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How and for whom can genetics education reduce beliefs in genetic essentialism?
No full textDespite advancements in genomics, misconceptions about the extent to which genetics contributes to observable differences across racial groups persist. These misconceptions are often rooted in genetic essentialism, a social-cognitive bias that leads individuals to believe that most complex traits are primarily determined by genetics. This scientifically inaccurate belief overlooks the environmental and social influences on complex human outcomes, reinforcing deterministic views about human diversity. Our study examines how and for whom genetics education can reduce genetic essentialist beliefs using targeted interventions. We use data from a randomized controlled trial collected at a large US West Coast public university in 2023, including 2,061 undergraduate students. Participants were randomly assigned to one of four curriculum-based interventions, ensuring balanced characteristics across conditions. Three interventions were compared: population thinking; multifactorial causation; and a curriculum where we combined both approaches, which we call full Humane Genetics Curriculum. Results are reported relative to a control group that taught students about climate change. Using structural equation modeling, we explore the effectiveness of these interventions with our data. We find that all three interventions reduce genetic essentialist beliefs by decreasing the perception of between-group racial variation and by reducing genetic attributions for complex human traits. We also find that the three intervention curricula are highly effective across sociodemographic group characteristics such as self-reported gender, self-reported race, and cultural/political belief systems. However, the interventions were more effective among students who possessed greater baseline genetics knowledge. Using these findings, we offer evidence-based strategies for curriculum development
Intersecting stigma of substance use and child welfare system involvement: Understanding stigma drivers, experiences, and outcomes from a socioecological perspective
No full textBackground: Substance use in parents is a common reason for child welfare system involvement (CWS). Stigma associated with substance use and disorders (SU/D) continues to negatively impact individuals; however, less is understood about the intersecting stigma of CWS involvement and SU/D. The current study seeks to understand parents' experiences of stigma related to SU/D and CWS involvement as well as the drivers and consequences of stigma at multiple socioecological levels using the Health Stigma and Discrimination Framework.
Methods: Qualitative data analysis was conducted on semi-structured interviews with N = 31 Child Welfare System (CWS) personnel (90.3 % female; 96.8 % White, Non-Hispanic), N = 28 SU/D service providers (85.7 % female; 67.9 % White; 89.3 % Non-Hispanic), and N = 28 parents (89.3 % female; 78.6 % White; 89.3 % Non-Hispanic) with a current or recent CWS case due to SU/D.
Results: Stigma drivers included a lack of understanding of SU/D at interpersonal, community, and organizational levels; negative stereotypes of parents with SU/D involved in CWS (seen as dishonest, unmotivated, poor parents); community neglect of SU/D; negative attitudes towards SU/D medications and harm reduction; and CWS policies unsupportive of SU/D. Parents described experiences of stigma by CWS and the healthcare system, their communities, and loved ones, leading to social isolation and hesitancy to engage in services. Consequently, stigma impacted SU/D service availability, housing/employment policies, and CWS practices, further negatively impacting parents.
Conclusion: Parents with SU/D and involved in CWS have unique experiences of stigmatization related to both SU/D and CWS involvement. Findings point to multiple targets for stigma reduction at different socioecological levels
Code Literacy for Information Professionals: A Critical Evaluation of Online MLIS Programs
No full textComputer programming languages play a crucial role in the education and training of librarians. This study examines the extent to which ALA-accredited online Master of Library and Information Science (MLIS) programs integrate programming languages into their curricula. Using a mixed-methods approach, data were collected from program websites, direct communication with program representatives, and publicly available information. The results indicate that while many programs (60%) offer courses with a coding component, these courses are more often electives (66.7%) than requirements (33.3%). This highlights a potential gap in essential skills training for future librarians, as the demand for coding skills in the library profession continues to rise
Cerebrospinal fluid diversion procedure utilization and physician reimbursement in adult hydrocephalus patients
No full textBackground: As the population continues to age, the number of adults receiving care for hydrocephalus is expected to increase. Here, we assess trends in the utilization and physician reimbursement for ventriculoperitoneal shunts (VPS), lumboperitoneal shunting (LPS), and endoscopic third ventriculostomy (ETV) for adult hydrocephalus.
