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Continuing De-escalation Trends: Is Adjuvant Radioactive Iodine Administration Truly Needed for Papillary Thyroid Carcinoma with Limited Cervical Disease?
No full textZOLL® Immediate Pad Placement (ZIPP) Pilot: Optimizing AED Pad Placement and Reducing Time to Defibrillation
No full textTrends in Faculty Tenure Status and Diversity in Academic Radiology Departments in the United States.
No full textBACKGROUND: Faculty tenure at U.S. medical schools has become less commonplace over the last several decades.
PURPOSE: This study aimed to assess the long-term trends in tenure status, according to gender and underrepresented in medicine (URiM) status for academic radiology faculty in US medical schools.
MATERIALS AND METHODS: The Association of American Medical Colleges (AAMC) Faculty Roster was used to study the number and proportions of academic radiology faculty (including radiologists and radiation oncologists) from 2000 to 2023 by tenure status stratified by gender and underrepresented in medicine (URiM) status. Simple linear regression was used for statistical comparisons.
RESULTS: The total number of academic radiology faculty increased from 5411 in 2000 to 10,597 in 2023. The proportion of non-URiM men decreased (from 73% to 65%), largely replaced by non-URiM women (from 21% to 27%), URiM men (3.7% to 4.4%), and URiM women (1.9% to 3%). The proportion of tenure-line (both tenured and on tenure track) radiology faculty members decreased across all groups, from 40% to 20% of total, an approximate 1%-point per year on average. Representation of women among tenure-line faculty increased (17% to 23% in 2023), but URiM representation remained stagnant (4.6% to 4.8% in 2023). When ranked by representation of female and URiM faculty among total tenured faculty, radiology placed 16th (of 18) for female representation (above surgery and orthopedics), and 18th (last) for URiM representation.
CONCLUSION: Since 2000, academic radiology faculty nationally has enlarged with increased representation of women but remains dominated by non-underrepresented men (65%). Underrepresented groups have increased only marginally. Tenure-line faculty positions decreased across all groups. Similar to other clinical departments, women and underrepresented groups in radiology had a lower proportion of tenure-line faculty than non-underrepresented men.
CLINICAL RELEVANCE STATEMENT: Since 2000, gender and racial/ethnic diversity in academic radiology has improved only marginally, particularly for tenure-line faculty. Increases in non-tenure positions nationwide likely represent an overall shift in academic practice prioritization of clinical over educational and research missions
Sex Differences in Long COVID.
No full textIMPORTANCE: A substantial number of individuals worldwide experience long COVID, or post-COVID condition. Other postviral and autoimmune conditions have a female predominance, but whether the same is true for long COVID, especially within different subgroups, is uncertain.
OBJECTIVE: To evaluate sex differences in the risk of developing long COVID among adults with SARS-CoV-2 infection.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from the National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER)-Adult cohort, which consists of individuals enrolled in and prospectively followed up at 83 sites in 33 US states plus Washington, DC, and Puerto Rico. Data were examined from all participants enrolled between October 29, 2021, and July 5, 2024, who had a qualifying study visit 6 months or more after their initial SARS-CoV-2 infection.
EXPOSURE: Self-reported sex (male, female) assigned at birth.
MAIN OUTCOMES AND MEASURES: Development of long COVID, measured using a self-reported symptom-based questionnaire and scoring guideline at the first study visit that occurred at least 6 months after infection. Propensity score matching was used to estimate risk ratios (RRs) and risk differences (95% CIs). The full model included demographic and clinical characteristics and social determinants of health, and the reduced model included only age, race, and ethnicity.
RESULTS: Among 12 276 participants who had experienced SARS-CoV-2 infection (8969 [73%] female; mean [SD] age at infection, 46 [15] years), female sex was associated with higher risk of long COVID in the primary full (RR, 1.31; 95% CI, 1.06-1.62) and reduced (RR, 1.44; 95% CI, 1.17-1.77) models. This finding was observed across all age groups except 18 to 39 years (RR, 1.04; 95% CI, 0.72-1.49). Female sex was associated with significantly higher overall long COVID risk when the analysis was restricted to nonpregnant participants (RR, 1.50; 95%: CI, 1.27-1.77). Among participants aged 40 to 54 years, the risk ratio was 1.42 (95% CI, 0.99-2.03) in menopausal female participants and 1.45 (95% CI, 1.15-1.83) in nonmenopausal female participants compared with male participants.
CONCLUSIONS AND RELEVANCE: In this prospective cohort study of the NIH RECOVER-Adult cohort, female sex was associated with an increased risk of long COVID compared with male sex, and this association was age, pregnancy, and menopausal status dependent. These findings highlight the need to identify biological mechanisms contributing to sex specificity to facilitate risk stratification, targeted drug development, and improved management of long COVID
The Milan Score Predicts Objective Gastroesophageal Reflux Disease in Patients With Type 2 Esophagogastric Junction.
No full textINTRODUCTION: High-resolution manometry (HRM) allows assessment of esophagogastric junction (EGJ) disruption. While type 3 EGJ predicts definitive gastroesophageal reflux disease (GERD), type 2 EGJ is less clearly implicated in GERD pathogenesis. This study aimed to characterize physiologic findings in type 2 EGJ to determine if the HRM-based Milan Score can define GERD within type 2 EGJ.
