraumeni syndrome Ulnar—mammary syndrome. HR Atrichia with papular lesions. Retrieved from " https: Transcription factor deficiencies Syndromes affecting the endocrine system Endocrine gonad disorders Intersex and medicine Syndromes with tumors. Webarchive template wayback links Infobox medical condition Pages using div col without cols and colwidth parameters Pages using Columns-list with deprecated parameters.

Views Read Edit View history. In other projects Wikimedia Commons. This page was last edited on 3 November , at By using this site, you agree to the Terms of Use and Privacy Policy.

While on the Neuro-oncology service, fellows are responsible for evaluations of new Neurooncology patients, participating in second opinions and the Brain Tumor Clinic, and participating in the care of all Neuro-oncology inpatients. The fellow may work with a dedicated Neuro-oncology fellow. In addition to clinical responsibilities, conferences with an emphasis on Neuro-oncology are held throughout the week. The elective fellow can chose between a variety of pre-arranged electives which include pathology, surgical oncology, palliative care, radiation oncology, late effects of chemotherapy and the pain management service or can arrange their own elective experience.

The fellow on elective continues to attend his or her hematology and oncology clinics. This clinic meets all day, five days per week. Each fellow accrues about 20 new oncology patients and approximately 5 stem cell transplant patients in this clinic and serves as their primary physician.

In general, the fellow spends about 6 hours per week in this clinic. Each clinic includes a conference where all patients are discussed with a team of attending physicians. This clinic has five half-day sessions per week. Fellows follow their hematology patients in one of these clinic sessions.

Fellows from all years take phone calls for the Hematology, Oncology and Stem Cell Transplant services overnight, including both in-hospital and outside calls. In some circumstances for example, a new patient with leukemia , fellows may be asked to return to the hospital from home. On the weekends, fellows cover all services. One fellow takes in-house call for the BMT service on Friday night, and a separate fellow is on call during the daytime on Saturday and Sunday.

The Hematology and Oncology services are covered by one fellow from Friday 5pm until Sunday 5pm. On Sunday night a different fellow assumes call, covering the Hematology and Oncology services from home from 5pm to 8am. Fellows are expected to attend conferences that are specific to a service during their rotations on that service and are invited to attend at other times. New patients presented and discussed. Academic presentations, focused on aplastic anemia, myelodysplasia, bone marrow failure.

Active patients with musculoskeletal tumors are presented, and diagnostic and management issues discussed. Fellows are urged to participate if one of their patients is attending the clinic that day. Many upper year fellows also attend. Current articles from the hematology literature are reviewed with a formal fellow-driven presentation. Fellows are encouraged to attend. The following topics represent the conference themes: For all first year fellows.

Includes a series of sessions at the beginning of the year on the analysis of peripheral blood and bone marrow slides. Teaching sessions are led by expert faculty. Fellows attend weekly on their assigned day for outpatient oncology clinic. Third year fellows are responsible for running the conference on their clinic day, providing education and ensuring that discussions are interesting and informative.

Involvement of clinicians and researchers in discussions over thrombosis and hemostasis issues, with a view of fostering collaborative research. In general, all first year fellows attend and present approximately three times per year. Upper-year fellows and oncology staff also attend. The fellow meets with the mentor about every three months to discuss any issues that may arise during that time. In addition, the mentor receives copies of the performance reviews done by the attending at the end of each rotation.

Should problems be detected, the clinical mentor will work with the fellow and the rest of the clinical staff as appropriate to address the issues. About 60 percent of our fellows choose to do laboratory 15 research and 40 percent choose clinical investigation. We strongly support both pathways. Most fellows remain with the same research mentor until the fellow assumes independent faculty status i.

Although the NIH only allows a maximum of three years postdoctoral research support on NIH Training Grants T32s , we have in the past and will continue to try and support fellows for as long as necessary for them to attain independence. This support is obtained through vigorous pursuit of competitive federal and nonfederal fellowships, supplemented by institutional resources. During that year, the fellow's stipend is derived from institutional funds.

Once this year is completed, the fellow enters a nearly full time research training program supported by two institutional training grants a total of 18 slots.

Clinical work is limited to an average of one clinic day per week. A comprehensive program of cross coverage has been instituted to insure that, to the extent possible, a fellow's research work is not hampered by clinical responsibilities on days other than the assigned clinic day. We provide listings of many laboratory and clinical researchers in the Boston area and ask the fellows to read about specific research areas and begin to identify potential mentors.

The meetings occur early in the first year. This process continues throughout the first half of the year, with the goal that all fellows will have secured a research position by January. Fellows are able to work with any of the thousands of experienced researchers in the Boston area, as long as the outside research sponsor is acceptable to an oversight committee composed of Drs.

Orkin and Pellman laboratory research and Sallan and Frazier clinical research. We view outside research experiences as particularly valuable since, if fellows rejoin the program as faculty, they bring new skills and areas of research. Clinical Research and Global Health. Fellows who are interested in these training tracks will benefit from a formal research curriculum and mentorship from leading experts in these areas.

Fellows in this track will accomplish these key signposts of clinical research expertise: Expertise in a specific area of interest in a disease, a therapeutic modality, or in relevant fields of risk reduction, outcomes research or cancer control that will lead to national recognition. A portfolio of research that demonstrates competency in various aspects of clinical research. Clinically-based research within the Program occurs on two tracks, which are not necessarily mutually exclusive but do require different expertise.

One track is for fellows interested in clinical-translational research with the ultimate goal of designing clinical trials. Other fellows in the Program pursue health-services research, focusing on outcomes and policy. The expertise of our faculty currently supports research in clinical trial design and evaluation, bioethics, medical education, improvement of patient-parent-physician communication, risk stratification, evaluation and mitigation of late effects, and optimization of palliative care.

Research in these areas can either be focused within the United States, or in low and middle income countries through our Global Health Program. CTIP includes protocol specialists, who are available to advise on the development and submission of protocols; statisticians with expertise in study design, data collection and evaluation; clinical research associates; and clinical research nurses.

Every clinical fellow is supported throughout their research experience by this readily-available expert team. Fellows choose a research mentor during the first year of fellowship. For fellows who come without substantial research methods training, the core didactic training is the Clinical Effectiveness Program at Harvard School of Public Health HSPH which is typically taken the summer after the first or second year of fellowship training. Tuition for this course is fully funded by the training program.

This intensive 7-week, 15 credit program includes core courses in epidemiology and biostatistics as well as 2 electives. One important goal of the summer course is to develop a complete clinical research proposal, including background, objectives, methods, statistical analysis, with input from both the clinical research mentor as well as the HSPH faculty. This project will serve as the blueprint for at least one of the projects the fellow intends to complete during the subsequent year s of fellowship.

This is a suggested schedule to be used as basis for discussion between fellow and mentor during regular meetings and to be reviewed by the Scientific Oversight Committee at their annual review of the fellow.

Each fellow should have at least two research projects. The goal of Project 1 should be to allow the fellow to become immersed in the research field of interest, to learn some of the pragmatic skills of clinical research, such as how to write an IRB application, as well as to hone methodological skills. By late winter, the fellow should have accomplished enough work to be able to write an abstract on that work to be submitted to a national meeting.

The analysis should be complete by fall of the 3rd year and a final paper produced by end of the 3rd year. Because the conceptualization on Project 1 will have entailed a very thorough review of the existing literature, a review article should be written by the fellow, summarizing the background information of Project 1, by the end of the 2nd year.

Current training programs include: In addition, the Dana-Farber offers two courses for fellows and junior faculty. The first course, recommended for all fellows in any type of clinical research, is a general overview of clinical research with special skill-building lectures, for instance on how to write a research paper, given by the editor of the Journal of Clinical Oncology.

This course is taken once a week during the second half of the second year and is a joint class with the medical oncology fellows. The second course is required for all fellows and junior faculty who intend to be the Principal Investigator on a clinical therapeutic trial. This course delves more deeply into methodology of clinical trial design, and the Participants during the course actually develop and receive iterative critique on a clinical protocol of their own design.

Finally, some fellows interested in clinical trials choose to participate in our fellowship program with Novartis, described separately. This one-year program offers fellows the opportunity to participate in early phase clinical trials at Novartis as preparation for ongoing investigation in the future. The Division also sponsors a weekly research seminar at which senior and junior faculty and fellows present their work on a rotating basis.

