Changing trends in ethnicity and academic performance: observational cohort data from a UK medical school.

OBJECTIVE: Quantify differential attainment by ethnicity in undergraduate medical assessments and evaluate whether institutional efforts to reduce the attainment gap have had impact. DESIGN: Observational cohort study. SETTING: A single UK MBBS medical programme. PARTICIPANTS: Pseudonymised data of adults aged ≥18 years enrolled in one of the UK MBBS medical programmes between 2012 and 2018. Ethnicity was self-declared during enrolment as White, Asian, Black, mixed and other. MAIN OUTCOME MEASURE: Module mark (distinction, merit, pass, fail) graded according to a variety of assessments, including single best answer examinations, objective structured clinical examinations and coursework submissions. All modular assessments are graded as a percentage. Logistic regression models were used to calculate relative risk ratio to study the association between ethnicity and attainment gap over a calendar and scholastic year. Models were adjusted for age, gender, social deprivation and scholastic year of study. RESULTS: 3714 student records were included. In the sample, 2134 students (57%) were non-white. The proportion of non-white students increased from 2007 (49%) to 2018 (70%). Mean age was 18 (IQR 18-21) and 56.6% were females. Higher proportion of non-white students 218 (24.8%) were from more deprived backgrounds versus white 76 (14.8%). Compared with non-white, there were no significant differences in the proportion of students failing assessments. However, white students were more likely to achieve merit (relative risk ratio 1.29 (95% CI 1.08 to 1.45)) or distinction (1.69 (95% CI 1.37 to 2.08)). Differences in attainment gap have remained unchanged over time, and for black students, attainment gap grew between their first and final year of study. CONCLUSION: A similar proportion (97%) of non-white and white students had a passing score, but attainment gap for higher grades persists over years despite widespread efforts in medical schools to diminish the attainment gap linked to ethnicity. Our findings are from a single institution, thus affecting generalisability.

Impact of Overlying Personal Items on CT Dose with Use of Automated Tube Current Modulation-Pilot Investigation.

PURPOSE: To determine the incidence and impact of overlying radiopaque personal items (e.g., cellular phones, zippers) on CT dose and image quality with use of automated tube current modulation. METHODS: Topogram images from 100 consecutive adult outpatient CT abdomen pelvis studies were retrospectively reviewed, and the number and type of overlying radiopaque personal items were recorded. Additionally, an anthropomorphic phantom was imaged with overlying personal items 1) present in topogram and axial images; 2) present in topogram but removed prior to axial acquisition; and 3) present in topogram positioned outside the field of view of the axial acquisition. dose length product (DLP) and CT dose index volume (CTDIvol) were compared to acquisitions performed without overlying personal items. Image noise was evaluated by assessing the standard deviation of Hounsfield units at the level of the overlying personal item. RESULTS: Overlying personal items were visible in topogram images for 55% of CT exams and included underwires (38% of exams), zippers (7%), and cellular phones (1%). DLP increased when a cellular phone was present in the topogram whether or not it was removed before axial image acquisition (3.7% p = 0.002, combined AutomA and SmartmA), and image noise increased (144%, p = 0.002; AutomA). No increase in dose or image noise was observed with overlying zippers or underwires or when any object was visible in the topogram outside the field of view of the axial images. CONCLUSIONS: Overlying personal items were observed in the majority of abdominopelvic CT scans. Large overlying radiopaque personal items resulted in increased dose and increased image noise. Removal of all overlying personal items will result in optimized dose and image quality.

Gender Reporting in Radiology Human Subjects Research.

PURPOSE: The aim of this report was to study the presence and extent of gender bias and reporting in radiology human subjects research. METHODS: For this bibliometric analysis, the authors reviewed all articles published between January 1, 2016, and June 30, 2016, in seven of the most cited general radiology journals. From each original research article studying human subjects, the number and gender of participants and whether gender-based results were reported were manually extracted. Articles evaluating gender-specific body parts were excluded. Article-level subject gender matching percentages were calculated and descriptive statistics reported. RESULTS: Of all 1,065 target journal articles during the study window, 522 met the human subjects research inclusion criteria. Of these, 48 (9.2%) made no mention at all of research subjects' gender. Of the 473 articles mentioning gender, 147 (31.1%) had more female and 308 (65.1%) more male subjects. But in aggregate, 105,763 of 254,102 (41.6%) of all subjects were male and 142,069 (55.9%) were female. By quartile distribution, subject gender matching was very variable (12.9% of articles with <25% match, 23.7% with 25%-50%, 29.4% with 50%-75%, and 34.0% with ≥75%). Of articles including subjects of both genders, however, only 27.5% (126 of 458) reported any gender-based results. CONCLUSIONS: In human subjects research published in the most cited general radiology journals, the gender of human subjects is a poorly controlled, and frequently neglected, variable. In an emerging era of personalized medicine, initiatives to ensure transparent reporting of gender-specific results may help catalyze otherwise overlooked discoveries to advance the health of all.

Human biting of children and oral manifestations of abuse: a case report and literature review.

A ten-month-old female was taken to the Children's Hospital of New York for evaluation of suspected child abuse. The child presented with a severe oral herpetic infection, tongue laceration, and multiple bite marks. Social services confirmed that a parent bit the child's tongue.