Examining the Role of Gender and Ethnic Concordance in Medical Student Specialty Selection.

Introduction: Representation of female and minority physicians varies across specialties and may influence career selection by medical students. To investigate the effect of demographic concordance between medical students and clinical role models on specialty selection, we conducted a survey of graduating medical students to assess the perceived importance and influence of third-year clerkship experiences with demographically concordant preceptors on their choice of specialty for post-graduate training. Methods: An 11-question survey was shared nationally through AAMC Organizational Student Representatives to medical students in the Class of 2023. Information gathered included demographics; specialty of choice; extent of exposure to preceptors of the same gender, race, or ethnicity during clinical clerkships; and perceived importance and influence of those interactions (Likert 1-5, Low-High) on specialty selection. Results: A total of 84 students responded. Female students ascribed more importance to gender concordance with preceptors on the third-year clerkship most associated with their specialty of choice than males [3.4 (SD 1.2) vs. 1.3 (SD 0.8) respectively, p < 0.0001] and greater influence to gender concordance on final specialty selection [2.37 (SD 1.1) vs. 1.31 (SD 0.8) respectively, p < 0.0001]. Non-Caucasians ascribed more importance to race/ethnicity concordance than Caucasians [2.8 (SD 1.4) vs. 1.2 (SD 0.5) respectively, p < 0.0001] and greater influence to race/ethnicity concordance on final specialty selection [2.0 (SD 1.3) vs. 1.1 (SD 0.4) respectively, p < 0.0001]. Caucasian females ascribed the greatest importance to gender concordance (p < 0.001), non-Caucasian females ascribed the greatest influence of gender concordance (p < 0.001), and non-Caucasian females ascribed both the greatest importance (p < 0.001) and influence (p < 0.001) to race/ethnicity concordance. Conclusions: We found that gender and race/ethnicity concordance between students and clinical preceptors during third year clerkships is perceived as especially important and influential in specialty selection by minority and female medical students. These findings highlight the importance of diversity in gender and race/ethnicity representation by preceptors on clinical clerkships. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-024-02044-6.

Molecular Detection of Salmonella typhi Isolated from Patients Undergoing Gallbladder Cholecystectomy in Baghdad.

BACKGROUND: Salmonella typhi is a specific strain of the Salmonella bacterium, responsible for triggering typhoid fever; a significant public health concern in developing nations. OBJECTIVE: The current study aimed to identify the bacteria from the gallbladder, taken during cholecystectomies of patients, by isolating Salmonella typhi and by using microscopic characteristics, biochemical and polymerase chain reaction (PCR) tests. METHODS: A total of 120 specimens were collected from the Baghdad Teaching Hospital, Iraq. A cross-sectional descriptive study was carried out from October, 2021, to July, 2022. During that study, 26 (54.2%) male patient tested positive for Salmonella typhias well as 22 (45.8%) female patients. The age of the patients varied from < 30 to > 60 years. p-value > 0.05 was considered significant to confirm a relationship between age and Salmonella typhi effect for patients. RESULTS: Out of the 120 blood samples taken for this study, 48 (40%) tested positive by use of PCR test, 40 (33.3%) tested positive by use of the Widal test, 35 (29.1%) were positive for biopsy culture, and 35 (29.1%) were positive for blood culture. All Salmonella typhi isolates were found to be sensitive to the imipenem, cefepime, and ceftriaxone, but were resistant to gentamycin, ciprofloxacin, amikacin, erythromycin, and tetracycline (72%, 29%, 43%, 100%, 100%, respectively). CONCLUSIONS: The real time polymerase chain reaction (RT-PCR) tests and the Vitek 2 compact system showed a high level of accuracy in the detection of Salmonella typhi. Multidrug resistance was observed, which should be a signal to reduce antibiotic consumption.

Anethole alleviates Doxorubicin-induced cardiac and renal toxicities: Insights from network pharmacology and animal studies.