Fellows working towards a career in clinical research are encouraged to apply for grant funding, either from a private foundation or for a National Institute of Health Career Development award K series near the end of their fellowship. In addition to support from their mentor, fellows receive comprehensive support and guidance throughout the grant application process. Program goal Trains fellows or junior faculty to become independent health services researchers; focused on creating new knowledge and strategies to improve access, quality, outcomes, and costeffectiveness in pediatric health care.

Structured seminars, intensive mentorship, and cross-disciplinary collaboration. Emphasis on clinical effectiveness and outcomes research, translation of evidence into practice and policy, analysis of large databases, and cost effectiveness of care. Trainees may have concurrent subspecialty fellowship appointment.

Extensive didactic curriculum at HSPH and HMS, including summer Clinical Effectiveness Program, longitudinal seminar series, physiological investigation tools, clinical trials methods, genetics, pharmacoepidemiology, and bioinformatics. Many additional courses throughout Harvard University are available to fellows on an auditor basis. For fellows interested in global health a 4-year fellowship is offered. Currently the sites that are available to fellows include any of the member institutions of AHOPCA Asociacion de Hemato-Oncologia Pediatrica de Centroamerica y Republica Dominicana , a pediatric oncology association that has a designated pediatric oncology facility in every country in Central America and the Dominican Republic.

Other projects include the collaboration with Partners-in-Health in the development of pediatric cancer and hematology programs in Rwanda and Haiti, the development of a sickle cell program in Liberia, and a retinoblastoma program in Davao, Philippines.

Fellows will spend a minimum of one month and up to three months per year at one of these sites during their second, third and fourth year of their fellowship training. Since this requires additional time to be spent off-site during the fellowship we extend training to four years for most fellows.

Ongoing collaboration when the fellow is not in residence at the site will be facilitated with interactive information technology, such as the Cure4Kids website. The overarching project for the summer course is to develop a complete clinical research proposal, including background, objectives, methods, statistical analysis, with input from both the clinical research mentor as well as the HSPH faculty.

This project will serve as the blueprint for the project the fellow will work on at the international site. During this fellowship, not more than one fellow per year may be identified by a selective process to work in the Novartis Oncology Translational Research Program in Cambridge.

Selected fellows will participate in an experiential education program that provides practical learning and clinical research experience. Fellows interested in this program will meet with team leaders at Novartis to discuss potential projects. The remainder of each week will be spent working in Oncology Translational Research at Novartis. The length of training varies widely from individual to individual but is almost always longer than the traditional 2 to 3 years of research training associated with MD fellowships.

Trainees pursuing clinical projects require broad training in experimental design, biostatistics, epidemiology, pharmacokinetics, and clinical trials. This emphasis is linked to Dr. The training program is individualized for each trainee since trainees come to the program with very different goals and experiences in research. Though most MD trainees choose to do their clinical work first, a few prefer to begin in the laboratory to avoid clinical distractions.

Williams himself is an example of this 22 II. While not a Ph. The clinical work itself is varied, depending on experience. Those with previous training in internal medicine take different rotations from those with a pediatrics background, etc. We also foster training of individuals whose interests lie astride or between disciplines. We encourage such hybrid individuals and the training of internists or graduates of combined medicine-pediatrics residencies within the division because we believe they enrich the program with new views and experiences.

The general philosophy is that training monies are available solely to support the needs of the trainees and not the needs of the division. In our experience this view is not universal.

Fellows typically present their work at lab meetings and once or twice per year at floor-wide research meetings. In addition, fellows frequently present their work at national meetings. Introduction to Statistical Genetics CRP Education core , and an overview of Clinical Pharmacology could also be valuable for the translationally oriented fellow. Abundant formal courses are available in the Harvard Medical School area.

All fellows must take a course in bioethics: Laboratory 23 researchers also take a course in radionuclides for researchers, and a course in the care and handling of laboratory animals.

All fellows are encouraged to attend scientific meetings and, when appropriate, to present their research. Careful attention is given to preparation for such presentations. Talks are carefully rehearsed and posters are examined by senior staff and specific feedback is given.

These sessions are of great value in helping fellows learn how to communicate science. The laboratory research mentoring program is supervised by Drs. David Pellman and Stuart Orkin and the clinical research mentoring by Drs. Stephen Sallan and Lindsay Frazier.

Fellows meet with their committees twice per year and present their research and future plans. Mentors are invited to attend. The committee offers advice on problems the fellow has encountered, suggestions for new research directions, and opinions about the most promising leads to pursue. The committee also advises the fellow about funding opportunities and grant writing; and otherwise assists the fellow in any way possible.

Research interests can be broadly subdivided into 37 laboratory research and 21 clinical research project areas. Letai, Look, and Walensky 2.

Adhesion, Migration, Cell Shape: Pellman, Springer, von Andrian, Wagner, and Williams 3. Cancer Cell and Molecular Biology: Cancer Cytogenetics and Fusion Oncogenes: Alt, Garraway, Hahn, and Look 5.

Cell and Molecular Biology: Cellular and Thiamine Metabolism: Bradner, Danial and Walensky 8. Bradner, Orkin and Roberts Daley, Look, Orkin, Segal, and Zon Fanconi Anemia and Bone Marrow Failure: Daley, Ebert, Orkin, Roberts, and Zon Gene Transfer and Gene Therapy: Immunology and Innate Immunity: Alt, Haining, Lieberman, Pai, and Ritz Immunology and stem cell transplantation: Iron Metabolism, Iron Overload: Fleming, Neufeld, and Pai Benz, Brugnara, Hartwig, and Lux Kieran, Look, Segal, and Stiles Cantor, Frelinger, Hartwig, Hoffmeister and Michelson Golub, Gregory, Lieberman, and Orkin 25 Frelinger, Heeney, Michelson, and Neufeld 2.

Bone Marrow Failure, Fanconi Anemia: Garraway, Golub, Janeway, and Stegmaier 4. Cancer Prevention and Cancer Epidemiology: Cancer Therapy, Small Molecules, Translational: Daley, Dubois, Lieberman, Stegmaier, and Williams 6.

End-of-Life and Palliative Care: Grier, Mack, Ullrich, and Wolfe 8. Frazier, Lehmann, and Kieran Daley, Sallan, Silverman, and Stegmaier Fleming, Heeney, Nathan and Neufeld Grace and Neufeld Ebert, Fleming, Hoffman, and Williams Diller, George, and Shusterman Neuro-oncology and Phase I trials: Diller, Frazier, Mack, and Wolfe Brugnara and Heeney Diller and Vrooman The fellow's salary is supported by clinical funds during the clinical year of training.

One training grant is available to support fellows during their research years. Fellows can receive up to three years of support from the training grants, but many choose to apply for other fellowships, especially "K-awards" K08, K23, etc , after one or two years of research because of the higher stipend they offer. We have specific faculty mentorship focused on assisting fellows developing their first NIH and other grants.

The following items are eligible for reimbursement: Fellows are also eligible for additional benefits, which are mostly available at reduced rates: Another way to look at the program is to analyze our success at achieving our major objective, which is to train leaders of American hematology and oncology.

To evaluate our success in preparing fellows for leadership positions, we have recently examined the cohort who began training between and More recent fellows are still completing their training or are early in their academic careers. For those of our graduates who began the program between and Of those in the program from to , many are still young and have not yet reached their full potential.

No other pediatric program, in any specialty, has such a record of accomplished alumni. George Buchanan and Eli Schwartz and Dr. Holcombe Grier is the immediate Past- President. Five alumni, one former mentoring faculty and one current mentoring faculty were awarded the prestigious William Dameshek Prize for Research in Hematology and six have received the equally prestigious E.

Donnall Thomas Prize for Research in Hematology. Both recognize outstanding accomplishments in hematology research. More than ten alumni have received the distinguished E. Mead-Johnson Award for Research in Pediatrics, which is the highest research award in that specialty. Seven have received the Henry M. Stratton Medal, given each year in recognition of a distinguished career in American hematology, and David Nathan was also the recipient of the Wallace H.

Coulter Award for lifetime achievement in Hematology. Dean, Duke University School of Medicine. Ex-Chief, Hematology Section, Dept. Director, Israel Red Cross General Hospital, Harvard Chief, of Transfusion Service, Chief, Div. Inpatient 6E service is an 8 bed hematology ward. New patient evaluations and follow-ups take place in the Jimmy Fund Clinic.

