Evaluating the Evidence: Scientometric Analysis of Highly Cited Neurofibromatosis 1 Publications.

The study of Neurofibromatosis 1 (NF1) is progressing rapidly. This study aimed to identify historical trends in publications focusing on NF1, to find the top 100 most cited publications on this topic, and to evaluate their level of evidence. This study identifies historical trends in publication regarding NF1 with the aim of providing readers useful information about the areas of research being performed, an educational guide to facilitate novice researchers in conducting effective evidence-based medical research, and unique insight into developments and trends of NF 1 research. This study also evaluates the evidence of highly cited papers on NF1. A search of all databases and journals accessible within Elsevier's Scopus was performed on June 27th, 2020, using combinations of the Boolean queries "Neurofibromatosis 1," "Von Recklinghausen," and "NF1," which yielded 13,599 documents. The top 100 most-cited papers were identified, analyzed, and evaluated for level of evidence. Evidence was assessed using the GRADE guidelines. The top 100 most-cited articles span years 1963-2010 and are published in 50 different journals. The average number of citations per publication was 366.5 (range 189-1527). The most cited article is "Neurofibromatosis: Conference Statement" (Stumpf et al., 1988). In this study, the top 100 most-cited works in NF1 are identified, characterized, and analyzed. This study will serve as a historical point of reference for future research, a jumping point for those unfamiliar with the topic, and an educational foundation for future NF1 specialists and researchers.

Outcomes of pregnancy and childbirth in women with hidradenitis suppurativa.

BACKGROUND: Many women affected by hidradenitis suppurativa (HS) are of childbearing age. To date, the literature is limited on pregnancy-related outcomes for women with HS. OBJECTIVE: To investigate maternal and obstetric outcomes and treatment utilization among women with HS. METHODS: This retrospective analysis used the IBM MarketScan Commercial Claims Database. Pregnant women with HS (n = 998) and 5:1 age-matched pregnant women without HS (n = 5065) were identified and information on claims related to diagnoses, procedures, and medications were analyzed. RESULTS: Compared to women without HS, pregnant women with HS had significantly lower odds of having a live birth (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.39-0.51) and significantly higher odds of having elective terminations (OR, 2.51; 95% CI, 2.13-2.96), gestational hypertension (OR, 1.44; 95% CI, 1.12-1.84), and cesarean deliveries (OR, 1.28; 95% CI, 1.06-1.55), and of receiving HS designated treatment during pregnancy (OR, 4.41; 95% CI, 3.56-5.46). LIMITATIONS: Retrospective and convenience sampling and absence of clinical information to correlate HS severity and outcomes. CONCLUSION: Pregnant women with HS have an increased probability of select complicated maternal and obstetric outcomes. Women planning for pregnancy or who are currently pregnant may benefit from coordinated care by dermatologists and obstetric providers.

Proceedings Report of the Fifth Symposium on Hidradenitis Suppurativa Advances (SHSA) 2020.

The Symposium on Hidradenitis Suppurativa Advances (SHSA) is a joint meeting of the United States Hidradenitis Suppurativa Foundation (HSF) and the Canadian Hidradenitis Suppurativa Foundation (CHSF). This annual cross-disciplinary meeting brings together experts from around the world in an opportunity to discuss the most recent advances in the study of hidradenitis suppurativa (HS). The fifth annual meeting was held virtually on 9-11 October 2020. A record 347 attendees, including 79 people with HS, from 20 different countries attended. Key take-home points included: Clinicians can optimize each visit by listening, provide education, and discuss treatments; a patient decision aid for HS (HS-PDA) is a freely available tool (www.informed-decisions.org); COVID-19 severity in HS patients was not different for patients treated with/without a biologic; comorbidity screening recommendations will be published soon; neutrophil extracellular traps (NETs) may play a role in HS; memory B cells, T helper 1 cytokines, and interleukin 1 signaling contributes to HS pathogenesis and are targets for new therapies; novel therapies are showing promise including a new JAK1 inhibitor (INCB054707) and brodalumab; and HS-specific outcome measures have emerged to better monitor disease severity, flare, and progression including a patient reported measure (HiSQOL) and an HS-specific investigator global assessment. J Drugs Dermatol. 2021;20(8):868-873. doi:10.36849/JDD.5836.

The impact of COVID-19-related changes in media consumption on public knowledge: results of a cross-sectional survey of Pennsylvania adults.

OBJECTIVE: During the COVID-19 pandemic, Americans have increasingly relied on internet versus television news. The extent to which this change in health news consumption practice impacts health knowledge is not known. This study investigates the relationship between most trusted information source and COVID-19 knowledge. METHODS: A cross-sectional online survey was sent to a convenience sample from a list of adults on a central Pennsylvania health system's marketing database 25-31 March 2020. Respondents were grouped by their trusted news sources and comparison of respondent COVID-19 knowledge was made between these groups for 5948 respondents. RESULTS: Those who selected government health websites as their most trusted source were more likely to answer COVID-19 questions correctly than those who selected other internet news sources or television news (OR 1.21, p < .05; 1.08, p > .05; and 0.87, p < .05, respectively). Those who used Facebook as an additional source of news in any way were less likely to answer COVID-19 questions correctly than those who did not (OR 0.93, p < .05). CONCLUSIONS: COVID-19 knowledge correlates with trusted news source. To increase public knowledge of COVID-19 in order to maximize information dissemination and compliance with COVID-19-related public health recommendations, those who provide health information should consider use of the public's most trusted sources of information, as well as monitoring and correcting misinformation presented by other sources. Independent content review for accuracy in media may be warranted in public health emergencies to improve knowledge.

