Publications by authors named "Karen DSouza"

Hidden curriculum, which consists of the implicit norms and values embedded within institutions, impacts how students navigate their experiences in higher education. While the formal curriculum provides structured learning objectives and content, the hidden curriculum shapes students' socialization, sense of belonging, and access to opportunities within academic settings. For diverse students, hidden curriculum often reinforces existing power dynamics and inequities, creating additional barriers to their success.

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Background: Uterine fibroids are non-cancerous neoplasms that arise from the uterus affecting over 75% of women. However, there is a disparity with Black women having an increased prevalence of nearly 80%. Black women also experience increased symptom burden, including younger age at the time of diagnosis and increased number and volume of fibroids.

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The hidden curriculum (HC), or implicit norms and values within a field or institution, affects faculty at all career stages. This study surveyed affiliates of a junior faculty training program ( = 12) to assess the importance of HC topics for junior faculty, mentors, and institutional leaders. For non-diverse junior faculty and their mentors, work-life balance, research logistics, and resilience were key HC topics.

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Previous studies described that asthma patients who received corticosteroid therapy have been constrained by the corticosteroid resistance subsequently fostered to severe refractory asthma. In this review, we discussed the implications of TSLP, RXR, the role of STAT5-activating cytokines, and IL-33/NH-cell signaling pathways, and recent clinical evidence on TSLP blockers in steroid-resistant asthma. We have searched several public databases such as Pubmed, Scopus, and Relemed and obtained information pertinent to the TSLP, RXR, TSLP blockers, the STAT5-activating cytokines, and IL-33.

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Purpose: To evaluate sex differences in operating room (OR) time and case volumes among comprehensive cataract surgeons in Ontario, Canada's most populated province.

Design: Retrospective, population-based cohort study.

Methods: Physician billing data of active comprehensive cataract surgeons between 2010 and 2019 were analyzed to identify all cataract surgeries in this timeframe.

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Research Question: What is the patient experience of women with high body mass index (BMI) with BMI restrictions that limit fertility care?

Design: Qualitative study using in-depth, semi-structured interview methodology. Interview transcripts were analysed for iterative themes in accordance with principles of grounded theory.

Results: Forty women with a BMI of 35 kg/m or higher with scheduled or completed appointment at the Reproductive Endocrinology and Infertility (REI) clinic completed an interview.

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Assessment of senior medical students is usually calibrated at the level of achieving expected learning outcomes for graduation. Recent research reveals that clinical assessors often balance two slightly different perspectives on this benchmark. The first is the formal learning outcomes at graduation, ideally as part of a systematic, program-wide assessment approach that measures learning achievement, while the second is consideration of the candidate's contribution to safe care and readiness for practice as a junior doctor.

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Background: With an aging population in Ontario, ophthalmologists provide most of their care to older adults, which has prominent human resource implications. In this study, we sought to investigate the supply and demographic characteristics of Ontario's ophthalmologists.

Methods: In this retrospective, population-based analysis, we evaluated cohort demographics, including sex and career stage, of Ontario's ophthalmologists from 2010 to 2019, which we reported using descriptive statistics.

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Article Synopsis
  • There have been significant initiatives aimed at recruiting and retaining diverse faculty, staff, and trainees in academic medicine.
  • Many institutions still lack effective strategies or comprehensive plans to support historically underrepresented groups.
  • The article outlines specific methods that institutions can implement to enhance inclusion and ensure the workforce reflects the diversity of patients and research participants.
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Decision-making in clinical assessment, such as exit-level medical school Objective Structured Clinical Examinations (OSCEs), is complex. This study utilized an empirical phenomenological qualitative approach with thematic analysis to explore OSCE assessors' perceptions of the concept of a "prototypical intern" expressed during focus group discussions. Topics discussed included the concept of a prototypical intern, qualities to be assessed, and approaches to clinical assessment decision-making.

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The effects of the COVID-19 pandemic on the healthcare system have been widespread, with many institutions in the United States pausing elective procedures to redirect resources to critical care. Fertility care and assisted reproductive procedures were classified as elective procedures and similarly paused. We conducted qualitative interviews with patients and/or their partners ( = 25 female patients;  = 3 male partners) receiving care at a fertility clinic in the Midwest to understand patient appraisal of COVID-19 risk on the resumption of care following a month-long closure of an infertility clinic, and patient agreement with the clinic closure.

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Youth are an understudied population requiring additional safeguards when participating in research. Their input is necessary to facilitate participation and interest in studies. To address this, Mayo Clinic established one of the first pediatric advisory boards (PAB) comprised of 18 diverse youth aged 11-17.