The SCT group consists of 14 attending physicians, 1 physician's assistant, 3 nurse practitioners, 1 program administrator, and 2 transplant coordinators. For more information on the ERAS system please visit the following: You will be directed to search for the program name. Our program name is: Please make sure that you click on that link. If not, you will be redirected to a different application. All applicants must supply at least three letters. If your application is not received by the deadline mentioned below, your application will be marked incomplete and will not be accepted.

We strongly recommend that you submit your application by December However, we accept applications until March 1, assuming it is possible to schedule an interview between that date and the date of our selection committee meeting. If you need further information please contact: We cannot accept applicants who are not registered with the NRMP. The NRMP phone number and web address are and http: Such decisions are made on a caseby-case basis. The deadline for applications is March 15; however, we strongly encourage you to apply before the end of December since we begin to sort applications and issue invitations for interviews at that time.

We do not issue all interview invitations at the same time because some candidates decide to apply later than others and we do not want to exclude them from consideration. Trishna Rana arranges all interviews and will gladly help with any other problems. Applicants are also welcome to contact Dr.

Receive applications mostly December - March Early December: Interviews on selected days Late April: Rank order list deadline Mid-May: Those seeking an exemption must apply by February 1, It is the training directors' intention that exemptions will only be granted in rare circumstances.

Please contact us if you feel an exemption is appropriate in your case or for any other questions. However, three single year clinical training programs are available within the division: Pediatric palliative care for those who have completed a general pediatrics residency, contact Dr. Additional information about this fellowship is available on the Pediatric Advanced Care Team's web page: The components of the program include time on the inpatient service as a coattending with a senior member of the transplant team, new patient evaluations, attending chronic GVHD clinic, working in the cell manipulation and apheresis facilities and a clinical research project for meeting submission and eventual publication.

Immensely diverse and vibrant, Boston is a city of some twenty neighborhoods with Cambridge and Brookline as bordering communities. Sites of pivotal battles at Bunker Hill, and in Lexington and Concord, are also national monuments and nearly every town has an historical society. Old Sturbridge Village is an authentic recreation of a colonial village, with historic housing and costumed inhabitant.

It is located in Sturbridge, an hour west of Boston. And touristy Salem, home of the infamous witch trials, lies to the north. More distant towns are served by commuter rail. The Longwood Medical area is centered within blocks of two different Green line routes.

There is also an extensive bus system, including a shuttle bus from Harvard University to the Medical School. Parking is expensive in the Longwood area, but fellows who drive can park in cheaper outlying lots and use shuttle buses. Fellows can park in the patient lot across from Children's for free at nights and on weekends. Residents who leave the hospital late at night can also obtain free taxi vouchers. The Boston Symphony is world-renowned, as is the Boston Pops, but there are several other professional symphonies and innumerable civic and college orchestras.

In fact, the medical area has its own orchestra, the Longwood Symphony, composed mostly of physicians, that is very high quality. There are also many outstanding amateur choral groups: Kennedy Library and Museum are also outstanding. Plus, Boston is a frequent venue for pre-Broadway tryouts and touring national companies.

The Revolution soccer are also among the top teams each year. Harvard University offers facilities for indoor and outdoor tennis, swimming and diving, ice skating, jogging, squash, basketball, baseball, field hockey, lacrosse, rugby, volleyball, rowing, and sailing, plus others, and extensive exercise and weight training. The Medical School has a gymnasium, squash courts, cardiovascular and strength training equipment and an outdoor tennis court.

Groups like the Boston Ski and Sports Club organize year round sports leagues, as well as sporting trips. Boston is a great running and biking city. There are numerous bikeways, particularly along the Charles River and through the 'Emerald Necklace' string of parks, which lies just 3 blocks from the Longwood area.

The same routes are popular for running. For serious runners, the famous Boston Marathon occurs each spring on Patriots Day, which is a local holiday, allowing those who wish to run, to participate. Many housestaff, fellows and faculty do.

Golfers have many opportunities in the Boston area. To compensate, the program offers higher than average salaries. Real estate information is available from a number of sources including the Boston Globe.

The Great Schools website contains considerable information about individual schools www. KIDS Boston is a great city for kids because there are so many things to see and do in the city and nearby, and because the transportation system is safe and extensive. The Children's Museum and the Museum of Science are each among the best in the country. The nearly free Community Boating Program is also outstanding.

A good list of activities for kids can be found at Boston Discovery Guide http: The latter site also contains useful information about Boston suburban communities. Unlike many cities, much of the waterfront is recreational space.

The harbor offers boating of all kinds, fishing, and a number of community beaches. There is a Harborwalk with many parks and other venues. The Harbor Islands are part of the National Park system and are accessible by ferry for day trips and picnicking. Every July 4th, the Esplanade is packed with crowds for a spectacular Boston Pops concert and fireworks show. The Charles River is also known for its rowing and sculling. The famous Head of the Charles regatta, the world's largest 2-day rowing event, is held every year in October.

No other major city has such a high proportion of students. Their youthful energy invigorates the city's restaurant and nightlife, from bar hopping in Faneuil Hall or the Back Bay, to the live music scene at the House of Blues on Landsdowne or in the cafes and coffeehouses. Live music 44 includes Latin, jazz, blues, gospel, folk and classical.

Boston is a great restaurant town. There are many outstanding restaurants and enormous variety. Beacon Hill dates from the 18th century and features cobblestone streets, gaslights and brick front Georgian townhouses. Back Bay was built a century later by the Boston elite and contains gorgeous Victorian townhouses with wide streets and small front gardens.

It also includes the fanciest shopping area in Boston, along lower Newbury and Boylston streets plus the Prudential Center and Copley Place shopping centers. The old North End, which dates from Colonial times, still retains much of its strong Italian heritage.

Georgian homes in Beacon Hill neighborhood The South End is a vibrant newly restored, cosmopolitan district and includes the Theater District and many of the best restaurants.

Bay Village is a charming historic part of the South End. The Harbor area is also newly renovated. Many wharves have been recycled as high-end condominiums. Chinatown is Boston's center for the Asian community. The Fenway area, which is closest to the hospitals and includes Fenway Ball Park, has a particularly high concentration of student housing, cultural organizations and parkland.

These are described in more detail at the Boston Neighborhoods website http: Some house staff and fellows have recently purchased homes in parts of Jamaica Plain, West Roxbury and Dedham, which are reasonably close to the Longwood Medical Area. Brookline is a very high quality suburb that begins just 3 blocks west of the Longwood Medical Area.

It has superb schools and shops and multiple subway lines. Although homes in Brookline are extraordinarily expensive, condominiums and apartments are more reasonably priced, and many residents and fellows live there. Many house staff and fellows enjoy the intellectual ferment of Cambridge and live in the residential areas near Harvard Square.

There is a regular shuttle bus from Harvard Square to Harvard Medical School and good subway connections. As such it differs greatly from the more homogeneous towns in many other parts of the country, because each of the Greater Boston communities has its own character, government and school system. The range of variation is quite remarkable. Marblehead is centered on sailing, Lincoln and Hamilton on horseback riding, Lexington and Concord on colonial history, and so on.

Beaches on the outer arm of the Cape and north of the Cape tend to have colder water than beaches on the south coast of the Cape, on Martha's Vineyard and Nantucket, and lining Long Island Sound, which are brushed by fringes of the Gulf Stream.

It offers a wide variety of attractions. From quaint, historic old towns like Sandwich, founded in , or charming, gray-shingled Chatham, to the Cape Cod National Seashore, with its 40 miles of ocean beaches, dunes, salt marshes and pine barrens, to free-living, freethinking Provincetown at the tip of the Cape. There is a ferry to Provincetown from Boston. Nantucket Town is historic and charming, with cobblestone streets and 18th century homes.

Outside the town one finds an otherworldly landscape of ponds, thickets, moors and heath. There are 80 miles of gorgeous beaches, great biking trails and the village of Siaconset 46 'Sconset with its privet hedges and rose-covered trellises. Martha's Vineyard is more varied and more Victorian, but also charming. It includes Rockport, a charming artist's colony, and the bizarre Hammond Castle.