Doxorubicin (Dox) is widely used as a chemotherapy drug, while anethole (AN) is primarily known as the main aromatic component in various plant species. This research focused on the impact of AN on the cardiac and renal toxicity induced by Dox and to understand the underlying mechanisms. For cardiac toxicity, Wistar rats were categorized into four groups: a Control group; a Dox group, where rats received 2.5 mg/kg of Dox intraperitoneally every other day; and two Dox + AN groups, where animals were administered Dox (2.5 mg/kg/every other day, IP) along with 125 mg/kg or 250 mg/kg of AN, respectively. The renal toxicity study included similar groups, with the Dox group receiving a single dose of 20 mg/kg of Dox intraperitoneally on the tenth day, and the Dox + AN groups receiving 125 mg/kg and 250 mg/kg of AN for two weeks, alongside the same dose of Dox (20 mg/kg, IP, once on the 10th day). Parameters assessed included ECG, cardiac injury markers (CK, CK-MB, and LDH), and kidney function tests (Cr, BUN, uric acid, LDL, Kim-1, NGAL, and CysC). Antioxidant activity, lipid peroxidation, inflammation, and apoptotic markers were also monitored in heart and renal tissues. Gene expression levels of the TLR4/MyD88/NFκB pathway, along with Bax and Bcl-2, were evaluated. Dox significantly altered ECG, elevated cardiac injury markers, and renal function markers. It also augmented gene expressions of TLR4/MyD88/NFκB, amplified oxidative stress, inflammatory cytokines and apoptotic markers. Conversely, AN reduced cardiac injury markers and kidney function tests, improved ECG, diminished TLR4/MyD88/NFκB gene expression, and alleviated oxidative stress by increasing antioxidant enzyme activities and reducing inflammatory cytokines. AN also enhanced Bcl-2 levels and inhibited Bax and the cleavage of caspase-3 and 9. AN countered the lipid peroxidation, oxidative stress, inflammation, and apoptosis induced by Dox, marking it as a potential preventive strategy against Dox-induced nephrotoxic and cardiotoxic injuries.

Contamination of trace, non-essential/heavy metals in nutraceuticals/dietary supplements: A chemometric modelling approach and evaluation of human health risk upon dietary exposure.

Across the world, nutraceuticals/dietary supplements are commonly consumed without medical supervision, and believing these products are harmless to health. However, these products may contain trace (TMs) and non-essential/heavy metals (nHMs) as contaminants at levels higher than the recommended daily allowance (RDA), which can be hazardous to human health. Consequently, it is crucial to assess the levels of these metals to ensure the safety of these products. This study aimed to analyze the concentration of TMs (Mn, Cu and Zn) and nHMs (Al, Cr, Ni, Cd and Pb) in nutraceuticals/dietary supplements. Metal analysis was conducted using inductively coupled plasma-optical emission spectrometry (ICP-OES). Multivariate and bivariate analysis including principle component analysis (PCA), hierarchical cluster analysis (HCA) and Pearson correlation coefficient (PCC) were applied to understand inter-metal association and sources of these metals. Concentration ranges for TMs were found as, Mn (0.2-4.3 mg/kg), Cu (0.11-2.54 mg/kg), and Zn (0.1-22.66 mg/kg) while the nHMs concentration ranges were: Al (0.046-3.336 mg/kg), Cr (0.11-1.63 mg/kg), Ni (0.18-0.72 mg/kg), Cd (0.04-0.92 mg/kg), and Pb (0.18-1.08 mg/kg). The levels of tolerable dietary intake (TDI) for Cr and Ni, and the provisional tolerable monthly intake (PTMI) limit for Cd, exceeded the values set by the World Health Organization (WHO) and the European Food Safety Authority (EFSA). The estimation of the target hazard quotient (THQ <1), hazard index (HI < 1) and cumulative cancer risk (CCR <1 ✕ 10-3) indicated no significant non-carcinogenic and carcinogenic health risks associated with consuming these products. Therefore, the primary recommendation from this study is to use the nutraceuticals/dietary supplements should be under the supervision of dietitian.

Combining a Base Deaminase Mutator with Phage-Assisted Evolution.

Phage-assisted evolution has emerged as a powerful technique for improving a protein's function by using mutagenesis and selective pressure. However, mutations typically occur throughout the host's genome and are not limited to the gene-of-interest (GOI): these undesirable genomic mutations can yield host cells that circumvent the system's selective pressure. Our system targets mutations specifically toward the GOI by combining T7 targeted mutagenesis and phage-assisted evolution. This system improves the structure and function of proteins by accumulating favorable mutations that can change its binding affinity, specificity, and activity.

