Implicit bias assessment by career stage in medical education training: a narrative review.

Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person based on individual characteristics. Early evaluation of implicit bias in medical training can prevent long-term adverse health outcomes related to racial bias. However, to our knowledge, no present studies examine the sequential assessment of implicit bias through the different stages of medical training.

Functional innovation through new genes as a general evolutionary process.

In the past decade, our understanding of how new genes originate in diverse organisms has advanced substantially, and more than a dozen molecular mechanisms for generating initial gene structures were identified, in addition to gene duplication. These new genes have been found to integrate into and modify pre-existing gene networks primarily through mutation and selection, revealing new patterns and rules with stable origination rates across various organisms. This progress has challenged the prevailing belief that new proteins evolve from pre-existing genes, as new genes may arise de novo from noncoding DNA sequences in many organisms, with high rates observed in flowering plants.

Applying the Modified Five-Item Frailty Index to Predict Complications following Lower Extremity Free Flap Reconstruction in Trauma Patients.

Background:  Free flap reconstruction in the setting of lower extremity trauma continues to be a challenging clinical problem fraught with a high risk of complications including flap compromise. Although studies have described certain risk factors that predispose these patients to poor outcomes, there remains a paucity of literature detailing frailty as a risk factor. As such, the aim of our study was to examine the application of the 5-item modified frailty index (mFI-5) in trauma patients undergoing lower extremity free flap reconstruction.

Sexual identity, sexual behavior, and drug use behaviors among people who use drugs in the rural U.S.

Introduction: People who use drugs (PWUD) are at risk of HIV infection, but the frequency and distribution of transmission-associated behaviors within rural communities is not well understood. Further, while interventions designed to more explicitly affirm individuals' sexual orientation and behaviors may be more effective, descriptions of behavior variability by orientation are lacking. We sought to describe how disease transmission behaviors and overdose risk vary by sexual orientation and activity among rural PWUD.

Novel compound heterozygous CYP17A1 mutations identified in a family with two siblings affected by 17α-hydroxylase/17,20-lyase deficiency.

Background: 17α-Hydroxylase/17,20-lyase deficiency (17OHD) is a rare form of congenital adrenal hyperplasia (CAH), caused by mutations in the CYP17A1 gene. It typically manifests clinically as variable degree of hypertension, hypokalemia, and disorders of sexual development (DSD), which can include abnormal sexual differentiation in males and sexual infantilism in females. Over 100 mutations in CYP17A1 have been identified, with most cases involving missense mutations or small deletions.

Comparison of Chart Review and Administrative Data in Developing Predictive Models for Readmissions in Chronic Obstructive Pulmonary Disease.

This study aimed to evaluate the performance of machine learning models for predicting readmission of patients with Chronic Obstructive Pulmonary Disease (COPD) based on administrative data and chart review data. The study analyzed 4,327 patient encounters from the University of Chicago Medicine to assess the risk of readmission within 90 days after an acute exacerbation of COPD. Two random forest prediction models were compared.

FIGG at 5: An update on U.S. public perspectives on forensic investigative genetic genealogy five years after its introduction to criminal investigations.

In 2018, after law enforcement announced it had used a technique called forensic investigative genetic genealogy (FIGG) to identify the Golden State Killer, we conducted a U.S. general population survey and found most respondents supported using FIGG to solve violent crimes.

Utilizing simulation-enhanced interprofessional education to identify differences in healthcare students' collaborative practice behaviors: A mixed method study.

Background: Teaching collaborative practice behaviors (CPBs) to interprofessional healthcare students could improve healthcare for underserved populations.

Objective: This study explained the impact of Simulation Enhanced Interprofessional Education (SIM-IPE) on healthcare students' self-reported CPBs and their perceptions of utilizing CPBs when caring for underserved populations, as well as the differences among professions within interprofessional teams.

Design: Mixed methods explanatory design.

An examination of factors contributing to different anesthesia models in underserved areas.

Background: Maternity care access is worsening across the United States, driven in part by difficulties staffing obstetric units in some hospitals. Certified registered nurse anesthetists (CRNAs) provide obstetric anesthesia services in underserved areas, including rural areas (Cohen et al., 2021; Martsolf et al.

Single-Session Interventions for Mental Health Problems and Service Engagement: Umbrella Review of Systematic Reviews and Meta-Analyses.

Most people with mental health needs cannot access treatment; among those who do, many access services only once. Accordingly, single-session interventions (SSIs) may help bridge the treatment gap. We conducted the first umbrella review synthesizing research on SSIs for mental health problems and service engagement in youth and adults.

Markers for Pressure Injury Risk in Individuals with Chronic Spinal Cord Injury: A Pilot Study.

Objective: To identify markers associated with pressure injury (PrI) history in individuals with spinal cord injury (SCI) using two approaches: skin blood flow (SBF) response toward localized heating, and serum marker for insulin resistance.

Methods: For this cross-sectional, observational study of adults with chronic traumatic SCI at T12 and above, researchers recruited two groups of participants: with history of PrI (group 1), and without history of PrI (group 2). The study protocol included obtaining fasting blood samples and measurement of SBF at bilateral heels with localized heating of 42 °C for 30 minutes from all participants.

Racial disparities in extended venous thromboembolism prophylaxis after hysterectomy.

Background: Venous thromboembolism (VTE) is a significant preventable cause of postoperative morbidity and mortality after major abdominopelvic surgery that calls for extended VTE prophylaxis (eVTEp). Literature suggests that significant racial disparities may exist in post-operative care.

