Publication trends among emergency medicine residents, fellows, and graduates and its relationship to future academic achievement

Purpose: Scholastic activity through research involvement is a fundamental aspect of a physician's training, and may have a significant influence on residency and fellowship match success. Despite this fact, little is known regarding the pursuit of academia and/or fellowships in emergency medicine graduates. In this review, we will (1) describe factors involved in academic research including peer-reviewed publications among emergency medicine residency graduates and (2) determine if a relationship exists between publication rates before, during, and after emergency medicine residency.Methods: Using a cross-sectional study design, we analyzed the research output of emergency medicine graduates and its relationship to future academic involvement from a random sample of 50 emergency medicine programs' graduates. Data were extracted for each graduate and analyzed using STATA 15.1 and Microsoft Excel. A public protocol is available here: https://osf.io/pwa6d/.Results: Using Doximity, we identified 238 emergency medicine residency programs of which we sampled 50. Of the 50 included programs, 6 programs were included, amounting in 154 graduates available for analysis. Of the 154 analyzed graduates, 97 (63.0%) were male, 91 (59.1%) were osteopathic graduates, and 91 (59.1%) had zero publications. Additionally, we found that 26/154 (16.9%) pursued academia and 16/164 (10.4%) pursued a fellowship, with 4/16 (25%) in medical toxicology and 4/16 (25%) in emergency medical services. The mean number of publications for each graduate was 0.87. Of the graduates with research, more research was published on average after graduation from residency (0.42) compared to before residency (0.17) and during residency (0.34).Conclusion: While a majority of psychiatry graduate's publications were post-residency, many publications occurred during residency, with the lowest number of publications occurring pre-residency

Cross-sectional review of publication trends among OBGYN graduates

Objective: Research and other scholarly activities are essential components to medical training and may predict (i) success for matching into residency or fellowship programs and (ii) a future in academia. Despite this importance, little is known about the research outputs of obstetrics and gynecology residency graduates. In this cross-sectional analysis, we explored the characteristics of published, peer-reviewed publications of obstetrics and gynecology residency graduates and publication rates before, during, and after residency.Study Design: We employed a cross-sectional study design using a random sample of 50 obstetrics and gynecology residency programs found on the 2019-2020 Doximity residency navigator (Doximity Residency Navigator). Data were extracted for each graduate of the included programs with a pilot-tested Google Form and then analyzed using STATA 15.1 and Microsoft Excel. A protocol is publicly available. Publication Trends Among Medical Resi...)Results: We identified 281 residency programs, from which we randomly sampled 50. Among the 50 programs, 15 were included, totaling 303 obstetrics and gynecology residency graduates available for analysis. Of the 303 graduates, a total of 111 (36.6%) produced no publications, 137 (45.2%) produced 1-5 total publications, 28 (9.2%) produced 6-10 publications, 15 (5.0%) produced 11-15 publications, and 12 (4.0%) produced 16-20 publications. Of the graduates we analyzed, 79 (79/303, 26.1%) pursued fellowships, with most in maternal and fetal medicine (23/79, 29.1%). Academia was pursued by 46/303 (15.2%) of graduates. The mean number of publications per resident was 2.9 (SD). Our results showed an increase of publications during the progression of training with a mean of 0.38 publications prior to residency, 0.8 during residency, and 1.75 after residency.Conclusion: Our results showed that the majority of obstetrics and gynecology graduates do not go on to pursue a fellowship or career in academia. According to the ACGME, the average number of research experiences (poster or abstract presentations, publications, etc.) for matched residents as a whole was 3.3 while matched obstetrics and gynecology residents averaged 3.4 research experiences1. While matched obstetrics and gynecology residents only averaged slightly more research experiences than the average resident, publications throughout obstetrics and gynecology training trended upward as training progressed. The highest average of publications was seen post- residency, which suggests there may be an opportunity for residents to increase their scholastic activity while in training. We propose that one way to increase the scholarly activity while in training is to encourage collaborative research involvement between medical students, residents, and attending physicians. This joint effort will not only increase resident scholarly activity but will also facilitate teaching research principles to medical students early in medical training and provide opportunities for networking and knowledge sharing