This charming early Colonial era town with narrow streets has over preRevolutionary War homes and overlooks a spectacular harbor filled with boats. Called the Yachting Capital of America, Marblehead was the birthplace of the American Navy and retains its sailing focus. The exceptional collection of impressionist paintings alone makes the Clark worth a visit. Six Flags also has an excellent water park, but the closest big water park is Water Country in New Hampshire. Right in the city is the famous ring of connected parks called the Emerald Necklace, which includes the Arnold Arboretum.

A short drive will get you a relaxing weekend in the Berkshire Mountains of Western Massachusetts, or to hiking and biking in 47 The Fenway, part of the Emerald Necklace system of parks, lies just 3-blocks from Children's the White Mountains of New Hampshire.

A free day from the hospital could mean escaping to scenic Vermont, or to miles of rugged coastline in Maine or to the beaches of Cape Cod. Take a ferry ride to the islands of Martha's Vineyard or Nantucket. And, New York City is only four-hour drive from Boston. The following guides are good places to start looking: The mansions, like the Vanderbilt's opulent 'The Breakers' or 'Rosecliff', of Great Gatsby fame, are worth the trip, as is the Ocean Drive along Newport's spectacular rocky shore.

There is also an aquarium and, nearby, two of the world's largest casinos: Foxwoods and Mohegan Sun. Acadia has the highest mountains on the ocean north of Rio de Janeiro and the only fiord in the Americas. The scenery is Bass Harbor Light on the Maine coast spectacular and is amplified by an extraordinary variety of outdoor activities hiking, biking, rock climbing, canoeing, sea kayaking, sailing, deep sea fishing, and whale watching , along with outstanding restaurants, art galleries and opportunities for antiquing.

Indeed many in northern Maine are wilderness lakes, only accessible by floatplane or logging road. Nearer Boston, Lake Winnipesaukee in mid-New Hampshire is a recreational paradise, especially along its western shore.

Sebago Lake in southern Maine is also a popular resort area. The White Mountains in New Hampshire are among the very best with 48 peaks above ft and many dozens of hikes. Acadia National Park is another extraordinary place for hiking. The miles of hiking trails were mostly built in the early 20th century and vary from gentle woodland and oceanside walks to exhilarating cliff climbs along ledges assisted by iron ladders and steps cut into the rocks.

Mt Monadnock is another excellent spot for hiking. The solitary mountain is located just over the Massachusetts-New Hampshire border, about an hour from Boston, and has excellent views. The surrounding region is charming and contains numerous prototypical New England villages. Biking is also excellent in New England, both mountain biking and trail riding, including numerous rides in the Beehive Trail in Maine's Acadia National Park Boston area. Acadia National Park has 50 miles of beautiful, fine gravel carriage roads, which wind among the lakes and mountains, with fabulous views and some exciting ups and downs.

They were built at great expense by John D. The trails are listed in the Top 10 biking trails in the US. For those who desire more adventurous canoeing or kayaking, the New England Division of the American Canoeing Association offers cruises and instruction and times of recreational water releases from dams.

The enormous numbers of lakes in the northern Maine Wilderness offer exceptional opportunities for extended fishing, camping and canoeing trips. One of the most famous is the trip down the Allagash Wilderness Waterway. The snow conditions are less predictably excellent than in the West, but the resorts are more accessible to those wanting day trips. The Blue Hills is a small area just south of the city and offers night skiing.

Sugarloaf, a terrific mountain in Maine, is even a bit further. Virtually all New England ski areas also cater to snow boarders. For cross-country skiing, it's hard to beat the trail system in Jackson, NH, which is also about hrs away.

Imagine a whole New England Village dedicated to Nordic skiing, with a white-steepled church, covered bridges, rivers with cascading waterfalls, sundry eateries, charming country inns and miles of cross country ski trails. For crosscountry skiing close to Boston, the Weston Ski Track is recommended.

Salt-water fishing is especially popular, and colleagues with boats and experience are available within the program to introduce interested individuals to the sport.

takes fair

This predictive ability is primarily retrospective in origin; the different functional domains of the AR gene have been elucidated by analyzing the effects of specific mutations in different regions of the AR.

Some mutations can adversely impact more than one functional domain. For example, a mutation in one functional domain can have deleterious effects on another by altering the way in which the domains interact. Other, more complex relationships have been observed as a consequence of mutated AR ; some mutations associated with male phenotypes have been linked to male breast cancer , prostate cancer , or in the case of spinal and bulbar muscular atrophy , disease of the central nervous system.

The trinucleotide repeat expansion of the polyglutamine tract of the AR gene that is associated with SBMA results in the synthesis of a misfolded AR protein that the cell fails to proteolyze and disperse properly. The phenotypes that result from the insensitivity to androgens are not unique to AIS, thus the diagnosis of AIS requires thorough exclusion of other causes.

Each of the three types of AIS complete, partial, and mild has a different list of differential diagnoses to consider.

Estimates for the incidence of androgen insensitivity syndrome are based on a relatively small population size, thus are known to be imprecise. Preimplantation genetic diagnosis PGD or PIGD refers to genetic profiling of embryos prior to implantation as a form of embryo profiling , and sometimes even of oocytes prior to fertilization. When used to screen for a specific genetic sequence, its main advantage is that it avoids selective pregnancy termination, as the method makes it highly likely that a selected embryo will be free of the condition under consideration.

Recorded descriptions of the effects of AIS date back hundreds of years, although significant understanding of its underlying histopathology did not occur until the s. The first descriptions of the effects of AIS appeared in the medical literature as individual case reports or as part of a comprehensive description of intersex physicalities. In , Scottish obstetrician Sir James Young Simpson published one such description [] in an exhaustive study of intersexuality that has been credited with advancing the medical community's understanding of the subject.

An alternative system of nomenclature has been recently suggested, [] but the subject of exactly which word or words should be used in its place still one of much debate. For example, 46,XY individuals who have a female phenotype, but also have testes instead of ovaries — a group that includes all individuals with CAIS, as well as some individuals with PAIS — are classified as having "male pseudohermaphroditism", while individuals with both an ovary and a testis or at least one ovotestis are classified as having " true hermaphroditism ".

Previous definitions of "pseudohermaphroditism" relied on perceived inconsistencies between the internal and external organs; the "true" sex of an individual was determined by the internal organs, and the external organs determined the "perceived" sex of an individual. German-Swiss pathologist Edwin Klebs is sometimes noted for using the word "pseudohermaphroditism" in his taxonomy of intersexuality in , [] although the word is clearly not his invention as is sometimes reported; the history of the word " pseudohermaphrodite " and the corresponding desire to separate "true" hermaphrodites from "false", "spurious", or "pseudo" hermaphrodites, dates back to at least , when Dutch anatomist Frederik Ruysch used it in a publication describing a subject with testes and a mostly female phenotype.

In , American gynecologist John Morris provided the first full description of what he called "testicular feminization syndrome" based on 82 cases compiled from the medical literature, including two of his own patients. A distinct name has been given to many of the various presentations of AIS, such as Reifenstein syndrome , [] Goldberg-Maxwell syndrome , [] Morris' syndrome , [] Gilbert-Dreyfus syndrome , [] Lub's syndrome , [] "incomplete testicular feminization" , [] Rosewater syndrome , [] and Aiman's syndrome Over the last 60 years, as reports of strikingly different phenotypes were reported to occur even among members of the same family, and as steady progress was made towards the understanding of the underlying molecular pathogenesis of AIS, these disorders were found to be different phenotypic expressions of one syndrome caused by molecular defects in the androgen receptor gene.

AIS is now the accepted terminology for the syndromes resulting from unresponsiveness of the target cell to the action of androgenic hormones. The more virilized phenotypes of AIS have sometimes been described as "undervirilized male syndrome", "infertile male syndrome", "undervirilized fertile male syndrome", etc.

She has given interviews about her condition [] [] and founded "Girl Comet, a non-profit diversity awareness and inspiration initiative. In , fashion model Hanne Gaby Odiele disclosed that she was born with the intersex trait androgen insensitivity syndrome. As a child, she underwent medical procedures relating to her condition , [] which she said took place without her or her parents' informed consent. In the Japanese horror novel Ring , by Koji Suzuki later adapted into Japanese, Korean, and American films , the central antagonist Sadako has this syndrome.

