Journal of the National Medical Association最新文献

{"title":"Addressing visual learning equity in undergraduate dermatology education: Skin color representation across dermatology lecture images at Rutgers New Jersey Medical School","authors":"Rucha Janodia ,&nbsp;Helen Nguyen ,&nbsp;Valerie A. Fitzhugh ,&nbsp;Christin Traba ,&nbsp;Sophia Chen ,&nbsp;Jeremy J. Grachan","doi":"10.1016/j.jnma.2025.01.010","DOIUrl":"10.1016/j.jnma.2025.01.010","url":null,"abstract":"<div><div>Minimally-melanated skin has been the standard for dermatologic education. Research has shown that the lack of brown and black images in dermatologic medical education may contribute to unequal early recognition of diseases across different skin types. Promoting visual equity in educational resources throughout undergraduate medical education may allow for students to improve their confidence in identifying skin lesions in patients of color. Dermatology lectures at Rutgers New Jersey Medical School (NJMS) were examined using the New Immigrant Survey (NIS) Skin Color Scale. Four pre-clerkship lectures featuring various skin lesions were analyzed and images were categorized as light/white, medium/brown, and dark/black skin types. The light/white skin category was the most heavily represented accounting for 59.5 % (<em>n</em> = 185) of all images across the four lectures, medium/brown skin type accounted for 16.1 % (<em>n</em> = 50), and dark/black skin type was 24.4 % (<em>n</em> = 76). Across the four lectures, there were 109 dermatologic conditions covered. Of the 109, 35 (32 %) only included images from one skin tone, which was usually light/white skin, whereas 17 (16 %) included images of all three skin types. INSTITUTION is located in Newark, New Jersey a diverse community with 48.2 % of its residents identifying as Black/African American and 36.8 % identifying as Hispanic/Latino in 2022. Currently, there have been efforts at INSTITUTION to promote visual learning equity, especially to represent the community it resides in. Addressing this disparity in medical education is a vital step toward achieving more equitable healthcare practices and outcomes for patients.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 74-79"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in osteoarthritis: Prevalence, presentation, and management in the United States","authors":"Youssef Abdullah ,&nbsp;Olayemi O. Olubowale ,&nbsp;Kevin V. Hackshaw","doi":"10.1016/j.jnma.2025.01.007","DOIUrl":"10.1016/j.jnma.2025.01.007","url":null,"abstract":"<div><div>Osteoarthritis (OA) is the most common form of arthritis in the United States, affecting approximately 24 % of adults. This literature review aims to summarize racial and ethnic disparities in OA prevalence, presentation, disability, diagnosis, and management among different groups in the U.S. The review found significant disparities, particularly affecting African Americans (AAs) and Hispanics (HISs) compared to non-Hispanic whites (WHs). AAs showed higher odds of developing symptomatic and radiological knee OA, with more severe radiological features. Pain and disability due to OA were also more pronounced in AAs and HISs. Disparities extended to imaging workup, with AAs less likely to undergo hip X-rays and MRIs for hip OA. Management strategies, including physical therapy, pharmacological treatments, and surgical interventions, were less utilized by AAs and HISs compared to WHs. These disparities are influenced by complex, multifaceted factors including socioeconomic status, education level, and healthcare access. The review highlights the urgent need for targeted interventions and policy changes to address these racial-ethnic disparities in OA care and outcomes.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 55-60"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross sectional analysis of residents by race/ethnicity and specialty from 2020-2023","authors":"William H. Swain ,&nbsp;Alec J. Calac ,&nbsp;Luis R. Gasca ,&nbsp;Benjamin R. Harris ,&nbsp;Alice Gallo de Moraes","doi":"10.1016/j.jnma.2024.10.006","DOIUrl":"10.1016/j.jnma.2024.10.006","url":null,"abstract":"<div><h3>Background</h3><div>Minorities are underrepresented in all areas of medical education relative to the United States general population, and minority physicians are more likely to practice in disadvantaged areas and in primary care settings. Many individual and structural factors contribute to this discrepancy. We aimed to demonstrate how resident race/ethnicity representation differs across the various resident specialties.