America is becoming increasingly diverse. Discrimination against minority groups persists and contributes to negative disparate outcomes for patients and healthcare professionals. Healthcare professionals have a responsibility to address inequity in the medical system. This activity defines the terms "diversity" and "discrimination" and highlights the interprofessional team's role in improving care for patients from diverse backgrounds.
Objectives:
* Define the terms "diversity" and "discrimination" and discuss their implications in healthcare.
* Explain the different levels on which bias and discrimination occur.
* Summarize relationships between bias and negative patient outcomes.
* Outline actions that healthcare systems can take to increase diversity and reduce disparities.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
License Tesim:
https://creativecommons.org/licenses/by/4.0/
Language:
English
Publisher:
StatPearls Publishing
Identifier:
Bookshelf ID: NBK568721 and PMID: 33760480
Type:
Other
Keyword:
patient care, negative disparate outcomes, discrimination, and diverse backgrounds
Dysfunctional Stem and Progenitor Cells Impair Fracture Healing with Age
Creator:
Kacena, M.A., Karnik, S., Li, J., Promer, H.J., Clauss, M., Loghmani, M.T., Wagner, D.R., McKinley, T.O., Nielsen, J.J., Low, P.S., Lowery, Jonathan W., Gunderson, Z.J., and Fennimore, A.
Related Url Tesim:
Originally published as an open access article in World Journal of Stem Cells, with publisher Published by Baishideng Publishing Group. It can be downloaded from the following URL: https://www.wjgnet.com/1948-0210/current.htm
Description:
Successful fracture healing requires the simultaneous regeneration of both the bone and vasculature; mesenchymal stem cells (MSCs) are directed to replace the bone tissue, while endothelial progenitor cells (EPCs) form the new vasculature that supplies blood to the fracture site. In the elderly, the healing process is slowed, partly due to decreased regenerative function of these stem and progenitor cells. MSCs from older individuals are impaired with regard to cell number, proliferative capacity, ability to migrate, and osteochondrogenic differentiation potential. The proliferation, migration and function of EPCs are also compromised with advanced age. Although the reasons for cellular dysfunction with age are complex and multidimensional, reduced expression of growth factors, accumulation of oxidative damage from reactive oxygen species, and altered signaling of the Sirtuin-1 pathway are contributing factors to aging at the cellular level of both MSCs and EPCs. Because of these geriatric-specific issues, effective treatment for fracture repair may require new therapeutic techniques to restore cellular function. Some suggested directions for potential treatments include cellular therapies, pharmacological agents, treatments targeting age-related molecular mechanisms, and physical therapeutics. Advanced age is the primary risk factor for a fracture, due to the low bone mass and inferior bone quality associated with aging; a better understanding of the dysfunctional behavior of the aging cell will provide a foundation for new treatments to decrease healing time and reduce the development of complications during the extended recovery from fracture healing in the elderly.
Editorial: Genetic and molecular determinants in bone health and diseases
Creator:
Rossi, M., Lowery, Jonathan W., and Del Fattore, A.
Related Url Tesim:
Available from the publisher: https://www.frontiersin.org/research-topics/39457/genetic-and-molecular-determinants-in-bone-health-and-diseases/magazine, Available from PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832011/, and Available from the library catalog: https://marianunivindianapolis.on.worldcat.org/oclc/10142325767
Description:
Alterations of bone remodeling impact skeletal integrity lead to excessive or impaired bone resorption as well as reduced or disorganized bone formation (1, 2). This Research Topic focuses on the identification of genetic and molecular determinants involved in both bone health and diseases. In this editorial, we highlight studies on rare diseases presented in the Research Topic with the aim of better understanding their etiopathogenesis and opening the way for the identification of new therapeutic approaches.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
License Tesim:
https://creativecommons.org/licenses/by/4.0/
Language:
English
Publisher:
Frontiers Media S.A.
Identifier:
PMID: 38304462, PMCID: PMC10832011, and DOI: 10.3389/fendo.2024.1347765
Type:
Article
Keyword:
bone remodeling, skeletal integrity, disorganized bone formation , bone resorption , and etiopathogenesis
Exploration of the integration of microbiology and immunology emerging topics into undergraduate medical education
Creator:
Bauer, M., Akbar, Samina, Bauler, T.J., Chacon, J., McClelland, Erin E., Staudaher, S., and Zhao, Y.
Related Url Tesim:
Available from the publisher: https://www.tandfonline.com/doi/full/10.1080/10872981.2024.2336331, Available from PubMed: https://pubmed.ncbi.nlm.nih.gov/38577972/, and Available from the library catalog: https://marianunivindianapolis.on.worldcat.org/oclc/10242158300
Description:
Purpose: Medical school educators face challenges determining which new and emerging topics to incorporate into medical school curricula, and how to do so. A study was conducted to gain a better understanding of the integration of emerging topics related to microbiology and immunology in the undergraduate medical curriculum (UME).