Methods: The Medicare Part B National Summary Data files from 2000 to 2021 were collected, and information was extracted on procedures performed per year, total charges billed, and actual payments. Linear mixed-model regression analyses were conducted to assess the significance of changes in procedural volume and physician reimbursement over time while adjusting for inflation.
Results: Over the period studied, there was a 26% increase in VPS placement (P = 0.11), 11.34% increase in ETV utilization (P < 0.01), and 43.1% decrease in LPS utilization (P < 0.01). This corresponded to annualized changes of + 4.29% for ETV procedures, -8.78% for LPS, and + 45.8% for VPS. There was a statistically significant difference in the change of rate of number of procedures annually between LPS and VPS (P = 0.04). In both inflation-unadjusted and inflation-adjusted analyses, all procedures experienced an annual decline in reimbursement with inflation-adjusted changes of -11.54%/year for ETV, -4.13% for LPS, and -13.12% for VPS. There was a statistically significant difference in the change of rate of reimbursement between LPS procedures and both ETV (P < 0.01) and VPS (P < 0.01).
Conclusion: Medicare reimbursement data shows that a commensurate decline in physician reimbursement has accompanied the ongoing rise in adult hydrocephalus procedures
Subtotal tumor resection as a predictor of post-resection hydrocephalus in pediatric patients with posterior fossa tumors
No full textObjective: Pediatric posterior fossa tumor (PFT) resection is frequently complicated by postoperative hydrocephalus. Previous hydrocephalus risk stratification tools demonstrate limited performance in external validation and do not account for important intra- and post-operative variables. We aimed to evaluate additional risk factors for post-resection hydrocephalus to improve risk-stratification.
Methods: We conducted a retrospective analysis of pediatric patients who underwent resection of primary PFT's at our institution (January 2016-June 2024). We collected perioperative variables thought to influence hydrocephalus risk. The primary outcome was permanent CSF diversion within 6 months after resection. We used univariable and multivariable logistic regression with bidirectional stepwise selection to identify predictors of post-resection hydrocephalus.
Results: A total of 112 patients were included. We identified age < 5 years, moderate/severe hydrocephalus, and subtotal resection (STR; ≥ 1.5 cm2 residual tumor) as independent predictors of post-resection hydrocephalus on multivariable regression. STR exhibited an odds ratio of 8.25 (95% CI 2.72-26.84; p < 0.001), highlighting its strong association with the need for permanent CSF diversion. A scoring tool that incorporated STR and an age cutoff of < 5 years improved the discriminative performance (area under the ROC curve = 0.826) compared to the modified Canadian Preoperative Prediction Rule for Hydrocephalus (AUC = 0.720).
Conclusions: These findings suggest STR is associated with increased risk of persistent hydrocephalus and emphasize careful intraoperative decision-making when pursuing incomplete resection. Future multicenter studies will be necessary to validate this framework and to further elucidate how STR, in conjunction with age and hydrocephalus severity, can be leveraged to optimize treatment strategies in diverse healthcare settings
Phosphorylation at serine 214 correlates with tau seeding activity in an age-dependent manner in two mouse models for tauopathies and is required for tau transsynaptic propagation
No full textBackground:
Tau aggregation and propagation are hallmark features of Alzheimer's disease and related tauopathies. The molecular identity and post-translational modifications that contribute to tau seeding activity remain incompletely understood.
Objective:
To characterize the temporal dynamics of tau seeding activity and identify specific phosphorylated tau species associated with tau propagation in vivo.
Methods:
We profiled tau seeding activity using a FRET-based biosensor cell line and correlated it with the abundance of phospho- and conformational tau species in two transgenic mouse models of tauopathy (P301S-1N4R and P301S-0N4R). Immunohistochemistry and subcellular fractionation were used to examine the spatial distribution of tau species. Functional relevance of serine 214 phosphorylation was assessed via phospho-dead mutants in Drosophila and primary neuronal cultures using a microfluidic platform.
Results:
Tau seeding activity was detected as early as 2 months and increased with age in both mouse models, preceding AT8-positive neurofibrillary tangles. Phosphorylation at serine 214 (pTau-Ser214) positively correlated with tau seeding in both models and was observed earlier and in distinct histological compartments compared to AT8. pTau-Ser214, but not AT8, localized to the synaptic compartment. Mutation of serine 214 to alanine reduced tau propagation in primary neurons and seeding activity in Drosophila, without affecting total tau levels.
