Journal of the National Medical Association最新文献

{"title":"Analyzing patterns of frequent mental distress in Alzheimer's patients: A generative AI approach","authors":"Yoshiyasu Takefuji","doi":"10.1016/j.jnma.2025.01.002","DOIUrl":"10.1016/j.jnma.2025.01.002","url":null,"abstract":"<div><div>This study tackles creating Python code for beginners with generative AI and analyzing trends in mental distress among Alzheimer's patients in the US (2015–2022 CDC data). It guides beginners through using AI to generate code for visualizing these trends by age and sex. The findings reveal females, particularly those 50–64 years old, experience the highest rates of mental distress. This emphasizes the importance of considering age and sex when developing care and interventions for mental distress in Alzheimer's patients.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 20-24"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384499","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":"Focus on Health Equity through Medical Education, Clinical Studies and Artificial Intelligence","authors":"Marie L. Borum MD, EdD, MPH, MACP, FACG, AGAF, FRCP","doi":"10.1016/j.jnma.2025.03.001","DOIUrl":"10.1016/j.jnma.2025.03.001","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 1-2"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621513","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":"Outcomes of procedures for abortions and early pregnancy loss among people with sickle cell disease: A single-center experience","authors":"Sydney A. Wade ,&nbsp;Erin Y. Chen ,&nbsp;Preetha Nandi ,&nbsp;Sophie M. Lanzkron ,&nbsp;Anne E. Burke ,&nbsp;Lydia H. Pecker","doi":"10.1016/j.jnma.2025.01.003","DOIUrl":"10.1016/j.jnma.2025.01.003","url":null,"abstract":"<div><div>People with sickle cell disease (SCD) have an increased risk of pregnancy loss and severe maternal morbidity in pregnancy yet there is little data on the outcomes of abortions or pregnancy loss among these individuals. This retrospective review aimed to describe the clinical outcomes of procedurally managed abortions and early pregnancy losses among individuals with sickle cell disease at a single center. We identified 19 individuals with sickle cell disease who underwent 24 procedures for the management of abortion (<em>n</em> = 18) or pregnancy loss (<em>n</em> = 6) at our center from 2013 to 2022. There were few procedure-related complications. Most of the post-procedural complications were painful crises. Individuals with a high frequency of painful crises before the procedure had a 1.2 higher odds of experiencing post-procedural painful crises (95 % CI: 1.0–1.4). Individuals with higher baseline rates of painful crises were more likely to develop post-procedural pain crises. This study is the first since 1995 to report on abortion and pregnancy loss outcomes in SCD. As threats to accessing reproductive health care continue to grow in the U.S., we must refine practice models to deliver safe care to patients with SCD who seek reproductive health services.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 25-31"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451406","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 IMF/NMA medical student mentorship program in health equity in multiple myeloma","authors":"Manisha Bhutani ,&nbsp;Semaje Testamark ,&nbsp;Randall C. Morgan ,&nbsp;Joseph Mikhael","doi":"10.1016/j.jnma.2025.01.001","DOIUrl":"10.1016/j.jnma.2025.01.001","url":null,"abstract":"<div><div>The Medical Student Scholars for Health Equity in Myeloma Mentoring program is sponsored by the International Myeloma Foundation (IMF) and the W. Montague Cobb/NMA Health Institute's Cobb Scholars Program. The initiative focuses on mentoring minority medical students to enhance the representation of minority physicians committed to myeloma health equity. By supporting innovative projects aimed at reducing health disparities in myeloma, the program seeks to inspire medical students and address diversity gaps in the field.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 15-19"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384503","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":"An experiential learning exercise in understanding social determinants of health in an urban pediatric residency program","authors":"Lynn C. Smitherman ,&nbsp;Anil N.F. Aranha","doi":"10.1016/j.jnma.2024.11.001","DOIUrl":"10.1016/j.jnma.2024.11.001","url":null,"abstract":"<div><h3>Purpose</h3><div>As part of the Community Pediatrics Rotation, the Shopping Assignment was developed to allow pediatric residents to understand social determinants of health (SDOH). The purpose of this study was to evaluate the 20-year experience with the Shopping Assignment as a tool in teaching SDOH to pediatric residents.</div></div><div><h3>Methods</h3><div>In the assignment, residents were designated as the head of a fictional family with limited resources and receiving support through the Michigan Department of Health and Human Services. Residents had to complete a series of exercises based on the family's budget and submit a final cash balance. Creativity was imperative for success. The assignment was graded on a 100-point scale with a 60 % passing score.</div></div><div><h3>Results</h3><div>168 Residents completed the assignment over a 20-year period (2000–2019). Most of the residents (79.2 %) worked in groups and 20.8 % worked individually. Residents were 72 % female with 60 % having attended U.S. medical schools. Eighty-six percent of residents obtained a passing score with performance not impacted by gender or medical school location (U.S. versus International). Residents obtaining a passing score performed better (<em>p</em> = 0.001) on most activities evaluated, including final cash balance and overall creativity.</div></div><div><h3>Conclusion</h3><div>The Shopping Assignment was a successful educational tool in improving residents’ knowledge of SDOH. Residents’ participation in the activity enhanced empathy for the patients served in their continuity clinics. Although training programs teach some of these concepts to trainees, this is first study to provide a scoring mechanism that quantifies the experiential learning process based on the assigned tasks.