Publications by authors named "Nicholas Van Wagoner"

Background: Transgender men (TGM) are underrepresented in genital microbiome research. Our prospective study in Birmingham, AL investigated genital microbiota changes over time in TGM initiating testosterone, including the development of incident bacterial vaginosis (iBV). Here, we present lessons learned from recruitment challenges encountered during the conduct of this study.

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Objective: To investigate how the shift of the United States Medical Licensing Examination (USMLE) Step 1 to a Pass/Fail (P/F) scoring system impacts the perceptions of Urology Program Directors (PDs) on evaluating urology residency applicants.

Methods And Materials: A cross-sectional survey was sent to 117 PDs, including questions about program characteristics, perceptions of shelf scores and medical school rank post-transition, beliefs about the predictive value of Step 1 and Step 2 Clinical Knowledge (CK) scores for board success and residency performance, and changes in applicant parameter ranking.

Results: Forty-five PDs (38% response rate) participated.

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Rationale And Objectives: The purpose of this study is to assess diagnostic and interventional radiology resident physicians' knowledge of core facets of financial literacy: loans, real estate, investments and retirement, and insurance, with the goal of determining the need for formal financial literacy education within radiology residency programs.

Methods: From May 2021 to March 2022, surveys were sent to 196 diagnostic and 90 interventional radiology residency programs. Residents were asked 10 knowledge multiple choice questions to assess areas of financial literacy.

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 Beginning January 26, 2022, the U.S. Medical Licensing Exam (USMLE) Step 1 changed from a numerical score to pass/fail (P/F).

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Objectives In February 2020, the National Board of Medical Examiners (NBME) announced that the United States Medical Licensing Examination (USMLE) Step 1 licensing examination would change from a numerical score to Pass/Fail (P/F). After implementation, many believe that USMLE-Step 2-Clinical Knowledge (CK) will become an important metric for students applying to otolaryngology (ENT). The purpose of this study is to determine factors important to resident selection after these changes.

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  • On January 26, 2022, the USMLE Step 1 transitioned from a numerical score to a Pass/Fail system, significantly impacting how residency programs evaluate applicants.
  • A survey of pathology residency program directors revealed that while many still value Step 1 scores for predicting board exam success, they believe other factors, like medical school ranking, will gain importance.
  • Despite the survey's findings suggesting little change in the overall importance of selection criteria post-Policy change, the low response rate (23.6%) indicates the need for further research to guide future applicants.
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  • * The virus establishes a lifelong presence in the body, lying dormant in nerve cells, and can reactivate, causing symptoms or asymptomatic shedding that may spread the infection to others.
  • * Treatment includes guanosine analogs to alleviate symptoms and reduce the frequency of outbreaks and transmission, with ongoing research into new preventive and therapeutic methods.
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Introduction: The effect of testosterone (T) therapy on the vaginal microbiota of transgender men (TGM) is not well characterised, although one cross-sectional study comparing the vaginal microbiota of cisgender women to TGM on T≥1 year found that, in 71% of the TGM, the vaginal microbiota was less likely to be -dominated and more likely to be enriched with >30 other bacterial species, many associated with bacterial vaginosis (BV). This prospective study aims to investigate changes in the composition of the vaginal microbiota over time in TGM who retain their natal genitalia (ie, vagina) and initiate T. In addition, we will identify changes in the vaginal microbiota preceding incident BV (iBV) in this cohort while investigating behavioural factors, along with hormonal shifts, which may be associated with iBV.

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Background: The primary objectives of this study were to assess utilization of sexual health services at a university's student health and wellness center and to determine whether the presence of a dedicated sexual health clinic (SHC) was associated with different utilization patterns for sexual health services when compared with primary care clinics.

Methods: This was a retrospective chart review of patients presenting to the University of Alabama at Birmingham's Student Health and Wellness Center for sexual health services between January 2015 and June 2019. Utilization of sexual health services, specifically sexually transmitted infection (STI) testing, was compared between the dedicated SHC and primary care clinics.

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Background: Pre-exposure prophylaxis (PrEP) is a highly effective biomedical prevention intervention and a major strategy for reducing the HIV burden in the United States. However, PrEP provision and uptake remain lower than estimated needs, and in ways that may exacerbate HIV disparities among Black adolescent girls and young women in the southern United States. Data suggest that gaps in provider knowledge of HIV epidemiology and PrEP and skills assessing sexual health practices are important barriers to provision and uptake, with limited evidence-based interventions to address these gaps.

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Background: Beginning January 26th, 2022, the National Board of Medical Examiners transitioned scoring of the United States Medical Licensing Examination (USMLE) Step 1 from a 3-digit score to pass/fail. In the past, the Step 1 score has been weighted heavily by program directors (PDs) as one of the most important metrics when assessing medical student's competitiveness.

Objective: The objective of this study was to evaluate the perceptions of emergency medicine (EM) PDs on the transition to a pass/fail USMLE Step 1 exam, and to elicit the opinions of EM PDs on the USMLE examinations' ability to predict resident performance.