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Article Synopsis
  • Uterine fibroids are non-cancerous tumors in the uterus that disproportionately affect women of color, particularly non-Hispanic Black and Hispanic women, who face greater challenges in diagnosis and treatment.
  • Women of color reported significant disruptions in their daily lives due to fibroid symptoms, and many felt that their race or ethnicity influenced their treatment experiences negatively, contributing to distrust in the medical system.
  • The study highlights the need for culturally sensitive healthcare and efforts to eliminate biases in the treatment of uterine fibroids to improve care for women of color.
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We developed a deep learning method to reduce noise and beam-hardening artifact in virtual monoenergetic image (VMI) at low x-ray energy levels. An encoder-decoder type convolutional neural network was implemented with customized inception modules and in-house-designed training loss (denoted as Incept-net), to directly estimate VMI from multi-energy CT images. Images of an abdomen-sized water phantom with varying insert materials were acquired from a research photon-counting-detector CT.

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The coronavirus disease 2019 pandemic may require rationing of various medical resources if demand exceeds supply. Theoretical frameworks for resource allocation have provided much needed ethical guidance, but hospitals still need to address objective practicalities and legal vetting to operationalize scarce resource allocation schemata. To develop operational scarce resource allocation processes for public health catastrophes, including the coronavirus disease 2019 pandemic, five health systems in Maryland formed a consortium-with diverse expertise and representation-representing more than half of all hospitals in the state.

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Background: Objective structured clinical examinations (OSCEs) are commonly used to assess the clinical skills of health professional students. Examiner judgement is one acknowledged source of variation in candidate marks. This paper reports an exploration of examiner decision making to better characterise the cognitive processes and workload associated with making judgements of clinical performance in exit-level OSCEs.

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Objectives: Maternal protein malnutrition is associated with impaired fetal growth, and lifetime consequences for the offspring. Our group has previously developed a model of protein-restriction in the non-human primate, which was associated with fetal growth restriction, stillbirth, decreased placental perfusion, and evidence of fetal hypoxia, suggesting perturbed vascular development. Our objective was to histologically characterize the micro-anatomic alterations associated with adverse pregnancy outcomes taking an approach that permits investigation of the 3D vascular structure and surrounding histology without the requirement for 3D vascular casting or relying on 2D stereology which both have methodological limitations.

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Background The function of medin, one of the most common human amyloid proteins that accumulates in the vasculature with aging, remains unknown. We aim to probe medin's role in cerebrovascular disease by comparing cerebral arterial medin content between cognitively normal and vascular dementia (VaD) patients and studying its effects on endothelial cell (EC) immune activation and neuroinflammation. We also tested whether monosialoganglioside-containing nanoliposomes could reverse medin's adverse effects.

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Lipoapoptosis of cardiomyocytes may underlie diabetic cardiomyopathy. Numerous forms of cardiomyopathies share a common end-pathway in which apoptotic loss of cardiomyocytes is mediated by p38α mitogen activated protein kinase (MAPK). Although we have previously shown that palmitic acid (PA), a saturated fatty acid (SFA) elevated in plasma of type 2 diabetes mellitus and morbid obesity, induces apoptosis in cardiomyocytes via p38α MAPK-dependent signaling, the downstream cascade events that cause cell death remain unknown.

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The objective of this collaborative study was to compare current practices of conducting high-stake, exit-level Objective Structured Clinical Examinations (OSCEs) at all Australian medical schools. We aimed to document similarities and differences between schools, and compare existing practice against available gold standard, evidence-based practice. We also aimed to identify areas where gold standards do not currently exist, and could be developed in the future.

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Article Synopsis
  • The gut microbiome significantly influences health, and antibiotics are known to alter it, though their effects on glucose tolerance in lean mice remain underexplored.
  • In this study, researchers treated lean, normoglycemic mice with different antibiotics to evaluate changes in body weight, glucose metabolism, liver and ileum gene expression, and gut microbiota shifts.
  • Results showed that antibiotics reduced fasting glucose levels and altered glucose tolerance without affecting body weight, revealing potential interactions between the microbiome, gene expression, and glucose metabolism in a non-obese context.
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Background: A key issue underpinning the usefulness of the OSCE assessment to medical education is standard setting, but the majority of standard-setting methods remain challenging for performance assessment because they produce varying passing marks. Several studies have compared standard-setting methods; however, most of these studies are limited by their experimental scope, or use data on examinee performance at a single OSCE station or from a single medical school. This collaborative study between 10 Australian medical schools investigated the effect of standard-setting methods on OSCE cut scores and failure rates.

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