From Wikipedia, the free encyclopedia. Androgen insensitivity syndrome AIS results when the androgen receptor AR pictured is not able to function as a transcription factor for androgens , which normally activate relevant genes. Complete androgen insensitivity syndrome. Partial androgen insensitivity syndrome.

Mild androgen insensitivity syndrome. Androgen enters the cell. Only certain organs in the body, such as the gonads and the adrenal glands , produce the androgen testosterone. Testosterone is converted into dihydrotestosterone , a chemically similar androgen, in cells containing the enzyme 5-alpha reductase. Both androgens exert their influence through binding with the androgen receptor. The androgen receptor is expressed ubiquitously throughout the tissues of the human body.

Before it binds with an androgen, the androgen receptor is bound to heat shock proteins. These heat shock proteins are released upon androgen binding. Androgen binding induces a stabilizing, conformational change in the androgen receptor. The two zinc fingers of the DNA-binding domain are exposed as a result of this new conformation. Receptor phosphorylation can occur before androgen binding, although the presence of androgen promotes hyperphosphorylation. The biological ramifications of receptor phosphorylation are unknown.

Nucleocytoplasmic transport is in part facilitated by an amino acid sequence on the AR called the nuclear localization signal. The AR's nuclear localization signal is primarily encoded in the hinge region of the AR gene. Dimerization is mediated by the second nearest the 3' end zinc finger. Target genes contain or are flanked by transcriptional enhancer nucleotide sequences that interact with the first zinc finger. These areas are called androgen response elements.

Type I coactivators i. Diagnosis of Complete Androgen Insensitivity Syndrome. Diagnosis of Partial Androgen Insensitivity Syndrome. Diagnosis of Mild Androgen Insensitivity Syndrome. Frasier syndrome associated with progressive glomerulopathy Denys-Drash syndrome associated with nephropathy and Wilms tumor WAGR syndrome associated with Wilms tumor and aniridia McKusick-Kaufman syndrome associated with postaxial polydactyly Robinow syndrome associated with dwarfism Aarskog-Scott syndrome associated with facial anomalies Hand-foot-genital syndrome associated with limb malformations Popliteal pterygium syndrome associated with extensive webbing behind knees Kallmann syndrome often associated with anosmia Hypospadias not otherwise specified Cryptorchidism not otherwise specified vaginal atresia not otherwise specified.

Management of Complete Androgen Insensitivity Syndrome. Management of Partial Androgen Insensitivity Syndrome. Management of Mild Androgen Insensitivity Syndrome. The pharmacology and classification of the nuclear receptor superfamily: American Journal of Human Genetics.

American Journal of Medical Genetics. The androgen receptor gene mutations database". Hung, Wellington, Becker, Kenneth L. Principles and Practice of Endocrinology and Metabolism. J Pediatr Adolesc Gynecol. Acta Obstet Gynecol Scand. Retrieved on October 1, The ethics of PGD for intersex conditions". Organisation Intersex International Australia.

Retrieved 28 September The diagnosis and treatment of endocrine disorders in childhood and adolescence. Charles C Thomas, , pp. Midwifery, obstetrics and the rise of gynaecology: Des monstres et prodiges. Chez Franc d'Amour We cannot accept applicants who are not registered with the NRMP. The NRMP phone number and web address are and http: Such decisions are made on a caseby-case basis. The deadline for applications is March 15; however, we strongly encourage you to apply before the end of December since we begin to sort applications and issue invitations for interviews at that time.

We do not issue all interview invitations at the same time because some candidates decide to apply later than others and we do not want to exclude them from consideration.

Trishna Rana arranges all interviews and will gladly help with any other problems. Applicants are also welcome to contact Dr. Receive applications mostly December - March Early December: Interviews on selected days Late April: Rank order list deadline Mid-May: Those seeking an exemption must apply by February 1, It is the training directors' intention that exemptions will only be granted in rare circumstances. Please contact us if you feel an exemption is appropriate in your case or for any other questions.

However, three single year clinical training programs are available within the division: Pediatric palliative care for those who have completed a general pediatrics residency, contact Dr. Additional information about this fellowship is available on the Pediatric Advanced Care Team's web page: The components of the program include time on the inpatient service as a coattending with a senior member of the transplant team, new patient evaluations, attending chronic GVHD clinic, working in the cell manipulation and apheresis facilities and a clinical research project for meeting submission and eventual publication.

Immensely diverse and vibrant, Boston is a city of some twenty neighborhoods with Cambridge and Brookline as bordering communities. Sites of pivotal battles at Bunker Hill, and in Lexington and Concord, are also national monuments and nearly every town has an historical society.

Old Sturbridge Village is an authentic recreation of a colonial village, with historic housing and costumed inhabitant. It is located in Sturbridge, an hour west of Boston. And touristy Salem, home of the infamous witch trials, lies to the north. More distant towns are served by commuter rail. The Longwood Medical area is centered within blocks of two different Green line routes. There is also an extensive bus system, including a shuttle bus from Harvard University to the Medical School.

Parking is expensive in the Longwood area, but fellows who drive can park in cheaper outlying lots and use shuttle buses. Fellows can park in the patient lot across from Children's for free at nights and on weekends. Residents who leave the hospital late at night can also obtain free taxi vouchers. The Boston Symphony is world-renowned, as is the Boston Pops, but there are several other professional symphonies and innumerable civic and college orchestras.

In fact, the medical area has its own orchestra, the Longwood Symphony, composed mostly of physicians, that is very high quality. There are also many outstanding amateur choral groups: Kennedy Library and Museum are also outstanding.

Plus, Boston is a frequent venue for pre-Broadway tryouts and touring national companies. The Revolution soccer are also among the top teams each year. Harvard University offers facilities for indoor and outdoor tennis, swimming and diving, ice skating, jogging, squash, basketball, baseball, field hockey, lacrosse, rugby, volleyball, rowing, and sailing, plus others, and extensive exercise and weight training.

The Medical School has a gymnasium, squash courts, cardiovascular and strength training equipment and an outdoor tennis court. Groups like the Boston Ski and Sports Club organize year round sports leagues, as well as sporting trips. Boston is a great running and biking city. There are numerous bikeways, particularly along the Charles River and through the 'Emerald Necklace' string of parks, which lies just 3 blocks from the Longwood area.

The same routes are popular for running. For serious runners, the famous Boston Marathon occurs each spring on Patriots Day, which is a local holiday, allowing those who wish to run, to participate.

Many housestaff, fellows and faculty do. Golfers have many opportunities in the Boston area. To compensate, the program offers higher than average salaries.

Real estate information is available from a number of sources including the Boston Globe. The Great Schools website contains considerable information about individual schools www. KIDS Boston is a great city for kids because there are so many things to see and do in the city and nearby, and because the transportation system is safe and extensive.

The Children's Museum and the Museum of Science are each among the best in the country. The nearly free Community Boating Program is also outstanding. A good list of activities for kids can be found at Boston Discovery Guide http: The latter site also contains useful information about Boston suburban communities. Unlike many cities, much of the waterfront is recreational space. The harbor offers boating of all kinds, fishing, and a number of community beaches.

There is a Harborwalk with many parks and other venues. The Harbor Islands are part of the National Park system and are accessible by ferry for day trips and picnicking.

Every July 4th, the Esplanade is packed with crowds for a spectacular Boston Pops concert and fireworks show. The Charles River is also known for its rowing and sculling. The famous Head of the Charles regatta, the world's largest 2-day rowing event, is held every year in October.

No other major city has such a high proportion of students. Their youthful energy invigorates the city's restaurant and nightlife, from bar hopping in Faneuil Hall or the Back Bay, to the live music scene at the House of Blues on Landsdowne or in the cafes and coffeehouses.

Live music 44 includes Latin, jazz, blues, gospel, folk and classical. Boston is a great restaurant town. There are many outstanding restaurants and enormous variety. Beacon Hill dates from the 18th century and features cobblestone streets, gaslights and brick front Georgian townhouses.

Back Bay was built a century later by the Boston elite and contains gorgeous Victorian townhouses with wide streets and small front gardens. It also includes the fanciest shopping area in Boston, along lower Newbury and Boylston streets plus the Prudential Center and Copley Place shopping centers.

The old North End, which dates from Colonial times, still retains much of its strong Italian heritage. Georgian homes in Beacon Hill neighborhood The South End is a vibrant newly restored, cosmopolitan district and includes the Theater District and many of the best restaurants. Bay Village is a charming historic part of the South End.