METHODS: 535 patients with suspected GERD who underwent HRM and reflux monitoring were retrospectively analyzed. Clinical, HRM, and reflux study data were compared between the EGJ morphology subtypes, with objective GERD defined according to Lyon Consensus 2.0. The Milan Score, a novel metric that integrates ineffective esophageal motility, EGJ-contractile integral, EGJ morphology, and straight leg raise response, was abnormal when ≥ 137 (risk rate 50% for GERD). Receiver operating characteristic (ROC) curve analysis was performed to assess the accuracy of the Milan Score to predict objective GERD.
RESULTS: Type 3 EGJ was associated with the highest rate of objective GERD, followed by type 2 and type 1 EGJ (p \u3c 0.001), with a corresponding stepwise increase in AET from type 1 to 3 EGJ (p \u3c 0.001). Type 2 EGJ with Milan Score \u3c 137 resembled type 1 EGJ (objective GERD in 23.6% vs. 33.2%, p = 0.09), and type 2 EGJ with score ≥ 137 resembled type 3 EGJ (objective GERD in 88.2% vs. 78.8%, p = 0.11). On ROC analysis, the Milan Score had an area under the curve of 0.858.
CONCLUSION: While type 2 EGJ includes varying GERD severity, the Milan Score can segregate patients at risk for objective GERD
Interventions implemented to remediate mold identified in Neonatal Intensive Care Unit (NICU) incubators, 2022 to 2023.
No full textBACKGROUND: Neonatal Intensive Care Units utilize incubators to sustain core temperatures associated with transepidermal water loss. High relative humidity in incubators provides an environment for fungi to grow. In August 2022, mold was identified growing in 11 (85%) Neonatal Intensive Care Unit incubators.
METHODS: A team assembled to address mold in incubators. The environment was addressed as a possible source of contamination by consulting an environmental specialist. The air handler, ducts, and environment were terminally cleaned. Specimens were collected from the contaminated incubators and the manufacturer reviewed cleaning practices. Experimental trials were conducted using the incubators to replicate mold growth after interventions.
RESULTS: The environmental consultant approved when the space could be reoccupied. Incubators introduced to the clean environment did not grow mold. Various fungi or yeast were identified in the contaminated incubators. Opportunities to improve cleaning and replacement of parts were identified by the manufacturer. September 2022 to February 2023, 7 experimental trials were completed after cleaning the incubators. Four (36%) of the 11 contaminated incubators were placed back in use due to no fungal growth. No patient illnesses occurred.
CONCLUSIONS: The interventions implemented stopped ongoing contamination of incubators and use of previously contaminated incubators
Candida albicans: a comprehensive view of the proteome
No full textWe describe a new release of the Candida albicans PeptideAtlas proteomics spectral resource (build 2024-03), providing a sequence coverage of 79.5% at the canonical protein level, matched mass spectrometry spectra, and experimental evidence identifying 3382 and 536 phosphorylated serine and threonine sites with false localization rates of 1% and 5.3%, respectively. We provide a tutorial on how to use the PeptideAtlas and associated tools to access this information. The C. albicans PeptideAtlas summary web page provides Build overview , PTM coverage , Experiment contribution , and Dataset contribution information. The protein and peptide information can also be accessed via the Candida Genome Database via hyperlinks on each protein page. This allows users to peruse identified peptides, protein coverage, post-translational modifications (PTMs), and experiments identifying each protein. Given the value of understanding the PTM landscape in the sequence of each protein, a more detailed explanation of how to interpret and analyse PTM results is provided in the PeptideAtlas of this important pathogen. Candida albicans PeptideAtlas web page: https://db.systemsbiology.net/sbeams/cgi/PeptideAtlas/buildDetails?atlas_build_id=578
Disease diagnostics using machine learning of B cell and T cell receptor sequences.
No full textClinical diagnosis typically incorporates physical examination, patient history, various laboratory tests, and imaging studies but makes limited use of the human immune system\u27s own record of antigen exposures encoded by receptors on B cells and T cells. We analyzed immune receptor datasets from 593 individuals to develop MAchine Learning for Immunological Diagnosis, an interpretive framework to screen for multiple illnesses simultaneously or precisely test for one condition. This approach detects specific infections, autoimmune disorders, vaccine responses, and disease severity differences. Human-interpretable features of the model recapitulate known immune responses to severe acute respiratory syndrome coronavirus 2, influenza, and human immunodeficiency virus, highlight antigen-specific receptors, and reveal distinct characteristics of systemic lupus erythematosus and type-1 diabetes autoreactivity. This analysis framework has broad potential for scientific and clinical interpretation of immune responses
Metagenomic estimation of dietary intake from human stool.
No full textDietary intake is tightly coupled to gut microbiota composition, human metabolism and the incidence of virtually all major chronic diseases. Dietary and nutrient intake are usually assessed using self-reporting methods, including dietary questionnaires and food records, which suffer from reporting biases and require strong compliance from study participants. Here, we present Metagenomic Estimation of Dietary Intake (MEDI): a method for quantifying food-derived DNA in human faecal metagenomes. We show that DNA-containing food components can be reliably detected in stool-derived metagenomic data, even when present at low abundances (more than ten reads). We show how MEDI dietary intake profiles can be converted into detailed metabolic representations of nutrient intake. MEDI identifies the onset of solid food consumption in infants, shows significant agreement with food frequency questionnaire responses in an adult population and shows agreement with food and nutrient intake in two controlled-feeding studies. Finally, we identify specific dietary features associated with metabolic syndrome in a large clinical cohort without dietary records, providing a proof-of-concept for detailed tracking of individual-specific, health-relevant dietary patterns without the need for questionnaires