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  • The USMLE Step 1 transitioned to pass/fail grading in January 2022, prompting a study to understand its impact on Diagnostic and Integrated Interventional Radiology residency program directors.
  • A survey of program directors revealed that they plan to place greater importance on Step 2 CK scores, favor the sharing of NBME shelf exam scores, and increase consideration of medical school class rankings post-change.
  • While the shift to pass/fail may aim to reduce stress and improve student performance, it risks overshadowing this goal by forcing residency programs to rely more heavily on other metrics for student evaluation.
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Background: Neurosurgery (NS) is among the most selective specialties in the United States. As the United States Medical Licensing Examination (USMLE) Step 1 transitions to a binary pass/fail score, residency programs face unclear challenges in screening and evaluating applicants. The aim of this study is to provide insights into the perceived impact of changes to the USMLE Step 1 grading in the applicant selection process.

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This survey study of medical residency program directors assesses differences in the relative importance of the US Medical Licensing Examination (USMLE) Step 1 in resident selection following its transition to pass/fail evaluation.

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  • Maple syrup urine disease (MSUD) is a genetic metabolic disorder caused by a defect in the BCKDC, leading to the buildup of harmful amino acids that can affect neurological functions.
  • A 29-year-old female with MSUD and rheumatoid arthritis presented to the emergency room with symptoms of a metabolic crisis and was diagnosed with COVID-19, showing elevated leucine levels.
  • The medical team implemented individualized treatment, including IV fluids and a protein-restricted diet, resulting in her stable recovery and discharge without significant complications from COVID-19.
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  • The NNPTC trains clinical providers in the U.S. on diagnosing and treating STIs, aiming to correlate provider training with STI rates at the county level.
  • Between 2015 and 2020, 21,327 providers, mostly nurses in public health settings, participated in NNPTC training.
  • Results indicate a significant relationship between the number of training events and higher STI rates in counties, suggesting that training effectively targets areas with greater STI challenges.*
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  • Chlamydia trachomatis (CT) infection is especially common among asymptomatic young women, leading to underdiagnosis and untreated cases.
  • A study involving 362 asymptomatic women in Birmingham, AL, revealed a CT infection prevalence of 67.7%, significantly higher when including CT antibody testing.
  • Findings indicate a lack of awareness regarding prior CT infections among many women, highlighting the urgency for improved screening and adherence to guidelines to reduce reproductive health risks.
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We examined the acceptability and feasibility of using a 30-minute chlamydia/gonorrhea test in a student health clinical setting. One hundred eight students were enrolled and 89.4% were willing to wait up to 20 minutes beyond the conclusion of their routine visit.

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Background: GEN-003 is a candidate therapeutic vaccine for genital herpes simplex virus type 2 (HSV-2). We compared virologic and clinical impact of varying GEN-003 doses.

Methods: Adults with symptomatic HSV-2 received placebo or GEN-003 (30 or 60 µg antigen with 25, 50, or 75 µg adjuvant).

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Purpose: The authors examined the usefulness of a commercially available Step 1 question bank as a formative academic support tool throughout organ-based modules in an integrated preclinical medical curriculum. The authors also determined the extent to which correlation between question bank utilization and academic metrics varied with Medical College Admission Test (MCAT) scores.

Method: In 2015, a cohort of 185 first-year medical students at University of Alabama School of Medicine were provided with 18-month full access to a commercially available Step 1 question bank of over 2,100 items throughout organ-based modules, although there were no requirements for use.

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The Southeast has high rates of church attendance and HIV infection rates. We evaluated the relationship between church attendance and HIV viremia in a Southeastern US, HIV-infected cohort. Viremia (viral load ≥200 copies/ml) was analyzed 12 months after initiation of care.

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The objective of this study was to evaluate whether nondisclosure or selective disclosure of HIV status to others is associated with retention in HIV care. This retrospective analysis evaluated the relationship of self-reported disclosure of HIV status as an indicator for poor retention in care (a gap in care >180 days) during the 12 months following initial entry into HIV care. Nondisclosure (disclosure to no one) and selective disclosure were compared to broad disclosure (referent).

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We present a case of primary disseminated herpes simplex virus type 2 (HSV-2) cutaneous disease in a 22-year-old male. We discuss the immune response to HSV-2 infection as well as the extragenital manifestations of HSV-2 observed in immune-competent and immune-suppressed persons.

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Epidemiologic links between chronic hepatitis C and herpes simplex type-2 infection have been suggested; however, type-specific tests for HSV-2 infection have not been validated in patients with chronic hepatitis C infection. The Focus HerpeSelect(®) HSV-2 IgG (Cypress, California) assay and the Biokit HSV-2 rapid assay (Biokit USA, Lexington, MA) were performed on serum samples obtained from 84 veterans with chronic hepatitis C who demonstrated a previously positive HSV-2 serologic test in their medical records. Using the Biokit HSV-2 as the comparator assay, the positive predictive value, and specificity for the HerpeSelect(®) HSV-2 assay were 62.

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