The Impact of United States Medical Licensing Examination Step 1 Transitioning To Pass/Fail on Medical Student Perception of Research Needed to Match Into One's Preferred Specialty.

Purpose To evaluate how the transition of United States Medical Licensing Examination (USMLE) Step 1 to a pass/fail scoring influenced medical student perceptions of the importance of research required to match into their preferred residency specialty. Methods A 14-item survey was distributed by e-mail to medical students at one medical school in the southeastern United States in November of 2021. Responses were compared between medical students taking USMLE Step 1 pass/fail in the future and medical students taking USMLE Step 1 for a three-digit score.

Utility of Gynecological Teaching Associates.

Introduction Gynecological teaching associates (GTAs) are trained to teach the pelvic exam using themselves as models, and it has been hypothesized that their use can improve learners' confidence and interpersonal skills. This study aims to gain greater insight into whether the use of GTAs is associated with increased medical students' confidence when performing the pelvic exam during clinical rotations. Methods An email survey was distributed to medical students in two different classes at a single United States Medical Licensing Examination (USMLE)-accredited medical school: one that learned the pelvic exam using GTAs and one that did not.

Concussion History and Heart Rate Variability During Bouts of Acute Stress.

Context: After a sport-related concussion, many athletes experience persisting neurophysiological alterations. These alterations may be absent at rest but emerge during moments of physiological stress. Unnoticed and untreated neurophysiological dysfunction may negatively affect long-term neurologic health in adolescent athletes, as they are at a critical point in development.

Association between cardiorespiratory fitness and cerebrovascular reactivity to a breath-hold stimulus in older adults: influence of aerobic exercise training.

Cerebrovascular reactivity (CVR) to a physiological stimulus is a commonly used surrogate of cerebrovascular health. Cross-sectional studies using blood oxygen level dependent (BOLD) neuroimaging demonstrated lower BOLD-CVR to hypercapnia among adults with high compared with lower cardiorespiratory fitness (CRF) in contrast to transcranial Doppler studies. However, whether BOLD-CVR changes following chronic aerobic exercise in older, cognitively intact adults is unclear.

Supporting Physical Activity in Patients and Populations During Life Events and Transitions: A Scientific Statement From the American Heart Association.

Achieving recommended levels of physical activity is important for optimal cardiovascular health and can help reduce cardiovascular disease risk. Emerging evidence suggests that physical activity fluctuates throughout the life course. Some life events and transitions are associated with reductions in physical activity and, potentially, increases in sedentary behavior.

Oral vitamin C restores endothelial function during acute inflammation in young and older adults.

Oxidative stress has been linked to reductions in vascular function during acute inflammation in young adults; however, the effect of acute inflammation on vascular function with aging is inconclusive. The aim of this study was to determine if oral antioxidant administration eliminates vascular dysfunction during acute inflammation in young and older adults. Brachial flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity (PWV) were measured in nine young (3 male, 24 ± 4 yrs, 26.

Cardiovascular Health Trajectories and Elevated C-Reactive Protein: The CARDIA Study.

Background The relationship between long-term cardiovascular health (CVH) patterns and elevated CRP (C-reactive protein) in late middle age has yet to be investigated. We aimed to assess this relationship. Methods and Results Individual CVH components were measured in 4405 Black and White men and women (aged 18-30 years at baseline) in the CARDIA (Coronary Artery Risk Development in Young Adults) study at 8 examinations over 25 years.

Agreement between blood pressure from research study visits versus electronic medical records and associations with hypertensive disorder diagnoses in pregnant women with overweight/obesity.

Objectives: Blood pressure (BP) abstracted from electronic medical records (EMR) is moderately correlated to BP in nonpregnant adults with limited agreement. Little is known about the agreement of research versus EMR BP measured during pregnancy or associations of EMR BP with hypertensive disorder of pregnancy (HDP) diagnoses.

Methods: BP was measured according to guidelines at in-person research study visits in 214 women with prepregnancy overweight or obesity (44.

Perception of body mass index and health issues related to overweight/obesity in an outpatient women's clinic.

A body mass index (BMI) ≥25 kg/m is linked to worse health outcomes. Little is known about women's awareness of their BMI and their awareness of associations between high BMI and cardiovascular and gynecologic diseases. We investigated perceived versus actual BMI of women in an outpatient women's health clinic and determined awareness of health risks linked to high BMI.

Importance of Sensitive Vascular Measurements for Evaluating Effects of Lifestyle in Premenopausal Women.

Premenopausal women generally have a favorable cardiovascular risk profile, owing to young age and the protective effects of estrogen. Rates of hypertension and more advanced cardiovascular disease (CVD) are low in premenopausal women. A large body of epidemiological evidence has shown that lifestyle behaviors in midlife, i.