</div></div><div><h3>Methods</h3><div>We used publically available data from the Association of American Medical College's <em>Report on Residents</em> data series and averaged the four academic years from 2019 to 2020 through 2022-2023. We then calculated the odds ratio (OR) of self-reported race/ethnicity (alone and in combination) in thirty-four specialties.</div></div><div><h3>Results</h3><div>Across the four-year study period, there were, on average, 147026 unduplicated resident trainees. The average number of duplicated residents by self-identified ethnic category (alone and in combination) include: American Indian or Alaska Native (839, 0.6%), Asian (31627, 21.5%), Black or African American (7935, 5.4%), Hispanic, Latino, or of Spanish Origin (10900, 7.4%), Native Hawaiian or Other Pacific Islander (296, 0.2%), White (76289, 51.9%), Other (4879, 3.3%), Unknown (522, 0.4%), and Non-US Citizens (23914, 16.3%). Across race/ethnicity, there are differences in ORs of representation in different specialties. Key findings include high representation in Public Health and Preventative Medicine by Black and African American (OR=3.7) and Native Hawaiian (OR=2.6) residents, and Family Medicine in Native Americans (OR=1.9), Native Hawaiian (OR=1.7), Black (OR=1.5), and Hispanic (OR=1.3) residents. Psychiatry also had high ORs of representation in minority residents.</div></div><div><h3>Conclusion</h3><div>This study illustrates relative resident ethnic representation across training specialties. Minorities ethnicities were more likely to be represented in primary care and public health domains. This has implications for creating a physician workforce suitable to serve the United States Population.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 6","pages":"Pages 654-661"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights on oral health, heart disease, COPD and diabetes with important information on minority representation in health care workforce","authors":"Marie L. Borum MD, EdD, MPH, MACP, FACG, AGAF, FRCP","doi":"10.1016/j.jnma.2024.11.002","DOIUrl":"10.1016/j.jnma.2024.11.002","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 6","pages":"Page 633"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sickle cell disease: Contributing factors and radiological assessments","authors":"Gail Cherry-Peppers ,&nbsp;Cheryl Fryer ,&nbsp;Andrea D. Jackson ,&nbsp;Xinbin Gu ,&nbsp;Debra Ford ,&nbsp;Alison Glascoe ,&nbsp;Dawn Smith ,&nbsp;Meirong Liu ,&nbsp;Jacquelyn Dunmore-Griffith ,&nbsp;Gillian Robinson-Warner ,&nbsp;Crystal McIntosh ,&nbsp;Jezelle Sonnier ,&nbsp;Lisa Slade ,&nbsp;Adel Rizkalla ,&nbsp;Shakeya Mundey ,&nbsp;Nyree Dawson ,&nbsp;Manouchka Fleurinord ,&nbsp;Baron Edmonson ,&nbsp;Courtney Ford ,&nbsp;Jillian Griffith ,&nbsp;Terri Watkins-Bryant","doi":"10.1016/j.jnma.2023.05.004","DOIUrl":"10.1016/j.jnma.2023.05.004","url":null,"abstract":"<div><div><span><span><span>Sickle Cell Disease (SCD) is genetically described as an autosomal </span>blood disorder resulting from the presence of a mutated form of hemoglobin. Morbidity, frequency of crisis, degree of anemia, and organ systems involved vary considerably per patient. Dental health professionals and other specialists commonly request comprehensive medical consultations prior to performing complex periodontal, endodontic, and surgical procedures. In order to have successful dental outcomes and minimize posttreatment dental complications, relevant disease indicators are noted. This review is to raise awareness of the impact of </span>oral diseases in patients with sickle cell disease and to emphasize the importance of full medical disclosure, radiographic interpretation, and a well-documented </span>medical history<span>, and a well-written consultation which can guide treatment planning and greatly improve the course of dental treatment.