The Harbor area is also newly renovated. Many wharves have been recycled as high-end condominiums. Chinatown is Boston's center for the Asian community. The Fenway area, which is closest to the hospitals and includes Fenway Ball Park, has a particularly high concentration of student housing, cultural organizations and parkland.

These are described in more detail at the Boston Neighborhoods website http: Some house staff and fellows have recently purchased homes in parts of Jamaica Plain, West Roxbury and Dedham, which are reasonably close to the Longwood Medical Area. Brookline is a very high quality suburb that begins just 3 blocks west of the Longwood Medical Area. It has superb schools and shops and multiple subway lines. Although homes in Brookline are extraordinarily expensive, condominiums and apartments are more reasonably priced, and many residents and fellows live there.

Many house staff and fellows enjoy the intellectual ferment of Cambridge and live in the residential areas near Harvard Square. There is a regular shuttle bus from Harvard Square to Harvard Medical School and good subway connections. As such it differs greatly from the more homogeneous towns in many other parts of the country, because each of the Greater Boston communities has its own character, government and school system.

The range of variation is quite remarkable. Marblehead is centered on sailing, Lincoln and Hamilton on horseback riding, Lexington and Concord on colonial history, and so on.

Beaches on the outer arm of the Cape and north of the Cape tend to have colder water than beaches on the south coast of the Cape, on Martha's Vineyard and Nantucket, and lining Long Island Sound, which are brushed by fringes of the Gulf Stream.

It offers a wide variety of attractions. From quaint, historic old towns like Sandwich, founded in , or charming, gray-shingled Chatham, to the Cape Cod National Seashore, with its 40 miles of ocean beaches, dunes, salt marshes and pine barrens, to free-living, freethinking Provincetown at the tip of the Cape. There is a ferry to Provincetown from Boston.

Nantucket Town is historic and charming, with cobblestone streets and 18th century homes. Outside the town one finds an otherworldly landscape of ponds, thickets, moors and heath. There are 80 miles of gorgeous beaches, great biking trails and the village of Siaconset 46 'Sconset with its privet hedges and rose-covered trellises.

Martha's Vineyard is more varied and more Victorian, but also charming. It includes Rockport, a charming artist's colony, and the bizarre Hammond Castle.

This charming early Colonial era town with narrow streets has over preRevolutionary War homes and overlooks a spectacular harbor filled with boats. Called the Yachting Capital of America, Marblehead was the birthplace of the American Navy and retains its sailing focus. The exceptional collection of impressionist paintings alone makes the Clark worth a visit. Six Flags also has an excellent water park, but the closest big water park is Water Country in New Hampshire.

Right in the city is the famous ring of connected parks called the Emerald Necklace, which includes the Arnold Arboretum. A short drive will get you a relaxing weekend in the Berkshire Mountains of Western Massachusetts, or to hiking and biking in 47 The Fenway, part of the Emerald Necklace system of parks, lies just 3-blocks from Children's the White Mountains of New Hampshire.

A free day from the hospital could mean escaping to scenic Vermont, or to miles of rugged coastline in Maine or to the beaches of Cape Cod. Take a ferry ride to the islands of Martha's Vineyard or Nantucket. And, New York City is only four-hour drive from Boston. The following guides are good places to start looking: The mansions, like the Vanderbilt's opulent 'The Breakers' or 'Rosecliff', of Great Gatsby fame, are worth the trip, as is the Ocean Drive along Newport's spectacular rocky shore.

There is also an aquarium and, nearby, two of the world's largest casinos: Foxwoods and Mohegan Sun. Acadia has the highest mountains on the ocean north of Rio de Janeiro and the only fiord in the Americas. The scenery is Bass Harbor Light on the Maine coast spectacular and is amplified by an extraordinary variety of outdoor activities hiking, biking, rock climbing, canoeing, sea kayaking, sailing, deep sea fishing, and whale watching , along with outstanding restaurants, art galleries and opportunities for antiquing.

Indeed many in northern Maine are wilderness lakes, only accessible by floatplane or logging road. Nearer Boston, Lake Winnipesaukee in mid-New Hampshire is a recreational paradise, especially along its western shore.

Sebago Lake in southern Maine is also a popular resort area. The White Mountains in New Hampshire are among the very best with 48 peaks above ft and many dozens of hikes.

Acadia National Park is another extraordinary place for hiking. The miles of hiking trails were mostly built in the early 20th century and vary from gentle woodland and oceanside walks to exhilarating cliff climbs along ledges assisted by iron ladders and steps cut into the rocks.

Mt Monadnock is another excellent spot for hiking. The solitary mountain is located just over the Massachusetts-New Hampshire border, about an hour from Boston, and has excellent views. The surrounding region is charming and contains numerous prototypical New England villages.

Biking is also excellent in New England, both mountain biking and trail riding, including numerous rides in the Beehive Trail in Maine's Acadia National Park Boston area. Acadia National Park has 50 miles of beautiful, fine gravel carriage roads, which wind among the lakes and mountains, with fabulous views and some exciting ups and downs.

They were built at great expense by John D. The trails are listed in the Top 10 biking trails in the US. For those who desire more adventurous canoeing or kayaking, the New England Division of the American Canoeing Association offers cruises and instruction and times of recreational water releases from dams.

The enormous numbers of lakes in the northern Maine Wilderness offer exceptional opportunities for extended fishing, camping and canoeing trips. One of the most famous is the trip down the Allagash Wilderness Waterway. The snow conditions are less predictably excellent than in the West, but the resorts are more accessible to those wanting day trips.

The Blue Hills is a small area just south of the city and offers night skiing. Sugarloaf, a terrific mountain in Maine, is even a bit further. Virtually all New England ski areas also cater to snow boarders. For cross-country skiing, it's hard to beat the trail system in Jackson, NH, which is also about hrs away. Imagine a whole New England Village dedicated to Nordic skiing, with a white-steepled church, covered bridges, rivers with cascading waterfalls, sundry eateries, charming country inns and miles of cross country ski trails.

For crosscountry skiing close to Boston, the Weston Ski Track is recommended. Salt-water fishing is especially popular, and colleagues with boats and experience are available within the program to introduce interested individuals to the sport.

Boston Harbor has been completely cleaned up beginning in the s with the installation of the massive Deer Island water treatment plant, and its waters are now pristine. Striped bass migrate North to Boston harbor in early May, and the 39 Boston Harbor Islands provide ideal structure and a very picturesque venue for striped bass fishing. In August and September, medium sized blue fin tuna 30 to Faculty member Tom Look with a striped bass caught lbs move into Cape Cod Bay near Boston, in Boston Harbor on a fly rod and feed actively on the surface, becoming prime targets for light tackle fly and spin fishing anglers.

Tuna travel with whales, providing interesting whale watching opportunities on Stellwagen bank while searching for the elusive schools of tuna. Bluefish arrive around the same time as the tuna, and provide exciting surface action as they feed on schools of baitfish in Boston Harbor.

Summer is the prime season for saltwater fishing in Boston, but for the dedicated fisherman or woman, large cod fish up to 50 lbs.

All fish species are safe to eat due to the successful harbor clean up. Fresh water fishing is also popular. Fly-fishing for trout in New England streams is also popular. And, for the hardy there is ice fishing in the winter. Many area farms provide boarding and lessons. To train fellows to care for patients undergoing stem cell transplantation. To develop physician leaders for a career in academic medicine through research training and scholarly work in the field II.

General issues in the fellowship a. Fellows must be grounded in the principles and methods of evidence-based medicine i. Have the ability to manage a difficult clinical problem using the primary medical literature. Should have a general knowledge of the statistical evaluation of clinical trials.

Learn the molecular basis of hematologic and oncologic diseases and develop the ability to apply this knowledge to the diagnosis and management of patients. Year specific goals i. They will be closely supervised in these roles by attending physicians who will evaluate the knowledge gained in these areas for newly diagnosed patients, and in the clinic for the ongoing care of patients. Second and third year: Fellows will also take on primary scholarly projects in their research settings.

Develop the knowledge and ability to appropriately communicate with patients and families i. The fellow will have appropriate increasing responsibility for communication with patients and families including at times such as when a patient is coming off therapy or has relapsed. Understand the problems of the dying patient, and develop skill in palliation and end-of-life care i. They will be assisted and taught this skill by their primary attendings in the clinic and the Pediatric Advanced Care Team.