Simulation-based clinical learning for the third year medical student: Effectiveness of transabdominal and transvaginal ultrasound for elucidation of OB/GYN scenarios.

Purpose: Point-of-care ultrasound (POCUS) is gaining recognition as a teaching modality that acts as an integrative learning tool during medical student transition to clinical rotations. This study aimed to determine if the use of ultrasound simulation enhances understanding of Obstetrical and Gynecological (Ob/Gyn) anatomy and pathology in third-year medical students (M3), and if M3 students found the simulator useful.

Methods: M3 students taking the OB/Gyn clerkship were invited to participate.

Making cell culture more physiological: a call for a more comprehensive assessment of racial disparities in endothelial cell culture studies.

In the United States, cardiovascular diseases (CVDs) are the leading cause of death and disproportionately affect ethnic and racial minority populations. Black individuals are more likely to develop advanced CVD and microvascular complications resulting in end-organ damage. Endothelial cell dysfunction leads to microvascular and macrovascular dysfunction and is predictive of the development of CVD.

Sedentary Time and Physical Activity Across Occupational Classifications.

Purpose: To examine differences in activity patterns across employment and occupational classifications.

Design: Cross-sectional.

Setting: A 2005-2006 Coronary Artery Risk Development in Young Adults (CARDIA) study.

Dietary sodium, potassium, and blood pressure in normotensive pregnant women: the National Health and Nutrition Examination Survey.

Dietary sodium, potassium, and sodium-to-potassium ratio are linearly associated with blood pressure in nonpregnant adults. Earlier investigations suggested null or inverse associations of blood pressure and sodium during normotensive pregnancy; findings have not been confirmed in race/ethnically diverse women or while accounting for potassium. Our purpose was to evaluate associations of blood pressure with sodium and potassium and sodium-to-potassium ratio in race/ethnically diverse normotensive pregnant women.

Long-Term Cardiovascular Risks Associated With Adverse Pregnancy Outcomes: JACC Review Topic of the Week.

Adverse pregnancy outcomes (APOs)-including pre-term birth, pre-eclampsia, and intrauterine growth restriction-are common interrelated disorders caused by placental dysfunction and maternal vascular abnormalities (endothelial activation, inflammation, and vasospasm) that occur in approximately 10% to 20% of pregnancies. Women who experience APOs are at increased risk for future cardiovascular disease (CVD). APOs are associated with increased risk of development of hypertension, left ventricular hypertrophy/dysfunction, vascular dysfunction, and renal dysfunction.

Effect of acute maximal exercise on vasodilatory function and arterial stiffness in African-American and white adults.

Introduction: African-Americans are at increased risk of cardiovascular disease compared with their white counterparts, potentially due to greater arterial stiffness and reduced vasodilatory capacity. Racial differences also exist in arterial stiffness and blood pressure (BP) following maximal aerobic exercise; African-Americans do not exhibit central post exercise BP reductions. Whether impaired vasodilatory function contributes to the lack of BP response is unknown.

Sex Differences in Aortic Hemodynamics Following Acute Exercise: Wave Separation Analysis.

The importance of sex differences in the control of blood pressure responses to exercise is controversial. It is unknown whether the potential sex differences are a result of magnitude differences in forward or reflected pressure waves. The purpose of this study was to investigate sex differences in BP following acute exercise using wave separation analysis.

Pre-pregnancy blood pressure and body mass index trajectories and incident hypertensive disorders of pregnancy.

There are few studies examining patterns in body mass index (BMI) and blood pressure (BP) and subsequent hypertensive disorders of pregnancy (HDPs). We examined the association of BMI (n = 1342) or BP (n = 2266) trajectories in the 5 years preceding birth with HDPs using adjusted logistic regression. Compared to normal-weight BMI and low-normal BP groups, membership to the overweight BMI group (OR: 2.

Healthy aging and carotid performance: strain measures and β-stiffness index.

Arterial stiffness is related to the risk of cardiovascular disease (CVD) and increases with aging. Functional impairment of the arterial wall can occur before structural changes and can be detectable before CVD symptoms. The elastic properties of the carotid arterial wall during the cardiac cycle can be evaluated by standard 2-dimensional (2D) ultrasound longitudinal or circumferential imaging of vascular deformation (strain) using speckle tracking.

Influence of fitness and age on the endothelial response to acute inflammation.

New Findings: What is the central question of the study? What are the effects of age and fitness on the vascular response to acute inflammation in younger and older adults? What is the main finding and its importance? In older adults, cardiorespiratory fitness level has a differential impact on endothelial function after acute inflammation. Compared with older adults with low fitness, older, moderately fit adults have a greater decrease in endothelial function, similar to that of younger adults. These findings have important implications in support of the beneficial effects of higher cardiorespiratory fitness in maintaining vascular reactivity and the ability to respond to stressors.