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Efficacy of First Aid Training in the Curriculum of First Year Medical Students
Get PDFBackground
First Aid First (FAF) provides free and accessible first aid training to members of the Detroit community, including first-year medical students, to empower individuals to respond quickly properly, and confidently during real life emergencies.
Methods
First aid training sessions last 1.5 hours, and are taught by Wayne State University School of Medicine (WSUSOM) medical students and physicians. FAF trains incoming WSUSOM medical students on CPR, Stop the Bleed, and many more skills. Didactic instruction and hands-on demonstration allows participants to practice skills under the guidance of trained instructors. A pre-/post 20-question quiz on emergency responses and any prior first aid training and certification were recorded. 321 pre-test responses and 310 post-test responses were collected.
Results
Of the participants, 181 had no prior emergency response certification, 126 held a CPR certification, 91 had received training in Basic Life Support (BLS), and 39 had completed EMT training. We conducted a two-tailed, independent T-test to determine whether there was a significant difference between the pre-test and post-test scores. The resulting p-value of
Conclusion
The FAF training program improves the knowledge of incoming medical students to respond and act appropriately in emergencies. As physicians in training, medical students should be prepared to respond to out-of-hospital health emergencies. Thus, the FAF training program should be incorporated into the medical education curriculum
Relationship Between Change in Body Mass Index and Testosterone Levels in Male Patients Using GLP-1 Receptor Agonists for Weight Loss
Get PDFIntroduction: Originally developed for type 2 diabetes management, glucagon-like peptide 1 receptor agonists (GLP-1 RA) have gained popularity for their weight loss effects. Excess fat stores are understood to enhance aromatization in peripheral tissues, converting testosterone to estrogen, and ultimately lowering testosterone levels. This study aimed to identify the relationship between changes in body mass index (BMI) and testosterone levels in male patients using GLP-1 RA\u27s for weight loss.
Methods: A retrospective review of male patients using GLP-1 RA\u27s was carried out from a single multicenter institutional database. Patients were grouped by age, change in BMI, and initial BMI quartiles to assess associations with average change in testosterone levels. Univariable and multivariable analysis was performed.
Results: Among the 18 patients analyzed, 17 received injectable medication and 1 received oral medication. Age, change in BMI, and initial BMI were not significantly associated with changes in testosterone levels. Variability in testosterone changes across patient demographics were noted, however not statistically significant. A 15.8% variance in average change in testosterone levels was noted.
Conclusions: Counter-intuitively, changes in BMI were not significantly associated with changes in testosterone levels in male patients undergoing weight loss treatment with GLP-1 RA\u27s. While this study suggests no clear association between BMI reduction and testosterone changes with medication use, the observed variability in testosterone changes across patient demographics warrants further investigation. Additional research with a larger patient cohort and additional variables may be necessary to better elucidate potential associations between changes in BMI and testosterone levels
Tattoos as a risk factor for malignant lymphoma
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Nielsen C, Jerkeman M, Jöud AS. Tattoos as a risk factor for malignant lymphoma: a population-based case-control study. EClinicalMedicine. 2024;72:102649. Published 2024 May 21. https://doi.org/10.1016/j.eclinm.2024.102649
for a teenage patient contemplating getting a tattoo
Clinical decision-making and artificial intelligence: The role of large language models in medicine
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Goh E, Gallo R, Hom J, et al. Large Language Model Influence on Diagnostic Reasoning: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(10):e2440969. https://doi.org/10.1001/jamanetworkopen.2024.40969
to explore the role of artificial intelligence in clinical settings
Ancient mitogenomes reveal population interactions with high maternal genetic diversity in the Central Plains of China during the late Neolithic period
Get PDFThe Central Plains of China is one of the earliest domestication hubs for broomcorn and foxtail millet. This region nurtured rich archaeological cultures and experienced extensive interactions with neighboring populations during the Neolithic period. However, limited genomic research has hindered a clear understanding of the maternal genetic structure and population expansion history in this era. Here, we report 12 complete mitochondrial genomes from individuals of the Yanzhai site population from Henan province of China during the Longshan Culture period, revealing a high level of maternal genetic diversity. The close genetic distance between these individuals and those of ancient populations from the Yellow River Basin highlights the maternal genetic continuity since the late Neolithic period. Furthermore, our research uncovers multiple population expansion events driven by various factors, which may have contributed to the genetic composition of modern East Asian populations. In summary, our study provides a new perspective on the genetic origins and demographic dynamics of the Central Plains region during the late Neolithic period
Paternal Origin of Yi People in Southwestern China: Insights from Phylogeographics of Founder Lineage
Get PDFThe Yi people in southwestern China are renowned for their unique history, social structure, and customs. However, due to extensive genetic admixture during their formative period, the early origin and evolutionary trajectory of the Yi people remain unclear. In this study, we identified four paternal founder lineages of Yi people and generated a highly revised phylogenetic tree for these four lineages with sixty-six sequences. Furthermore, the geographic distribution of four lineages within China was summarized, based on 465 individuals identified among 60,009 Chinese males. The divergence topology indicated that among all Tibeto-Burman-speaking populations, the Naxi, Bai, and Burmese populations exhibit the closest genetic affinity with the Yi people. The distribution of four founder lineages shows similar higher frequency in the Yunnan-Guizhou Plateau, the center of the Yi people’s inhabited area. We conducted an in-depth analysis of the possible origin, migration patterns, and the roles of these four components in the demographic history of Yi people
Machine Learning to Predict the Severity Score of Trauma Pediatric Patients
Get PDFBackground
Many scoring systems currently exist to predict severity and mortality among trauma patients. However, controversy remains over the validity of these scoring systems in pediatrics and their use in guiding treatment. Additionally, many of these tools utilize variables that can only be collected days after admission, prohibiting predictions from being determined in the immediate hours following the trauma. The goal of this study is to develop an appropriate scoring system utilizing variables collected in the pre-hospital setting and on admission of a trauma pediatric patient that could be used to help determine the minimal necessary level of care for survival.