Learn the art of being a consultant i. Fellows provide consultations to other services while on the hematology and oncology rotations. They learn to work with the physicians asking for consultation, providing information to those physicians first and then to families.

Become proficient in managing patients in pain i. Again, they will be assisted and taught this skill by their primary attendings in the clinic and the Pediatric Advanced Care Team. Become competent teachers in patient-based and research settings i. Fellows lead several didactic sessions, including weekly heme rounds and oncology tumor boards.

Understand the principles of research protocols and learn to administer and use them i. They are taught these principles in orientation and supervised as they learn by their attendings. Some fellows will develop clinical research protocols as part of advanced training in clinical research. Develop the ability to work effectively with a multi-disciplinary team and lead patient management i. They also work with such teams in the care of their continuity patients in oncology, stem cell transplantation and hematology.

Become familiar with the principles of pathologic evaluation of cancer and hematologic diseases 53 III. Become familiar with the principles of the radiological work up of oncology and hematology patients i. Perform original scholarly work in a primary research setting i. Design and conduct original research basic science, translational work, clinical investigation , engage with a research community in presenting work in progress, acquire needed technical and analytic skills to perform research, present work orally and in written form, form a Scholarship Oversight Committee, complete work to meet the requirements for scholarly work during fellowship, as approved by the SOC.

Become competent at diagnosing pediatric hematologic disease. Inherited and acquired anemias Disorders of leukocytes including chronic granulomatous disease Inherited and acquired disorders of platelets Hemophilia and other coagulopathies Thrombotic disorders Bone marrow failure syndromes Newborn hematologic problems All primarily done in first year of fellowship b.

Learn to evaluate the clinical laboratory data pertinent to hematology i. Become competent in evaluating blood smears and bone marrow aspirates i. They also have a lecture series in the evaluation of blood smears and marrow specimens. Understand the principles of blood banking 1. Inherited and acquired anemias 2. Disorders of leukocytes including chronic granulomatous disease 3. Inherited and acquired disorders of platelets 4.

Hemophilia and other coagulopathies 5. Thrombotic disorders 54 6. Bone marrow failure syndromes 7. Newborn hematologic problems All primarily done in first year of fellowship. Become competent in evaluating oncologic disease in bone marrow aspirates and biopsies i.

Fellows also have a lecture series in the evaluation of blood smears and marrow specimens. Become competent at diagnosing and managing pediatric oncologic diseases i. They also have a lecture series in oncology. Become competent in prescribing and managing the complications of chemotherapy i. They also have a lecture that includes issues with chemotherapy. Understand the principles of radiation oncology i. They also have a lecture that includes issues with radiation oncology.

Understand the principles of surgical oncology i. They also have a lecture that includes issues with surgical oncology. Become competent in the management of recurrent cancer i. Learn the problems seen in the cancer survivor i. Perini quality of life Long Term Survivor clinic, and in subsequent years continue to follow the patient s they picked up, as well as following their own continuity clinic patients.

Second and third years: Stem cell transplantation a. Become competent in managing the care of patients undergoing stem cell transplantation i. They also have lectures that includes issues with stem cell transplantation. Learn to evaluate HLA typing i. Understand the management of acute and chronic graft-versus-host disease i. They also have lectures that include issues with stem cell transplantation. Academic training goals a. All fellows will be trained in one of the following disciplines: Laboratory based scientific research ii.

Each fellow will obtain the basic skills needed for research in their specific discipline; the majority of this training occurs in the second and third year. Fellows learn these skills during their first year: Lumbar puncture and administration of intrathecal chemotherapy iii. Bone marrow harvests b. Fellows continue to perform procedures on their own patients whenever possible in the second and third year.

Research The second and third year are devoted to research training. These research activities are guided by and overseen by the Scholarship Oversight Committee and the research mentor for each fellow. Agarwal, who completed his postdoctoral fellowship in the laboratory of George Daley in our program, was recruited to the position of Assistant Professor through an open search process. He studies the genetics and potential treatment of dyskeratosis congenital, one of the most instructive bone marrow failure syndromes.

He has used iPS cells to model the disorder and is currently leading a clinical trial for improved preconditioning for bone marrow transplantation. Alt is a world leader in B-cell immunology and DNA repair. His research employs genetically manipulated mice and is directly relevant to hematopoietic malignancies, e.

Alt has analyzed the molecular genetics of DNA end-joining reactions that form the basis of immunoglobulin gene rearrangements and chromosomal translocations. He has collaborated widely with other training faculty members Drs. Orkin, Look , and is recognized as a highly committed mentor. His group has identified several target sequences and putative splicing factors involved in the tissue-specific regulation of a red cell cytoskeletal protein—4.

In addition, his group has also characterized distinct roles for different 4. He has served as a mentor for more than 50 trainees. Bischoff studies the role of endothelial colony forming cells ECFCs and endothelial plasticity in vascular tumors and vascular malformations.

Bradner is on the forefront of chemical biology and epigenetics. He has shown that BRD4 inhibition selectively shuts off Myc expression and serves as a potential therapeutic in Myc-dependent cancers, such as multiple myeloma, leukemia, and neuroblastoma.

He has collaborated on BRD4 treatment of neuroblastoma with Dr. Kim Stegmaier, and is working closely with cliinical colleagues in designing approaches to uses of BRD4-inhibition in leukemias.

Bradner, MD Assistant Professor The ability to undergo cell division is encoded in the genomes of all human cells. This process requires a symphony of growth genes to be turned on, and then silenced when cell division is no longer needed.

The activation of the growth program in healthy cells is conducted by a small number of master regulatory genes called transcription factors. In contrast, abnormal unrestricted cell growth is encoded in the genomes of all cancer cells. Laboratory, Department of membranes. His studies have identified the role of specific transport proteins in inducing Laboratory Medicine, CHBregulators of cancer cell growth. The primary focus erythrocyte in called sickle cell disease, leading toisnew Dr.

Bradner is using new chemical approaches to develop small molecule drugs directed at the master of his efforts dehydration is a master regulator Myc. Abnormal activation of Myc one oftherapeutic the most common events in all human cancers. By targeting Myc in cancer cells, he hopes to discover new, prototype drugs that can be used as more effective targeted anti-cancer agents.

His studies have also shed light on the regulation of ion transport in other hematological diseases, such as hereditary spherocytosis and thalassemias. All cancers Research Area: A major focus of study is the function of the Hippo signaling pathway, a potent regulator of organ size in mice and this has provided a conceptual link between organ size regulation and stem cell activity through Hippo signals.

Current studies are aimed at fully dissecting the role of this cascade in somatic stem cells to shed light on fundamental aspects of tissue regeneration. The work will facilitate the development of therapeutic approaches based on cellular transplantation. Camargo is also investigating the relevance of organ size regulatory mechanisms as new components of a tumor suppressor pathway. Finally the Camargo Lab studies the cellular and molecular biology of hematopoietic stem cells with focus on the in vivo roles of transcription factors and microRNAs in stem cell fate decisions, differentiation, and malignancy.

Cantor's research focuses on molecular hematopoiesis, and specifically on the role of GATA and Runx multiprotein complexes in megakaryopoiesis and leukemias. His group is applying new proteomic and genome-wide transcription factor binding techniques to these problems. He has recently identified a new zinc-finger protein that is critical to early hematopoietic progenitors and lineage maturation.

His group has also uncovered functionally important interactions between Runx-1 and the Ets transcription factor Fli-1, which may have relevance to myelodysplastic syndrome. He has ongoing collaborations with Drs. Orkin, Zon, and Daley within the Division. His research focuses on regulators of non-apoptotic cell death of neutrophils and hematopoietic progenitor cells, with emphasis on both pyroptosis and necroptosis.

His lab is currently investigating the role of pyroptosis and necroptosis during normal hematopoiesis, infection, chronic inflammation and tumorigenesis. Daley is a leader in the field of stem cell biology. His group focuses on the use of human embryonic stem hES cells with the hope of generating hematopoietic stem and progenitor cells for therapy. He served as mentor to one of our new Asst Prof faculty Dr. Agarwal and has collaborated with other training faculty Drs.