Methods: An anonymous survey with 17 questions was emailed to medical school faculty who teach immunology and/or microbiology through the DR-Ed listserv, the American Society for Microbiology (ASM) Connect listserv, and attendees of the Association of Medical School Microbiology and Immunology Chairs (AMSMIC) Educational Strategies Workshop. Participants were asked about experiences, perceptions, and the decision-making process regarding integrating emerging topics into UME.
Results: The top emerging topics that were added to the curriculum or considered for addition in the last 10 years included COVID-19, Zika virus, mRNA vaccines, and Mpox (formerly known as monkeypox). Most respondents reported lectures and active learning as the major methods for topic delivery, with most faculty indicating that formative assessment was the best way to assess emerging topics. Content experts and course directors were the most cited individuals making these decisions. Top reasons for incorporating emerging topics into curricula included preparing students for clinical treatment of cases, followed by demonstrating the importance of basic science, and opportunities to integrate basic science into other disciplines. Challenges for incorporating these topics included making room in an already crowded curriculum, followed by content overload for students.
Conclusions: This study describes the rationale for integrating emerging topics related to microbiology and immunology into UME, and identifies the current new and emerging topics, as well as the main methods of integration and assessment. These results may be used by medical educators to inform curricular decisions at their institutions. Future studies will include developing innovative learning modules that overcome barriers to integration.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
License Tesim:
https://creativecommons.org/licenses/by/4.0/
Language:
English
Publisher:
Taylor & Francis
Identifier:
PMID: 38577972, PMCID: PMC11000598 , and DOI: 10.1080/10872981.2024.2336331
Type:
Article
Keyword:
emerging topics, clerkship readiness, integration of basic science, microbiology and immunology, and undergraduate medical curriculum
Extracranial hypoglossal neurofibroma with a variant ansa cervicalis: a case report
Creator:
Dykstra, Chandler, Dwenger, Emma, Parent, Elizabeth, and Sakthi-Velavan, Sumathilatha
Related Url Tesim:
PubMed: https://pubmed.ncbi.nlm.nih.gov/36723635/, Available from publisher: https://link.springer.com/article/10.1007/s00276-023-03085-z, and Available from the library catalog: https://marianunivindianapolis.on.worldcat.org/oclc/9754729532
Description:
Purpose: This case report aims to explore a rare combination of findings in a cadaver donor: variant ansa cervicalis, vagus (CN X) and hypoglossal (CN XII) nerve fusion, and extracranial hypoglossal neurofibroma.
Background: The type of ansa cervicalis variation presented in this report has been documented in less than 1% of described cases. The CN X-CN XII fusion has been reported in one prior study. Additionally, hypoglossal neurofibromas are benign neoplasms of the peripheral nerve sheath. There are only two known cases of extracranial hypoglossal neurofibroma described in the literature.
Case report: The study investigated a swelling of the right CN XII in a 90-year-old female cadaver donor. Detailed dissection, examination of the region, and histopathological analysis of the mass followed. The entire course of CN XII and other cranial nerves were examined to exclude concurrent pathology. A fusiform enlargement of the right CN XII was observed in the submandibular region, measuring ~ 1.27 × 1.27 cm. The superior portion of the right CN XII was fused to the right CN X, exiting the jugular foramen. The superior root of ansa cervicalis, normally a branch of CN XII, was found to arise from CN X on the right side. The left CN XII and CN X were unremarkable. Histopathological examination revealed benign neurofibroma.