</span></div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 6","pages":"Pages 636-641"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why men don't talk about domestic violence","authors":"David E. Myles","doi":"10.1016/j.jnma.2024.10.005","DOIUrl":"10.1016/j.jnma.2024.10.005","url":null,"abstract":"<div><div>A personal anecdote highlighting the myriad myths and misconceptions about why men don't often report domestic violence and the steps that society can take to ensure that everyone who has experienced such violence gets the resources and support they need.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 6","pages":"Pages 634-635"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between heart failure and systemic inflammatory response index: A cross‐sectional study","authors":"Yu Zheng ,&nbsp;Zixing Nie ,&nbsp;Yifan Zhang ,&nbsp;Zhihua Guo","doi":"10.1016/j.jnma.2024.10.007","DOIUrl":"10.1016/j.jnma.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>The systemic inflammatory response index (SIRI) is a recently developed composite index that assesses the entire extent of inflammation in the body, closely linked to heart failure (HF). This study aimed to evaluate the potential association between SIRI and HF.</div></div><div><h3>Methods</h3><div>The cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) database from 2001 to 2018. SIRI is calculated based on the counts of monocytes, neutrophils, and lymphocytes. A weighted multiple-variable linear regression model examined the correlation between SIRI and HF. Using restrained cubic splines explored the nonlinear relationship between the two, and the robustness of the results was verified by subgroup analysis and interaction tests.</div></div><div><h3>Results</h3><div>Our study included 30,294 participants, 814 of whom were diagnosed with HF and 29,480 with non-HF. The multiple linear regression analysis showed that SIRI was positively correlated with HF (OR = 1.66; 95 % CI, 1.21, 2.29) and that there was no nonlinear relationship between the two. This relationship persisted in subgroup analyses.</div></div><div><h3>Conclusions</h3><div>The results indicate a linear positive correlation between SIRI and HF. Further extensive prospective studies are needed to validate these findings.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 6","pages":"Pages 662-672"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the risks and relationships between oral health and chronic diseases","authors":"Gail Cherry-Peppers ,&nbsp;Cheryl Fryer ,&nbsp;Andrea D. Jackson ,&nbsp;Debra Ford ,&nbsp;Alison Glascoe ,&nbsp;Dawn Smith ,&nbsp;Jacquelyn Dunmore-Griffith ,&nbsp;Morton Iris ,&nbsp;Dexter Woods ,&nbsp;Gillian Robinson-Warner ,&nbsp;Alphonzo Davidson ,&nbsp;Crystal McIntosh ,&nbsp;Jezelle Sonnier ,&nbsp;Lisa Slade ,&nbsp;Goulda Downer ,&nbsp;Shakeya Mundey ,&nbsp;Jennifer Darden-Wilson ,&nbsp;Nyree Dawson ,&nbsp;Arielle Downes ,&nbsp;Adel Rizkalla ,&nbsp;Theresa Watkins-Bryant","doi":"10.1016/j.jnma.2024.01.003","DOIUrl":"10.1016/j.jnma.2024.01.003","url":null,"abstract":"<div><div><span><span><span>Advances in medical science and in preventive dentistry have changed the context of oral health. The American population is living longer with numerous complex chronic diseases. This paper is to raise awareness about the impact of </span>multiple chronic diseases and their associations with </span>oral diseases<span>. Comorbidities can worsen the course of dental treatment. Inflammation has been the connecting factor in the bidirectional pattern of oral and </span></span>systemic diseases. High occurrences of chronic diseases generally occur in aging as well as disadvantaged populations. Serious infections, slow healing, prolonged bleeding, and hospitalizations can escalate in patients with uncontrolled chronic diseases. A multidisciplinary team-based approach to patient management can minimize complications and unexpected challenges.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 6","pages":"Pages 646-653"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139506419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of immune-related hub genes in chronic obstructive pulmonary disease","authors":"Lingyu Zhang ,&nbsp;Liwei Zuo","doi":"10.1016/j.jnma.2024.10.008","DOIUrl":"10.1016/j.jnma.2024.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>As a prevalent persistent respiratory disease, chronic obstructive pulmonary disease (COPD) is featured by airflow limitation and chronic inflammation. This study focused on the identification of immune-related hub genes in COPD.