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 3-14"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808982","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":"Non-Hodgkin lymphoma in Williams syndrome: A coincidence or an association?","authors":"Merve Tanrısever Türk ,&nbsp;Gizem Ürel Demir ,&nbsp;Gülen Eda Utine ,&nbsp;Bilgehan Yalçın ,&nbsp;Pelin Özlem Şimşek-Kiper","doi":"10.1016/j.jnma.2025.01.011","DOIUrl":"10.1016/j.jnma.2025.01.011","url":null,"abstract":"<div><div>To date there have been multiple clinical reports of pediatric patients with Williams Beuren syndrome developing non-Hodgkin lymphoma. However, there is no clear evidence of an association between this microdeletion syndrome and lymphoma risk and as of yet there are no recommendations for cancer surveillance in the follow-up of these patients. In this report we descibe two patients with Williams Beuren syndrome, both of whom were diagnosed with non-Hodgkin lymphoma, one at the age of 2 years and the other at the age of 6 years during clinical follow-up. Although Williams-Beuren syndrome is not a cancer-predisposing genetic syndrome, rare cases of malignancy have been reported in these patients, necessitating consideration of this fact during patient follow-up.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 80-85"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416563","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":"Institutional characteristics, faculty rank and URM faculty representation","authors":"Kendall M. Campbell ,&nbsp;Ashley Collazo ,&nbsp;Xiaoying Yu ,&nbsp;Christen Walcher","doi":"10.1016/j.jnma.2025.01.006","DOIUrl":"10.1016/j.jnma.2025.01.006","url":null,"abstract":"<div><h3>Introduction</h3><div>It has been well documented that underrepresented faculty in academic medicine are concentrated in lower faculty ranks than their well represented counterparts. This promotion disparity has resulted in concerted efforts by medical institutions to change academic culture and climate surrounding this group. This study provides a more detailed characterization of minority faculty underrepresentation, evaluating longitudinal trends in faculty rank among US medical schools looking particularly at academic rank, region, ownership, institution type, social mission score and research intensity ranking.</div></div><div><h3>Materials and Methods</h3><div>Using data from the AAMC Faculty Roster, AAMC Organizational database, and Mullan et al.’s social mission score, multiple adjusted Generalized Estimating Equation (GEE) models were constructed to evaluate trends in faculty number by race/ethnicity, academic rank, and specific institutional characteristics as noted above.</div></div><div><h3>Results and Discussion</h3><div>Compared to URM faculty in the South, the change rate of URM faculty is higher by 1.7 % in the West. At the Instructor rank, there are increased rates of change for all racial groups in the West when compared to the South by 6.3 % for Asian faculty, 5.1 % for White faculty, and 5 % for URM faculty. URM faculty at HBCUs at the Instructor level have decreased rates of change by 4.9 % as compared to predominantly white institutions. URM Professor rank faculty at private institutions showed significant increased rates of change of 1.7 % as compared to public institutions. URM faculty at the Professor rank had a decreased rate of 1.4 % at schools with high social mission score compared to low social mission scores.</div></div><div><h3>Implications</h3><div>There are differences in overall URM faculty trends based on region, ownership, institution type, social mission score and research intensity ranking. All institutional characteristics showed different effects on URM faculty at specific academic ranks and the reasons for these differences need further study to be more fully understood.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 42-54"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426679","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":"Peter Buxtun, the Tuskegee study whistleblower: Memorandum of a hero","authors":"Ulysses G Gardner ,&nbsp;Shearwood McClelland III","doi":"10.1016/j.jnma.2025.01.004","DOIUrl":"10.1016/j.jnma.2025.01.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The Tuskegee Syphilis Study, a dark chapter in medical history, still resonates today. The Tuskegee Study, conducted between 1932 and 1972 by the U.S. Public Health Service (USPHS) and Centers for Disease Control and Prevention (CDC), is the longest controversial study performed in the U.S. Peter Buxtun, an epidemiologist at the USPHS, raised ethical concerns about the study and eventually leaked the story to the press, leading to the study's termination. Buxtun has died at the age of 86. It is imperative to remember this study and the heroic actions of Buxtun to expose this ethically unjustified study.</div></div><div><h3>Results and discussion</h3><div>The Tuskegee Syphilis Study included 399 African American men with syphilis in Tuskegee, Alabama. The participants were promised free medical care to participate in the study; however, they were not informed of their diagnosis of syphilis and they were not treated. Despite the availability of penicillin in 1943, these men were still untreated by the USPHS as the study design was to evaluate the full progression of untreated syphilis on the body. As a result, 28 died directly from syphilis and 100 from complications, 40 spouses were infected, and 19 children were born with congenital syphilis. Buxtun leaked the story to the press in 1972, leading to the termination of the Tuskegee Syphilis Study.</div></div><div><h3>Implications</h3><div>The Tuskegee Syphilis Study is the longest ethically and morally controversial study in the U.S., mainly based on the lack of respect of the African American race. It disregarded ethical standards and physicians participating in it directly violated the Hippocratic Oath to “do no harm.” The medical community is forever indebted to Buxtun who died on May 18, 2024, for his courage, moral compass, and compassion.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 1","pages":"Pages 32-35"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426680","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":"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":"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}