Rates of Internal Hiring of Ophthalmology Faculty from their Institution of Training at Top Academic Medical Centers: A Cross-Sectional Study.

Background Throughout graduate and postgraduate education, trainees need to gauge the impact of training location on future institutions of practice. Objective We assessed rates of internal hiring of ophthalmology faculty at academic institutions from their same institution of training. Methods This was a cross-sectional study. We included 1,246 clinical ophthalmology faculty at the 13 top-ranked institutions listed in the 2021 U.S. News and World Report. Primary, emeritus, adjunct, and affiliate faculty were included. Publicly available information was collected from institutional websites and other online sources. Statistical analyses were conducted using t -tests or Mann-Whitney tests, chi-squared or Fisher's exact tests, and multivariate logistic regression. The main outcome measured was internal hires, defined as faculty who had completed residency and/or fellowship training at their current institution. Results In total, 47.3% of faculty were internal hires who completed residency or fellowship at the same institution. Among externally trained faculty, 27.7% completed residency and 56.0% completed fellowship at another top 13 programs. Internal hires were more frequently fellowship-trained, had a greater number of publications, and practiced in smaller departments ( p < 0.001, p < 0.001, and p = 0.002, respectively). A greater proportion of internal hires held leadership positions ( p = 0.012). Faculty practicing in the Midwest or West and with more years since residency graduation were less likely (odds ratio [OR], 0.29, 95% confidence interval [CI], 0.18-0.48; OR, 0.49, 95% CI, 0.31-0.78; OR, 0.98, 95% CI, 0.97-0.99, respectively) to be internal hires. Faculty with non-R01 National Institutes of Health funding were more likely to be internal hires (OR, 1.82, 95% CI: 1.12-2.96). Conclusions Training institution is key to determining the institution of practice. These results may be beneficial for trainees to consider when selecting a training program.

Traumatic axonopathy in spinal tracts after impact acceleration head injury: Ultrastructural observations and evidence of SARM1-dependent axonal degeneration.

Traumatic axonal injury (TAI) and the associated axonopathy are common consequences of traumatic brain injury (TBI) and contribute to significant neurological morbidity. It has been previously suggested that TAI activates a highly conserved program of axonal self-destruction known as Wallerian degeneration (WD). In the present study, we utilize our well-established impact acceleration model of TBI (IA-TBI) to characterize the pathology of injured myelinated axons in the white matter tracks traversing the ventral, lateral, and dorsal spinal columns in the mouse and assess the effect of Sterile Alpha and TIR Motif Containing 1 (Sarm1) gene knockout on acute and subacute axonal degeneration and myelin pathology. In silver-stained preparations, we found that IA-TBI results in white matter pathology as well as terminal field degeneration across the rostrocaudal axis of the spinal cord. At the ultrastructural level, we found that traumatic axonopathy is associated with diverse types of axonal and myelin pathology, ranging from focal axoskeletal perturbations and focal disruption of the myelin sheath to axonal fragmentation. Several morphological features such as neurofilament compaction, accumulation of organelles and inclusions, axoskeletal flocculation, myelin degeneration and formation of ovoids are similar to profiles encountered in classical examples of WD. Other profiles such as excess myelin figures and inner tongue evaginations are more typical of chronic neuropathies. Stereological analysis of pathological axonal and myelin profiles in the ventral, lateral, and dorsal columns of the lower cervical cord (C6) segments from wild type and Sarm1 KO mice at 3 and 7 days post IA-TBI (n = 32) revealed an up to 90% reduction in the density of pathological profiles in Sarm1 KO mice after IA-TBI. Protection was evident across all white matter tracts assessed, but showed some variability. Finally, Sarm1 deletion ameliorated the activation of microglia associated with TAI. Our findings demonstrate the presence of severe traumatic axonopathy in multiple ascending and descending long tracts after IA-TBI with features consistent with some chronic axonopathies and models of WD and the across-tract protective effect of Sarm1 deletion.

Socioeconomic Factors Influence Health Information Seeking and Trust Over Time: Evidence From a Cross-Sectional, Pooled Analyses of HINTS Data.

PURPOSE: Assessed socioeconomic factors in health information seeking behavior and trust of information sources from 2007 to 2017. DESIGN: Pooled cross-sectional survey data. SETTING: Health Information National Trends Survey. PARTICIPATION: Data included 6 iterations of U.S. adults (Pooled: N = 19,496; 2007: N = 3,593; 2011: N = 3,959; 2013: N = 3,185; FDA 2015: N = 3,738; 2017: N = 3,285; and FDA 2017: N = 1,736). MEASURES: Outcome variables were health information seeking, high confidence, and high trust of health information from several sources. Independent variables were education and income group, controlling for other sociodemographic variables. ANALYSIS: Weighted descriptive and multivariate logistic regression for the pooled sample assessed associations by education and income. Fully interacted models with education/income-survey year interactions compared differences in outcomes between years. RESULTS: We found information seeking, confidence, and trust were associated with income and education, which supported previously reported findings. Additionally, our findings indicated low-and medium-income groups had significantly lower odds of seeking health information compared to those in a high-income group. Regarding trust of information, a high school education was associated with higher odds of trust in family and friends. We also found that, over time, information seeking, confidence, and trust behavior differed by income and education, with some differences persisting. CONCLUSION: Disparities by income and education in trust of information sources remained across time. Understanding optimal information sources, their reach, and their credibility among groups could enable more targeted interventions and health messaging. We also describe the implications for our findings in the context of COVID-19.