He has trained many physician-scientists in his laboratory. He is a pediatric oncologist with an active clinical and translational research program focused on patients with advanced neuroblastoma and Ewing sarcoma. He conducts phase 1 and 2 clinical trials of novel targeted agents. His clinical practice focuses on providing outstanding team-based care for children and young adults with solid cancers.

The laboratory employs a range of genomic technologies as well as classical cellular and molecular biology approaches to investigate the biology of specific human diseases, particularly hematopoietic malignancies and disorders of red blood cell production. He and his colleagues identified RPS14 as a gene that plays a central role in the pathophysiology of the 5q- syndrome, a subtype of MDS, work that was published in Nature in Golub, Haining, and Berliner.

Fleming works with trainees and faculty to facilitate the development of preclinical and, ultimately, human translational trials seeking to improve the care of children with serious diseases. Under the leadership of David Williams, the TRP provides support for faculty-initiated research projects along with infrastructure to get these projects done in a fast and efficient manner.

Focus areas of the TRP include supporting several types of grants seed, core and career development awards, as well as providing regulatory guidance. Fleming is a hematological pathologist. His laboratory uses positional cloning in mice and humans to identify novel genes in the iron metabolic and heme biosynthesis pathways. He or his laboratory are responsible for identifying the intestinal and endosomal iron transporter, DMT1, the erythroid ferrireductase of the transferrin cycle, STEAP3, and that TMPRSS6 is a key modulator of production of the iron regulatory hormone, hepcidin.

This research is translational — and is highly interactive with a broad network of research and clinical collaborators, internationally. These approaches have directly enabled both national Food and Drug Administration, USA and international approvals for six targeted therapy indications in the past ten years.

Thus, a major aim of his laboratory is to identify factors contributing to variable response to antiplatelet therapy. The lab also participates in large multi-centered national and international clinical trials evaluating platelet function in patients treated with novel therapeutic agents.

Furie's research interests focus within the area of hemostasis and thrombosis. Major activities in the laboratory involve the study of the structure-function relationships of the blood coagulation proteins, with special attention directed toward the vitamin Kdependent proteins and gamma-carboxyglutamic acid, the structure of Factor VIII and the assembly of Factor IX and Factor VIII on membrane surfaces. In addition, this laboratory discovered P-selectin, and the study of vascular cell adhesion molecules has remained a major theme of the laboratory.

This group, which has developed novel instrumentation for the study of thrombus formation in vivo using confocal and widefield microscopy in the microcirculation of a live mouse, is currently studying the pathophysiology of thrombosis and the regulation of thrombus formation. Furie has mentored nearly pre- and postdoctoral trainees. Garraway, a faculty member in Medical Oncology, focuses on cancer genomics. Golub, and other training faculty members.

His research centers on novel genomic approaches to identification of critical cancer genes. George focuses on neuroblastoma. Her goal is to translate basic findings in the laboratory to clinical trials in neuroblastoma. In particular, he and his colleagues utilize gene expression profiling to develop a molecular taxonomy for cancer and also examine the use of gene expression signatures as the basis for chemical screening for new therapeutic small molecules.

Grace is the site PI for an industry sponsored study of a novel oral iron chelator. Grace launched a multicenter, international registry for patients with pyruvate kinase deficiency. He has discovered important roles for miRNAs in embryonic stem cells. His focus on miRNAs is directly relevant to cancer. Gutierrez, a minority Junior faculty mentor, recently completed his postdoctoral research in the laboratory of Dr.

He was recruited to the position of Assistant Professor following a national search process. His research focuses on the mechanisms of drug-resistance in T-cell leukemia and on liposarcoma.

He uses both zebrafish and mouse systems, in addition to study of human material. Haining focuses on understanding the basis for protective T cell immunity in humans, and discovering new drug targets to manipulate T cell function.

Hartwig studies the structure and mechanics of platelet shape change and its cytoskeletal dynamics; signal pathways that regulate actin assembly; mechanical events that lead to the formation of blood platelets; and mechanisms that remove senile and damaged platelets from the blood.

He is also the clinical member of a multidisciplinary translational research team in congenital iron disorders including hemochromatosis, iron refractory iron deficiency and congenital sideroblastic anemia. Hoffmeister provided the first evidence that survival of platelets is intimately tied to expression of surface lactosaminyl glycans.

Her current research pertains to the role of lactosaminyl glycans in thrombopoiesis and platelet survival following storage. Her research in cancer stem cells is directly relevant to the aims of this training grant. She focuses on fundamental pathways of oncogenesis and tumor metastasis.

In particular his group studies molecular mechanisms that underlie the cell's sorting machineries responsible for receptor-mediated endocytosis and for secretion, and how they are high-jacked by toxins, viruses and bacterial pathogens to enter cells. He also studies how during cell division, cells control their size and organelle architecture. Lieberman has been in the forefront in harnessing RNA interference for disease prevention and therapy, especially for HIV and cancer.

She was the first to show that RNA interference could be used to protect mice from disease. Her laboratory also studies how cytotoxic T lymphocytes kill viral infected or cancerous target cells and how T cell effector immune responses are regulated in the setting of chronic infections, such as HIV. She has helped develop two candidate HIV vaccines — one based on a detoxified bacterial toxin and another based on an engineered intracellular bacterium.

Mentor Much of Dr. He also studies hematopoietic stem cells; he identified stromal cells in the fetal liver and other organs that support stem cell self- renewal in vivo, and identified novel growth factors that support their expansion in culture. He also investigates the roles of microRNAs in lineage commitment of hematopoietic stem and progenitor cells.

He has collaborated with and copublished with Drs. Look and his colleagues study cancer genetics using the zebrafish genetic system to clarify developmental pathways subverted in human leukemias and solid tumors. His laboratory has been pursuing models of leukemias and neuroblastoma in the zebrafish. He has mentored several trainees and collaborated widely with the training faculty including Drs.

His most recent work is directed toward understanding ankyrin function, studying hereditary defects in membrane skeleton proteins, and characterizing the organization of the membrane skeleton components in the red cell membrane. Lux has received many awards recognizing his research E. Lux was the former PI on this training grant. He works closely with Dr. Nathan's research has focused on the inherited disorders of red cells and granulocytes and particularly on thalassemia.

He has trained over hematologists many of whom hold leading positions in pediatrics and internal medicine. His text book entitled Hematology of Infancy and Childhood is the leading text in the field. Kober Medal of the Association of American Physicians. He is one of three physicians to receive both the Howland and the Kober medals.

He has mentored more than 20 trainees. In , she accepted her current position in the Div. He and his colleagues have defined a transcriptional network controlling hematopoietic stem cell development and function and mechanisms of lineage selection.

In addition, his laboratory is studying how mutations of specific transcription factors may lead to leukemia, how pluripotency of embryonic stem cells is regulated, how fetal hemoglobin is regulated, and modeling human cancers in mice.

He has served as mentor for Drs. Zon, Roberts, and Cantor, and has mentored more than 75 trainees. She is also active as an attending in bone marrow transplantation. In addition, she has developed an active clinical program in immune deficiency, and collaborates with Dr.

David Williams in gene therapy protocols. As part of her clinical studies, she works closely with Dr. His group has extended the findings to mammalian models by targeted gene disruption in the mouse. He has collaborated with Drs. She studies regulatory functions of serine proteases, cathepsins, and serpins, especially SerpinB1 Program in Cellular and Molecular Medicine, Div. Once relevant target antigens are identified, further studies characterize the role of B and T cell responses to these antigens and the regulation of these responses in vivo.

These studies lay the foundation for the development of novel methods to specifically enhance immune reconstitution and tumor immunity following HSCT. He trained in the laboratory of Irv Weissman at Stanford. In addition, his laboratory developed an innovative method for modifying mRNA for cell delivery and therapeutics. His studies utilize rare and common human genetic variation to improve our understanding of red blood cell production erythropoiesis and globin gene regulation with application to numerous blood diseases including sickle cell anemia, thalassemia, Diamond-Blackfan anemia, and childhood leukemia.

Investigator, Program in Molecular Medicine, Div. These engraft conditioned recipients upon al paradigm for stem cell use in otential of HSCs, surprisingly little is mental properties. Our lab has a bling self-renewal and multi-potency in and epigenetic approaches. In particular we are exploring hematopoietic stem cell biology and hich stem cells maintain genomic age accrual impacts stem cell functional.

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