Conclusion: The anatomical variation and rare location of the tumor necessitate further investigation to better understand pathogenesis, clinical correlation, and surgical implications. This study furthers knowledge of this condition and contributes to the currently limited body of research.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
License Tesim:
https://creativecommons.org/licenses/by/4.0/
Language:
English
Publisher:
Springer
Identifier:
DOI: 10.1007/s00276-023-03085-z and PMID: 36723635
Type:
Article
Keyword:
Anatomical variation, Ansa cervicalis, Extracranial neurofibroma, and Neurofibroma
A founder CHEK2 pathogenic variant in association with kidney cancer
Creator:
Holman, M, Steding, Catherine, Tucker, M, and Brooks, K
Related Url Tesim:
Available from PubMed: https://pubmed.ncbi.nlm.nih.gov/34992046/ and Available from Publisher at: https://www.cancergeneticsjournal.org/article/S2210-7762(21)00240-4/fulltext#relatedArticles
Description:
The gene CHEK2 is located at 22q12.1 and codes for the protein checkpoint kinase 2, a protein that functions in cell cycle regulation and is a known tumor suppressor. CHEK2 is activated due to DNA damage generating a cascade of protein phosphorylation events involving key mediators such as Cdc25A, Cdc25C, and BRCA1. The phosphorylation of these substrates leads to cell cycle arrest, DNA repair, or apoptosis. Pathogenic variants in the gene CHEK2 are known to be associated with an increased lifetime risk for developing male and female breast, colorectal, and prostate cancer. Preliminary literature suggests certain pathogenic variants in the gene CHEK2 may be associated with an increased lifetime risk for developing other cancers, such as papillary thyroid cancer. Four studies in the literature support that a pathogenic variant in the gene CHEK2 may lead to an increased lifetime risk of developing clear cell renal carcinoma. Our patient has a personal history of clear cell renal and gastric cancer, a family history of clear cell renal and breast cancer, and a IVS2+1G>A pathogenic variant in CHEK2. This case study supports the limited evidence that pathogenic variants in CHEK2 may be associated with an increased lifetime risk of developing clear cell renal carcinoma. Further investigation into this association could impact the recommended genetic testing and medical management for individuals with a personal or family history of clear cell renal cancer.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
Language:
English
Publisher:
Published by Elsevier Inc.
Identifier:
PMID: 34992046 and DOI:https://doi.org/10.1016/j.cancergen.2021.12.007
Health-Related Quality of Life - Measurement Tools, Predictors and Modifiers
Creator:
Arbor, S., Mullings, J., and Cumbay, Medhane (co-editor)
Related Url Tesim:
Available from the publisher: https://www.intechopen.com/books/10561
Description:
The concept of health-related quality of life (HRQoL) has evolved since the 1980s, with broad-based applications for clinical care, research, and health policy, as well as for individual and patient use. This book, Health-Related Quality of Life - Measurement Tools, Predictors and Modifiers, highlights measurement tools for HRQoL, as well as predictors and modifiers, examining HRQoL in various disease states, including psychological health. It also discusses ethical issues in the use of HRQoL measurements. The book is a compendium of original research, sharing perspectives from across developing and developed world settings. It is a useful text for researchers and students of academic disciplines in public health and clinical studies, extending to healthcare administrators and policymakers.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
Language:
English
Publisher:
IntechOpen
Identifier:
ISBN: 978-1-83969-021-1, 10.5772/intechopen.92935, ISBN:978-1-83969-022-8, and ISBN: 978-1-83969-020-4
Type:
Book
Keyword:
health-related quality of life (HRQoL) and psychological health
ID Family Protein Expression and Regulation in Hypoxic Pulmonary Hypertension
Creator:
Jones, M.T., Frump, A.L., diCarlo, G.E., Lowery, Jonathan W, Anderson, L.A., and de Caestecker, M.
Description:
Bone morphogenetic protein (BMP) signaling has been linked to the development of pulmonary hypertension (PH). Inhibitors of differentiation (ID) proteins (ID1-4) are a family of basic helix-loop-helix transcription factors that are downstream targets of the BMP signaling pathway, but the role that ID proteins play in the development of PH is unknown. To address this, we evaluated pulmonary expression of ID proteins in a mouse model of hypoxia-induced PH. There is selective induction of ID1 and ID3 expression in hypoxic pulmonary vascular smooth muscle cells (VSMCs) in vivo, and ID1 and ID3 expression are increased by hypoxia in cultured pulmonary VSMCs in a BMP-dependent fashion. ID4 protein is barely detectable in the mouse lung, and while ID2 is induced in hypoxic peripheral VSMCs in vivo, it is not increased by hypoxia or BMP signaling in cultured pulmonary VSMCs. In addition, the PH response to chronic hypoxia is indistinguishable between wild type and Id1 null mice. This is associated with a compensatory increase in ID3 but not ID2 expression in pulmonary VSMCs of Id1 null mice. These findings indicate that ID1 is dispensable for mounting a normal pulmonary vascular response to hypoxia, but suggest that ID3 may compensate for loss of ID1 expression in pulmonary VSMCs. Taken together, these findings indicate that ID1 and ID3 expression are regulated in a BMP-dependent fashion in hypoxic pulmonary VSMCs, and that ID1 and ID3 may play a cooperative role in regulating BMP-dependent VSMC responses to chronic hypoxia.
Rights statement:
http://rightsstatements.org/vocab/InC/1.0/
Language:
English
Identifier:
10.1152/ajpregu.00866.2009
Type:
Article
Keyword:
Myocytes, Phosphorylation, Inhibitor of Differentiation Proteins, Hypoxic Pulmonary Hypertension, and Immunohistochemistry