</div></div><div><h3>Methods</h3><div>We employed the GSE38974 dataset to analyze differentially expressed genes (DEGs) of COPD. Then, we obtained COPD immune-related DEGs (COPD-IMDEGs) based on the intersection of DEGs and immune-related genes. Subsequently, we carried out Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses on COPD-IMDEGs. We established a protein-protein interaction network based on COPD-IMDEGs. The hub genes were determined by utilizing the Maximal Clique Centrality method. We utilized receiver operating characteristic (ROC) curves to analyze the clinical significance of hub genes in COPD. In addition, potential drugs targeting hub genes were predicted based on interactions between hub gene-corresponding proteins and drugs.</div></div><div><h3>Results</h3><div>A total of 45 COPD-IMDEGs were obtained through differential analysis. Enrichment analyses showed that COPD-IMDEGs were associated with cytokines, growth factors, and receptor ligands. Ten COPD-IMDEGs were identified as hub genes. As shown by ROC curves, these genes had potential value in identifying COPD patients. Drug prediction results showed that simvastatin and other drugs targeted hub genes.</div></div><div><h3>Conclusion</h3><div>This study analyzed the potential biological functions enriched by COPD-IMDEGs, identified ten genes as biological markers for diagnosing COPD, and predicted potential drugs for treating COPD.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 6","pages":"Pages 673-681"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin use and its association with all-cause mortality and incident diabetes/prediabetes in African Americans: Findings from the jackson heart study","authors":"Alula Hadgu ,&nbsp;Fengxia Yan ,&nbsp;Valery Effoe ,&nbsp;Robert Mayberry","doi":"10.1016/j.jnma.2024.10.009","DOIUrl":"10.1016/j.jnma.2024.10.009","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigates the association between statin use and all-cause mortality, as well as the association between statin use and incident diabetes or prediabetes among African Americans.</div></div><div><h3>Methods</h3><div>This study is based on the Jackson Heart Study (JHS), a community-based cohort study of African Americans (AAs). The baseline period for JHS was 9/26/2000 to 3/31/2004. The first follow-up period was from 10/1/2005 to 12/21/2008, and the second follow-up period was from 2/26/2009 to 1/31/2013. All study participants who were statin users or non-users at baseline were included in this study. We applied two common propensity score adjustment techniques to analyze the data: propensity score matching (PSM) and the inverse probability of treatment weighting (IPTW) algorithms.</div></div><div><h3>Results</h3><div>In this cohort there were 510 deaths. The baseline prevalence of statin use was 13.95% (95% CI: 12.91% - 14.98%), while the baseline rate of all-cause mortality was 11.82% (95% CI: 10.87% - 12.82%). In crude analyses, statin users had an 80% higher risk of mortality compared to non-users, with an odds ratio (OR) of 1.80 (95% CI: 1.43 - 2.27). However, after adjusting for confounders using PSM and IPTW, the adjusted ORs for the association between statin use and mortality were 0.77 (95% CI: 0.53 - 1.12) and 0.80 (95% CI: 0.68 - 0.95), respectively. A post hoc power analysis suggested that the matched analysis was underpowered.</div><div>The incidence of diabetes/ prediabetes was 39.42% (95% CI: 37.39% - 41.45%), with 879 new cases observed. Statin users had a crude odds ratio (OR) of 2.02 (95% CI: 1.52 - 2.67) for developing diabetes/prediabetes compared to non-users. After adjusting for confounding using PSM) and IPTW, the adjusted ORs were 1.84 (95% CI: 1.21–2.81) and 1.82 (95% CI: 1.59–2.08), respectively.</div></div><div><h3>Conclusion</h3><div>Statin use was associated with a 20% decrease in all-cause mortality but an 80% increased risk of incident diabetes/prediabetes. Clinicians should consider the implications of these findings when prescribing statins to patients in this population.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 6","pages":"Pages 682-693"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}