Conclusions:
pTau-Ser214 marks an early, synaptically enriched tau species that correlates with seeding activity and promotes transsynaptic propagation. These findings highlight the functional diversity of tau species and support pTau-Ser214 as a potential biomarker and therapeutic target for early-stage tauopathy
Long-term Dietary Fat Intervention Affects Retinal Health in APOE Mice
No full textThe APOE genotype influences metabolic and neurodegenerative outcomes, with APOE4 carriers at higher risk for Alzheimer's disease (AD) and metabolic dysfunction. This study examines how long-term dietary interventions affect systemic metabolism, retinal structure/function in APOE3-knock-in (KI, neutral for AD) and APOE4-KI mice. Humanized APOE3 and APOE4-KI mice received either a control diet (CD) or a Western diet (WD) for 2, 6, or 12 months. Body weight, glucose metabolism, lipid profiles, retinal structure, function, vasculature, visual performance, and inflammatory markers were analyzed. WD induced early glucose intolerance in APOE4 mice (2 months); APOE3 mice showed impairment only after prolonged exposure (6-12 months). Notably, WD-fed APOE3 mice exhibited more pronounced hyperlipidemia than APOE4 mice. APOE4 CD mice displayed early retinal thinning (6 months), while APOE4 WD mice initially exhibited retinal swelling, followed by degeneration (12 months). WD exacerbated retinal vascular dysfunction in APOE4 mice, with increased tortuosity and reduced vascular area. Elevated Il1b expression in WD-fed APOE4 mice confirmed inflammation-associated retinal dysfunction. APOE4 mice showed heightened vulnerability to diet, with WD worsening metabolic, retinal, and vascular impairments. While CD improved glucose metabolism, it did not prevent retinal dysfunction. These findings underscore genotype-specific dietary strategies to mitigate APOE4-associated risks
Prediction of hypertension and diabetes in twin pregnancy using machine learning model based on characteristics at first prenatal visit: national registry study
No full textObjective: To develop a prediction model for hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) in twin pregnancy using characteristics obtained at the first prenatal visit.
Methods: This was a cross-sectional study using national live-birth data in the USA between 2016 and 2021. The association of all prenatal candidate variables with HDP and GDM was tested on univariable and multivariable logistic regression analyses. Prediction models were built with generalized linear models using the logit link function and classification and regression tree (XGboost) machine learning algorithm. Performance was assessed with repeated 2-fold cross-validation and the area under the receiver-operating-characteristics curve (AUC) was calculated. A P value < 0.001 was considered statistically significant.
Results: A total of 707 198 twin pregnancies were included in the HDP analysis and 723 882 twin pregnancies were included in the GDM analysis. The incidence of HDP and GDM increased significantly from 12.6% and 8.1%, respectively, in 2016 to 16.0% and 10.7%, respectively, in 2021. Factors associated with increased odds of HDP in twin pregnancy were maternal age < 20 years or ≥ 35 years, infertility treatment, prepregnancy diabetes mellitus, non-Hispanic Black race, overweight prepregnancy BMI, prepregnancy obesity and Medicaid as the payment source for delivery (P < 0.001 for all). Obesity Class II and III more than doubled the odds of HDP. Factors associated with increased odds of GDM in twin pregnancy were maternal age ≤ 24 years or ≥ 30 years, infertility treatment, prepregnancy hypertension, non-Hispanic Asian race, maternal birthplace outside the USA and prepregnancy obesity (P < 0.001 for all). Maternal age ≥ 30 years, non-Hispanic Asian race and obesity Class I, II and III more than doubled the odds of GDM. For both HDP and GDM, the performances of the machine learning model and logistic regression model were mostly similar, with negligible differences in the performance domains tested. The mean ± SD AUCs of the final machine learning models for HDP and GDM were 0.620 ± 0.001 and 0.671 ± 0.001, respectively.