Objective: The study sought to examine if racial disparities exist in the administration of eVTEp after hysterectomy in a statewide collaborative.

Instagram Engagement Helps Increase Residency Applicant Interest in Orthopaedic Surgery.

Introduction: This study aims to evaluate whether Instagram engagement data affect residency application volumes for orthopaedic surgery residency programs and rank the top 50 Instagram accounts associated with programs based on engagement.

Methods: Data from January 1, 2020 to June 30, 2023 were collected in August 2023 for Instagram metrics through Popsters social media analytic tool for business accounts and manually for nonbusiness accounts, as well as applicant numbers through the Association of American Medical College (AAMC) Residency Explorer Tool. Top 50 rankings were created from 2020 to 2022 based on engagement score, number of applicants, and growth in application numbers.

A Comprehensive Evaluation of the Neuropharmacological Potential of Methanolic Leaf Extract of Acanthus ebracteatus (Vahl.) Using Experimental and In Silico Approaches.

This study was undertaken to assess the antioxidant and neuropharmacological potentials of the methanol leaf extract of Acanthus ebracteatus (MAEL) through experimental and in silico methods. The phytochemical screening (PS) and GC-MS (gas chromatography-mass spectrometry) identified 28 phytochemicals with different classes in nature in MAEL. The MAEL revealed better antioxidant activity through various in vitro antioxidant assays.

Impact of Race on Transplantation in Autosomal Dominant Polycystic Kidney Disease.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic cause of end-stage kidney disease (ESKD) and occurs without racial predilection. In general, non-White ESKD patients have less access to transplantation, especially living donor transplantation. We examined long-term outcomes of ADPKD-ESKD patients by self-reported race, with attention to the trajectory of Estimated Post-Transplant Survival (EPTS) scores over time.

The prevalence of postpartum depression among women with physical disabilities: a systematic review and meta-analysis.

Purpose: Pregnant and postpartum mothers with physical disabilities face discrimination in healthcare settings and high rates of maternal and obstetric complications, as well as having higher rates of lifetime depression prior to pregnancy, potentially increasing their likelihood of experiencing postpartum depression (PPD). Some studies have found higher rates of PPD in mothers with physical disabilities than in mothers without physical disabilities, with more disabling symptoms associated with worse PPD systems; however, the literature is sparse and heterogenous. This systematic review and meta-analysis advanced this area of study by evaluating the strength of the association between PPD and physical disability.

Skin cancer knowledge, attitudes, beliefs, and prevention practices among beachgoers: a narrative review.

People who spend time at the beach at increased risk for ultraviolet light (UV) exposure. This review assessed skin cancer-related knowledge, attitudes, beliefs, and prevention practices among beachgoers and sunbathers at the beach. Relevant articles were search in the following electronic databases: PubMed (Medline), Cumulative Index to Nursing and Allied Health (CINAHL), ERIC, and PsycINFO.

Progesterone induces meiosis through two obligate co-receptors with PLA2 activity.

The steroid hormone progesterone (P4) regulates multiple aspects of reproductive and metabolic physiology. Classical P4 signaling operates through nuclear receptors that regulate transcription. In addition, P4 signals through membrane P4 receptors (mPRs) in a rapid nongenomic modality.

Use of AI in Cardiac CT and MRI: A Scientific Statement from the ESCR, EuSoMII, NASCI, SCCT, SCMR, SIIM, and RSNA.

Artificial intelligence (AI) offers promising solutions for many steps of the cardiac imaging workflow, from patient and test selection through image acquisition, reconstruction, and interpretation, extending to prognostication and reporting. Despite the development of many cardiac imaging AI algorithms, AI tools are at various stages of development and face challenges for clinical implementation. This scientific statement, endorsed by several societies in the field, provides an overview of the current landscape and challenges of AI applications in cardiac CT and MRI.

A 26-Year-Old Woman with Postpartum Abdominal Pain.

AbstractMorning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 26-year-old woman who developed acute hepatocellular liver injury following a cesarean delivery for fetal distress.

Policy Recommendations to Support Equitable Access to Long-Acting Injectables for Human Immunodeficiency Virus Prevention and Treatment: A Policy Paper of the Infectious Diseases Society of America and the HIV Medicine Association.

Long-acting injectables (LAIs) for HIV prevention and treatment could dramatically improve health outcomes and health equity for people with HIV and those who could benefit from pre-exposure prophylaxis. Despite widespread acceptability and demand by providers and potential users of LAIs, implementation has been extremely limited since the introduction of cabotegravir/rilpivirine, the first LAI for HIV treatment, in January 2021, and long-acting cabotegravir, the first LAI for HIV prevention, in December 2021. We report results of a provider survey, conducted by the HIV Medicine Association, which identified LAI implementation barriers related to health insurance processes, staffing and administrative support, drug costs and acquisition, and access for individuals who are uninsured.

The effect of caregiver opinion leaders to increase demand for evidence-based practices for youth anxiety: A cluster randomized controlled trial.

Background: Dissemination initiatives have the potential to increase consumer knowledge of and engagement with evidence-based treatments (e.g., cognitive behavioral therapy [CBT]).

Minimally invasive pancreaticoduodenectomy: A bibliometric method applied to the top one hundred cited articles.

Background: Minimally invasive pancreaticoduodenectomy (MIPD) is considered one of the most complex procedures in general surgery. The number of articles on MIPD has been increasing annually. However, published reports often have complex research directions, and the focal points frequently change.