Publication trends in Family Medicine graduates: A cross-sectional review

Purpose: The ACGME emphasizes the importance of research throughout residency as it establishes the basis of evidence-based medicine. As future physicians practicing evidence-based medicine, it is crucial that physicians in training are able to both interpret and produce quality research. Currently, the long-term impact of active research participation is unknown in this population. In this study, we aim to (1) explore research activity as measured by peer-reviewed publications among family medicine residency graduates and (2) determine if an association exists between publication rates before, during, or after family medicine residency.Methods: We utilized a cross-sectional study design analyzing research output by family medicine residency graduates in relation to future publications and academic involvement from a random sample of 50 family medicine programs. Data were extracted for each graduate and analyzed using STATA 15.1 and Microsoft Excel. The public protocol can be found here: https://osf.io/pwa6d/.Results: We identified 654 residency programs of which we randomly sampled 50. Among the 50 programs, 8 were included, totaling 101 graduates from family medicine residencies for analysis. Of the 101 analyzed residents, 76 (75.2%) produced zero publications. Of the analyzed residents, 30 (29.7%) pursued a fellowship, with most in sports medicine (5/101 [5.0%]). The mean number of publications for all analyzed residents was 0.8, with most publishing after completion of residency.Conclusion: While a majority of family medicine graduate's publications were post-residency, the average number of publications was lowest during residency training. Increased research opportunity and activity during residency may increase the proportion of family medicine graduates pursuing fellowships and careers in academia, as well as increase resident comfort with both interpretation and utilization of evidence-based interventions in clinical practice

Short-term Treatment with Dabigatran Alters Protein Expression Patterns in a Late-Stage Tau-Based Alzheimer\u27s Disease Mouse Model

Proteins that regulate the coagulation cascade, including thrombin, are elevated in the brains of Alzheimer\u27s disease (AD) patients. While studies using amyloid-based AD transgenic mouse models have implicated thrombin as a protein of interest, the role of thrombin in tau-based animal models has not been explored. The current study aims to determine how inhibiting thrombin could alter oxidative stress, inflammation, and AD-related proteins in a tau-based mouse model, the Tg4510. Aged Tg4510 mice were treated with the direct thrombin inhibitor dabigatran or vehicle for 7 days, brains collected, and western blot and data-independent proteomics using mass spectrometry with SWATH-MS acquisition performed to evaluate proteins related to oxidative stress, intracellular signaling, inflammation, and AD pathology. Dabigatran reduced iNOS, NOX4, and phosphorylation of tau (S396, S416). Additionally, dabigatran treatment increased expression of several signaling proteins related to cell survival and synaptic function. Increasing evidence supports a chronic procoagulant state in AD, highlighting a possible pathogenic role for thrombin. Our data demonstrate that inhibiting thrombin produces alterations in the expression of proteins involved in oxidative stress, inflammation, and AD-related pathology, suggesting that thrombin-mediated signaling affects multiple AD-related pathways providing a potential future therapeutic target

Marine protected areas, marine heatwaves, and the resilience of nearshore fish communities

Anthropogenic stressors from climate change can affect individual species, community structure, and ecosystem function. Marine heatwaves (MHWs) are intense thermal anomalies where water temperature is significantly elevated for five or more days. Climate projections suggest an increase in the frequency and severity of MHWs in the coming decades. While there is evidence that marine protected areas (MPAs) may be able to buffer individual species from climate impacts, there is not sufficient evidence to support the idea that MPAs can mitigate large-scale changes in marine communities in response to MHWs. California experienced an intense MHW and subsequent El Niño Southern Oscillation event from 2014 to 2016. We sought to examine changes in rocky reef fish communities at four MPAs and associated reference sites in relation to the MHW. We observed a decline in taxonomic diversity and a profound shift in trophic diversity inside and outside MPAs following the MHW. However, MPAs seemed to dampen the loss of trophic diversity and in the four years following the MHW, taxonomic diversity recovered 75% faster in the MPAs compared to reference sites. Our results suggest that MPAs may contribute to long-term resilience of nearshore fish communities through both resistance to change and recovery from warming events