Conclusions: The incidence of HDP and GDM in twin pregnancies in the USA is increasing. The predictive accuracy of the machine learning models for HDP and GDM in twin pregnancies was similar to that of the logistic regression models. The models for HDP and GDM had modest predictive performance, were well calibrated and did not have poor fit
Ethical Mindfulness in Directing Research at a Student Run Free Clinic: A Case Study
No full textEthical Mindfulness in Directing Research at a Student Run Free Clinic: A Case Study
Background
Student-run free clinics (SRFCs) often conduct research to evaluate clinical offerings, improve operations, and contribute to the distribution of knowledge. While Institutional Review Boards (IRBs) ensure regulatory compliance, ethical tensions frequently arise in the day-to-day oversight of research involving underserved and structurally vulnerable populations. At this SRFC, student research co-chairs hold a leadership role in reviewing, guiding, and managing research activity. This case study examines how ethical decision-making was integrated into this role, beyond formal IRB review.
Methods
Over an 8-month period, the student research co-chairs documented key decisions, policy developments, and stakeholder discussions surrounding research activities at the clinic. A narrative case study approach was used to reflect on ethical questions related to project selection, patient autonomy, data stewardship, and clinic-wide collaboration. The ethical frameworks of Beauchamp and Childress’s Four Principles of Biomedical Ethics1 and the Structural Competency Framework2 were used to analyze the decision-making process.
Results
The case study will describe several ethically complex moments in clinic research leadership, such as implementing new research bylaws, evaluating proposals from external collaborators, addressing concerns around patient burden, and negotiating the impact to clinic flow. Each scenario will be interpreted using the selected ethical frameworks, offering insight into how abstract ethical principles were applied in real-world student leadership contexts. Particular attention will be paid to how justice and beneficence were balanced in a structurally vulnerable patient population.
Conclusion
Ethical leadership in SRFC research requires proactive reflection, shared decision-making, and sensitivity to both biomedical ethics and social context. This case study illustrates how student leaders can meaningfully engage with ethical frameworks to guide research oversight and shape institutional norms. The lessons drawn may inform similar leadership roles at other SRFCs seeking to ethically ground their research infrastructure.
References
1. Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 8th ed. Oxford University Press; 2019. ISBN: 9780190640873
2. Metzl JM, Hansen H. Structural competency: Theorizing a new medical engagement with stigma and inequality. Soc Sci Med. 2014;103:126-133. doi:10.1016/j.socscimed.2013.06.032Research reported in this publication was supported by the National Institute Of General Medical Sciences of the National Institutes of Health under Award Number T32GM148382. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health
The COVID-19 Pandemic and Associated Depression Among Emergency Medicine Interns: Results from a National Longitudinal Cohort Study
No full textTo explore the prevalence of depression among emergency medicine (EM) interns before and during the COVID-19 pandemic. The Intern Health Study is a national longitudinal cohort study examining mental health among interns across various specialties. In this secondary analysis, we focused specifically on EM interns from 2008 to 2022. Participants completed a baseline survey before their intern year and quarterly surveys throughout their intern year. Depression severity was assessed using the Patient Health Questionnaire (PHQ9), with scores of 10 or higher indicating moderate-to-severe depression. In total, 1956 EM interns from 160 programs completed all PHQ9 surveys. PHQ9 scores at baseline (start of the intern year) were significantly lower prior to the COVID-19 pandemic compared to during it (p < 0.001). PHQ9 scores at month 9 were significantly higher during the COVID-19 pandemic (p < 0.05) compared to pre-COVID-19 pandemic interns at month 9. One-way ANOVA comparing pre-COVID-19 and during COVID-19 differences in PHQ9 from baseline to the end of intern year revealed a significant difference, with during COVID-19 differences being significantly less than pre-COVID-19. There was no significant difference in the proportion of interns with PHQ9 scores greater than 10 during the COVID-19 pandemic. The COVID-19 pandemic had a significant effect on the mental health of EM interns, with higher baseline depression scores observed during the pandemic. However, the smaller change in depression severity over the intern year during the pandemic suggests a complex interplay of factors that warrants further investigation. Our study is the first to examine depression among EM interns during the COVID-19 pandemic using a large, multi-year sample, providing a unique and comprehensive analysis of how the pandemic impacted mental health in this high-risk group. Unlike previous studies with smaller sample sizes, our research offers robust, generalizable insights into the trends and severity of depression in EM interns, highlighting the critical need for ongoing mental health support in medical training