A review of racial disparities in ovarian cancer and clinical trials.

PURPOSE OF REVIEW: Ovarian cancer ranks fifth in mortality among women with cancer and accounts for more death compared to any other gynecological cancers. This review summarizes the most recent literature on disparities in ovarian cancer as well as within recent clinical trials. RECENT FINDINGS: Recent studies have identified a notable disparity in genetic testing utilization, disease stage at the time of diagnosis, and adherence to treatment guidelines between Black women and their White counterparts, ultimately leading to increased mortality rates among Black women from ovarian cancer. Additionally, there is an underreporting of race in clinical trials and those that do report race demonstrate significant racial disparities within trial participants with the majority of participants being White. SUMMARY: It is imperative that we address the significant racial disparities within ovarian cancer and clinical trials to establish a framework of equitable healthcare provision. Multiple determinants, such as implicit bias, provider mistrust, accessibility hurdles, and socioeconomic influences, appear to contribute to the current disparities faced by women of color. Further investigation is warranted, encompassing a deeper understanding of diverse patient perspectives and identifying barriers to receiving optimal care and participating in clinical trials.

The Impact of the COVID-19 Pandemic on Educational and Academic Activities of Healthcare Professionals in Bahrain.

INTRODUCTION: Since its emergence, the COVID-19 pandemic has had a radical effect on different aspects of health worldwide. The burden created by the COVID-19 pandemic on healthcare systems has also involved educational and academic activities among healthcare professionals. OBJECTIVES: This study aimed to explore the effect of the COVID-19 pandemic on the participation of doctors and nurses in educational and academic activities in Bahrain. METHODS: A cross-sectional survey was conducted through an online questionnaire that was distributed among 204 healthcare providers (HCPs) in the Kingdom of Bahrain. RESULTS: Out of 204 HCPs, 110 (53.9%) were doctors and 94 (46.1%) were nurses. A total of 154 responses were received (100 (64%) doctors and 54 (35.1%) nurses) with an overall response rate of 75.5%. Seventy-four (74%) doctors and 32 (59.2%) nurses stated that their overall academic activities had decreased since the start of the pandemic, yet this was not statistically significant (P=0.059). Unlike nurses, doctors attended more webinars 54 (54%) and online courses 47 (47%), compared to the time before the pandemic (P=0.022, P=0.014, respectively). CONCLUSION: The COVID-19 pandemic had a negative impact on educational and academic activities among healthcare workers. However, it created an opportunity to expand the use of electronic and online methods in those activities.

Mortality Due to Complications Associated With Acute Ogilvie's Syndrome in an Older Adult Treated for Psychosis: A Case Report.

Acute colonic pseudo-obstruction or Ogilvie's syndrome is a disorder causing massive colonic dilation with no evidence of mechanical obstruction. The actual incidence of acute colonic pseudo-obstruction is unclear; However, electrolyte imbalance, psychiatric disorders, the use of medications such as anticholinergics or antipsychotics, and recent abdominal surgery are the most common predisposing factors associated with this syndrome. Ogilvie's syndrome is most likely caused due to impairment of the gut's motor system and an imbalance of the autonomic nervous system including a reduction in the activity of stimulatory neurotransmitters. The predisposition to psychotic disorders could be, in some instances, due to neurodevelopmental abnormalities of the brain and the gut's autonomic nervous system. The symptoms of Ogilvie's syndrome are similar to mechanical obstruction of the colon but no physical cause of obstruction is usually present. Ogilvie's syndrome can be managed conservatively; however, if left untreated, Ogilvie's syndrome can lead to bowel perforation, which is associated with a high mortality risk. Antipsychotics have been considered the cornerstone treatment for psychiatric disorders including schizophrenia. Even though they are highly effective in treating psychiatric illnesses, their usage carries multiple risks. Overall, constipation is a common side effect of antipsychotic medications with some classes posing more risk than others. Constipation can be severe and may lead to serious complications such as paralytic ileus, bowel ischemia, and death. We present here a case of delusional disorder managed with risperidone and complicated by intestinal pseudo-obstruction. This case reiterates the need to consider all complications of antipsychotic medications, even rare ones, and include them in the discussion with patients and their caregivers before commencement.