Performance of a novel left ventricular lead with short bipolar spacing for cardiac resynchronization therapy: Primary results of the Attain Performa Quadripolar Left Ventricular Lead Study

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Anti-glycation and anti-oxidative effects of a phenolic-enriched maple syrup extract and its protective effects on normal human colon cells

Oxidative stress and free radical generation accelerate the formation of advanced glycation endproducts (AGEs) which are linked to several chronic diseases. Published data suggest that phenolic-rich plant foods, show promise as natural anti-AGEs agents due to their anti-oxidation capacities. A phenolic-enriched maple syrup extract (MSX) has previously been reported to show anti-inflammatory and neuroprotective effects but its anti-AGE effects remain unknown. Therefore, herein, we investigated the anti-glycation and anti-oxidation effects of MSX using biochemical and biophysical methods. MSX (500 μg mL−1) reduced the formation of AGEs by 40% in the bovine serum albumin (BSA)–fructose assay and by 30% in the BSA–methylglyoxal (MGO) assay. MSX also inhibited the formation of crosslinks typically seen in the late stage of glycation. Circular dichroism and differential scanning calorimeter analyses demonstrated that MSX maintained the structure of BSA during glycation. In the anti-oxidant assays, MSX (61.7 μg mL−1) scavenged 50% of free radicals (DPPH assay) and reduced free radical generation by 20% during the glycation process (electron paramagnetic resonance time scan). In addition, the intracellular levels of hydrogen peroxide induced reactive oxygen species were reduced by 27–58% with MSX (50–200 μg mL−1) in normal/non-tumorigenic human colon CCD-18Co cells. Moreover, in AGEs and MGO challenged CCD-18Co cells, higher cellular viabilities and rapid extracellular signal-regulated kinase (ERK) phosphorylation were observed in MSX treated cells, indicating its protective effects against AGEs-induced cytotoxicity. Overall, this study supports the biological effects of MSX, and warrants further investigation of its potential as a dietary agent against diseases mediated by oxidative stress and inflammation

Climate change promotes parasitism in a coral symbiosis.

Coastal oceans are increasingly eutrophic, warm and acidic through the addition of anthropogenic nitrogen and carbon, respectively. Among the most sensitive taxa to these changes are scleractinian corals, which engineer the most biodiverse ecosystems on Earth. Corals' sensitivity is a consequence of their evolutionary investment in symbiosis with the dinoflagellate alga, Symbiodinium. Together, the coral holobiont has dominated oligotrophic tropical marine habitats. However, warming destabilizes this association and reduces coral fitness. It has been theorized that, when reefs become warm and eutrophic, mutualistic Symbiodinium sequester more resources for their own growth, thus parasitizing their hosts of nutrition. Here, we tested the hypothesis that sub-bleaching temperature and excess nitrogen promotes symbiont parasitism by measuring respiration (costs) and the assimilation and translocation of both carbon (energy) and nitrogen (growth; both benefits) within Orbicella faveolata hosting one of two Symbiodinium phylotypes using a dual stable isotope tracer incubation at ambient (26 °C) and sub-bleaching (31 °C) temperatures under elevated nitrate. Warming to 31 °C reduced holobiont net primary productivity (NPP) by 60% due to increased respiration which decreased host %carbon by 15% with no apparent cost to the symbiont. Concurrently, Symbiodinium carbon and nitrogen assimilation increased by 14 and 32%, respectively while increasing their mitotic index by 15%, whereas hosts did not gain a proportional increase in translocated photosynthates. We conclude that the disparity in benefits and costs to both partners is evidence of symbiont parasitism in the coral symbiosis and has major implications for the resilience of coral reefs under threat of global change