Methods
A retrospective chart review was performed for 1277 pediatric patients presenting to an inner-city Level 1 trauma hospital via emergency medical services (EMS) status post motor vehicle collision. Many variables were collected from the EMS documentation, including the restraints in use, position in vehicle, location of the accident, and pre-hospital Glasgow coma scale (GCS). Additionally, variables were collected from the medical charts including admission vital signs, mechanism and speed of the collision, as well as injuries sustained and procedures performed in the operating room (OR). This data was then provided to the Human-Interactive Robotics (HIRo) Lab at Purdue University to analyze with their machine learning technology.
Results and Conclusion
Data is currently being analyzed by the HIRo machine learning lab at Purdue University. Analysis and conclusions will be completed in time to be presented at the symposium in March
Variation in Treatment Recommendations for Low-Risk Prostate Cancer: A Focus on Active Surveillance Across Physician Specialties
Get PDFProstate cancer (PC) is the second leading cause of cancer-related death in men globally, with 1 in 8 men in the US diagnosed during their lifetime. For Low-Risk Prostate Cancer (LRPC), management options include Watchful Waiting (WW), Active Surveillance (AS), or curative treatments such as prostatectomy or radiation. While curative treatments can have significant long-term side effects like urinary incontinence and sexual dysfunction, AS is less invasive and preferred due to fewer adverse effects. However, variations in physician training may lead to differing recommendations, potentially causing confusion or frustration for patients consulting multiple specialists. This study investigates whether treatment recommendations—AS, WW, or curative treatment—vary by physician specialty.
Using a population-based retrospective design, the study examines 1688 men aged ≤75, diagnosed with LRPC from 2014–2017. Participants self-reported race and completed baseline surveys about treatment options and provider recommendations. Data collection is ongoing, and analysis will focus on differences in treatment recommendation rates by physician specialty.
This research aims to clarify how physician specialty influences treatment recommendations for LRPC. Future studies could explore how physician attitudes toward AS, WW, or curative treatments impact their recommendations and further investigate the interaction between physician recommendations and patient race, as racial disparities have been observed in AS recommendations by urologists
Investigating the Effects of Intranasal Esketamine on Suicidal Ideation in Patients with Treatment-Resistant Depression
Get PDFTreatment-resistant depression (TRD) remains a significant challenge, with many patients failing conventional treatments. While intranasal esketamine has demonstrated efficacy for depression, its specific effects on suicidal ideation (SI)—a critical symptom of depression—are underexplored. Unlike most studies that adhere to the 84mg dosing paradigm administered twice weekly, this study explores the novel use of varying esketamine doses, including 54mg, 84mg, and 112mg. This study aims to evaluate the impact of varying esketamine doses (54mg, 84mg, and 112mg) on SI in a real-world outpatient population (n=24). This study analyzed data from patients in Southwest Michigan with major depressive disorder (MDD) and psychiatric comorbidities who received intranasal esketamine treatments between July 2022 and July 2024. The primary outcome was change in SI, measured by question 9 on the Patient Health Questionnaire-9 (PHQ-9). Preliminary findings suggest that an increase in the esketamine dose to 112mg was associated with lower SI scores, especially when comparing 84mg to 112mg (p=0.025).This indicates that patients may benefit from a higher dose, especially those who have had inadequate responses to the standard 84mg dosing paradigm. Based on these results, a trial of 112mg esketamine could be considered for patients with insufficient improvement on the typical dosing regimen. This study provides initial evidence that intranasal esketamine may reduce SI in TRD patients. Further research is necessary to refine dosing and investigate esketamine’s broader effects on mental health outcomes, especially in high-risk populations
Safety and Efficacy of 112 mg Intranasal Esketamine in Patients with Treatment-Resistant Depression: A Retrospective Observational Study from Outpatient Community Clinics
Get PDFThis retrospective study examined the safety and efficacy of 56, 84, and 112 mg intranasal (IN) esketamine via medical record review of 24 patients with treatment resistant depression (TRD). Doses ranged from 56 mg to 112 mg and were titrated across sessions to maximize individual response while considering tolerability. Treatment response was defined by reduction in average Patient Health Questionnaire-9 (PHQ-9) scores. Tolerability was defined by blood pressures at baseline, 40 minutes after, and 2 hours after drug administration. Patients ranged from 19 to 60 years old (average 38.87), and 15 (62.5%) were female. Patients received an average of 1 treatment at 56 mg, 21.65 treatments at 84 mg, and 21.87 treatments at 112 mg. Average baseline PHQ-9 was 19.38 (SD 4.07). Increasing esketamine doses were associated with a stepwise reduction in PHQ-9 (p=0.064, 0.002, 0.003 for 56mg, 84mg, and 112 mg treatments respectively). 112 mg treatments were associated with a 2.37 day longer interval between treatments compared to 84 mg (p\u3c0.001). Average mean arterial pressures (MAP) before, 40 minutes after, and 2 hours after drug administration were not significantly higher in 84 mg treatments than in 56 mg treatments (p= 0.990, 0.993, 0.959 respectively). However, all three average MAP were significantly higher in 112 mg treatments than in 84 mg treatments (p= 0.034, 0.002, 0.005). No patients required adjunctive medication or dose reduction. Currently, the field is lacking data on the efficacy and tolerability of 112 mg IN esketamine, and this study offers practical clinical guidance for esketamine dosing