Relative United States Medical Licensing Examination (USMLE) Performance by Specialty Is Not a Predictor of Board Exam Pass Rate: The Case of Diagnostic Radiology.

Introduction In 2010 diagnostic radiology (DR) changed the board certification process for residents using the new Core exam. However, there is not a standardized way to evaluate DR residency graduates. With no specific target pass rate for the exam, the "appropriate" pass rate has remained a debated topic among the field. In this paper, the board certification exam passage rates of DR are compared to other medical specialties to assess the standardization method of the American Board of Radiology (ABR) and serve as basis for additional specialties considering changes to their board exam structure. Methods Performance on the United States Medical Licensing Examination (USMLE) was obtained from the National Resident Matching Program (NRMP) and San Francisco match. Boards passage rates were analyzed using data from the American Board of Medical Specialties. USMLE and board exam passage rates were averaged and ranked, and statistical analysis was conducted using Stata (College Station, TX). Results DR performance on USMLE Step 1 has increased at the lowest rate (0.563 points/year) since 2005 and anesthesiology performance has increased at the greatest rate (1.313 points/year). Residents matching from US allopathic medical schools during the 2010 and 2012 years had DR oral board exams with USMLE 1 averages of 232 and 235, respectively. First-time pass rate for the first Core exam was 87% and the overall pass rate since the first Core exam has been 88.54%. The Spearman rho coefficient for specialty ranks of board passage rate and USMLE 1 was 0.0679 (p = 0.8101). The Spearman rho coefficient for board passage rate and USMLE 2 CK was 0.1430 (p = 0.6257). The Spearman rho coefficient for USMLE 1 and USMLE 2 CK was 0.8317 (p = 0.0002). Conclusions Specialty board pass rates have not increased in concert with improved trainee performance on the USMLE. USMLE performance among those matching in diagnostic radiology has increased, ABR board exam passage rate has decreased. ABR determines passing thresholds to the relative performance of examinees rather than using a criterion referenced Angoff standard.

Knowledge, Perceptions, and Preferred Information Sources Related to COVID-19 Among Healthcare Workers: Results of a Cross Sectional Survey.

PURPOSE: To compare COVID-19 related knowledge, perceptions, and preferred information sources between healthcare workers and non-healthcare workers. DESIGN: Cross-sectional survey. SETTING: Web-based. SUBJECTS: Convenience sample of Pennsylvanian adults. MEASURES: Primary outcomes were binary responses to 15 COVID-19 knowledge questions weighted by a Likert scale assessing response confidence. ANALYSIS: Generalized linear mixed-effects models to assess comparisons between clinical decision makers (CDM), non-clinical decision makers working in healthcare (non-CDM) and non-healthcare workers (non-HCW). RESULTS: CDMs (n = 91) had higher overall knowledge than non-CDMs (n = 854; OR 1.81 [1.51, 2.17], p < .05). Overall knowledge scores were not significantly different between non-CDMs (n = 854) and non-HCW (n = 4,966; OR 1.03 [0.97, 1.09], p > .05). CONCLUSION: The findings suggest a need for improved education about COVID-19 for healthcare workers who are not clinical decision makers, as they play key roles in patient perceptions and compliance with preventive medicine during primary care visits.

A Case of Lichen Planus Masquerading as Guttate Psoriasis.

Lichen planus (LP) is a chronic inflammatory disease that affects the skin, hair, nails, and mucous membranes, with variants such as drug-induced lichen planus, which is triggered by medications such as angiotensin-converting enzyme (ACE) inhibitors and antimalarials. Guttate psoriasis (GP), a clinical variant of psoriasis, is associated with streptococcal infections and presents with drop-like papules on the trunk and proximal extremities. In this report, we present a case of LP in an atypical location masquerading as GP and the importance of prompt dermatological referral to improve the patient's quality of life. Coexistence and similarities between several variants of LP and plaque psoriasis have been seen in the literature. However, to our knowledge, our report is the first to show LP specifically mimicking GP.

Factors Influencing In-State Retention Rates of Graduating Residents From Penn State College of Medicine Compared to National Average Retention Rates.

This study analyzes in-state retention rates at Penn State University (PSU) and nationally. Data were taken from the PSU handbook with location information of graduated residents and compared to data from the Association of American Medical Colleges (AAMC). The retention rate at PSU was lower than that nationally in all but three specialties. PSU retention rate was lower than that of Pennsylvania. Pennsylvania's retention rate was lower than the national average. Community size and physician per capita may play a role in graduating resident retention rate.

Public Intent to Comply with COVID-19 Public Health Recommendations.

Stay-at-home orders have been an essential component of coronavirus 2019 (COVID-19) management in the United States. As states start lifting these mandates to reopen the economy, voluntary public compliance with public health recommendations may significantly influence the extent of resurgence in COVID-19 infection rates. Population-level risk from reopening may therefore be predicted from public intent to comply with public health recommendations. We are conducting a global, convergent design mixed-methods survey on public knowledge, perceptions, preferred health information sources, and understanding of and intent to comply with public health recommendations. With over 9,000 completed surveys from every US state and over 70 countries worldwide, to our knowledge this is the largest pandemic messaging study to date. Although the study is still ongoing, we have conducted an analysis of 5,005 US surveys completed from April 9-15, 2020 on public intent to comply with public health recommendations and offer insights on the COVID-19 pandemic-related risk of reopening. We found marked regional differences in intent to follow key public health recommendations. Regional efforts are urgently needed to influence public behavior changes to decrease the risk of reopening, particularly in higher-risk areas with low public intent to comply with preventive health recommendations. [HLRP: Health Literacy Research and Practice. 2020;4(3):e160-e165.].

Residency Specialty and National Resident Matching Program Outcomes as Predictors of Academic vs Non-Academic Position as an Attending Physician.

PURPOSE: Previous studies have shown that research can be used as a predictive factor for an academic career for physicians in the fields of radiation oncology, orthopedic surgery, and diagnostic radiology. We seek to determine if this factor is predictive for all medical specialties based on an analysis of public data on physicians who have trained at Hershey Medical Center (HMC) and public National Resident Matching Program (NRMP) charting outcomes. METHODS: We determined the location and job title of all graduates of HMC residency training programs through a combination of publicly available information on HMC's website and other institutions' websites. We separated these into academic and non-academic positions and performed Chi-square analysis to determine if the number of research experiences was predictive of an academic career. RESULTS: Participating in the residency specialties of general surgery, pathology, internal medicine, and neurological surgery are statistically significant predictors of an academic career upon graduation. The average number of research experiences obtained by matched U.S. medical students is not a statistically significant predictor of an academic career upon graduation. CONCLUSION: In contrast to previously published studies, a higher number of research experiences in medical school is not a significant predictor of an academic career for attending physicians who graduated residency at HMC.

Synergistic Growth in Number of Diagnostic and Interventional Radiology Matches at Pennsylvania State College of Medicine After 2016.

In 2016, when interventional radiology (IR) separated from diagnostic radiology (DR), the future implications were unknown. The goal of this study is to investigate trends in DR and IR matches at Penn State College of Medicine (PSCOM) from 2011-2020, particularly before and after 2016. This retrospective study generated descriptive statistics and paired t-tests, finding a statistically significant difference in mean number of DR and IR matches before and after 2016. More specifically, the number of DR matches increased from 3.8 to 6.4 (p = 0.0004) and IR matches increased from 0 to 2 (p = 0.03). These trends suggest a synergistic growth in both specialties.

Spinal Coccidioidomycosis: A Complication From Medication Noncompliance.

Spinal coccidioidomycosis is a rare disseminated form of coccidioidomycosis infection. According to the literature, majority of patients are African American males. We present a rare case of spinal coccidioidomycosis in a young, Caucasian female with coccidioidomycosis meningitis at age 16 years who presented with bilateral lower extremity weakness after antifungal medication lapse for one year. Imaging revealed cystic arachnoid formations along her thoracic spine. Pathology report confirmed spinal arachnoiditis with coccidioidomycosis. This case report details a rare incidence of spinal coccidioidomycosis and reviews previous literature.

Scientometric Analysis: University Hospital Versus University College of Medicine.

Many medical specialties use scientometrics to assess the impact of publications, journals, and authors. The aim of this study was to analyze and compare trends of publications from a hospital medical center to publications from a college of medicine connected to that hospital and compare collaboration rates between them to other domestic and international institutions. We used Elsevier's SCOPUS database to compare Penn State College of Medicine (PSCOM) publications to Hershey Medical Center (HMC) publications, analyzing 31,856 total publications. We hypothesized that HMC and PSCOM have room to improve on both internal and international collaborations. Our results show that despite PSCOM's international collaboration being nearly three times higher than HMC, overall international collaboration is less than 2%, far below the US national average.

Trends in Gender Representation and Post-residency In-State Retention at Both an Academic Medical Center and in the United States.

This study examines gender representation and in-state retention rates of practicing residency graduates from Pennsylvania State University (PSU), as well as at the national level. PSU and national data were collected from a PSU handbook and the Association of American Medical Colleges (AAMC), respectively. There were significant differences between male and female representation both at PSU and at the national level. Furthermore, there was a significant difference between male and female retention rates nationally. This study demonstrates a true gender discrepancy for graduates from PSU and at the national level. Moving forward, investigating potential causes of this discrepancy may help minimize gender differences.