Chair Of Medicine Research Articles

More Than a Joke: The Intersection of Gender-Based Humor and Gender Inequities Experienced by Women Department Chairs in Academic Medicine.

Purpose: The purpose of this qualitative descriptive study is to describe how women academic department chairs in emergency medicine, surgery, and anesthesiology experience humor in the workplace. Method: Interviews were conducted with 35 women department chairs in academic medicine from 27 institutions that aimed to describe women's leadership emergence. The data from the primary study yielded rich and revealing themes involving participants' experiences with humor in the context of their leadership roles, justifying a secondary analysis focusing specifically on these experiences. Relevant remarks were extracted, coded, and summarized. Results: Participants discussed two broad types of humor-related experiences. First, they described how they responded to aggressive gender-based humor directed at themselves or their colleagues by tolerating it or expressing disapproval. This humor includes demeaning quips, insulting monikers, sexist jokes, and derogatory stories. Participants often did not confront this humor directly as they feared being rejected or ostracized by colleagues. Second, they described how they initiated humor to address gender-related workplace issues by highlighting gender inequalities, coping with sexual harassment and assault, and managing gender-based leadership challenges. Participants felt constrained in their own use of humor because of the need to be taken seriously as women leaders. Conclusion: Women leaders in academic medicine use humor to confront gender-related issues and experience aggressive gender-based humor in the workplace. The constraints placed on women leaders discourage them from effectively confronting this aggressive gender-based humor and perpetuating gender inequities. Eliminating aggressive gender-based humor is needed to create safe and equitable work environments in academic medicine.

Cardiac Sodium Channel Nav1.5 Arg222Gln Variant Induces a Sex-Specific Arrhythmia and Alters Mitochondrial Function

Introduction: Encoded by the SCN5A gene, cardiac Nav1.5 sodium channels initiate the action potential to trigger a heartbeat. As the predominant sodium channel in the heart, variants can have devastating consequences, leading to potentially lethal arrhythmias. With the gain of function arginine to glutamine (Arg222Gln) variant in Nav1.5, patients develop intermittent arrhythmias and dilated cardiomyopathy. The stress induced by chronic arrhythmias can trigger adverse metabolic reprogramming, exacerbating the underlying condition. We have generated a murine model harboring the human Arg222Gln variant where we observe that only males produce a clear observable arrhythmia. We hypothesize that the maladaptive metabolic response to the arrhythmia caused by the Arg222Gln variant maybe be a potential link to the sex differences. Methods: The human exon containing the Arg222Gln mutation was knocked into a murine model under the endogenous SCN5A promoter. Cellular metabolism (oxygen consumption) was measured using primary adult mouse cardiomyocytes (CMs) with the Seahorse XFe analyzer. Mitochondrial membrane potential was measured using ratiometric JC-1 dye and imaged on a scanning confocal microscope. Heart tissues were diced into 1mm3 cubes and fixed to perform serial block face electron microscopy to obtain 3D structure of mitochondria and mitochondrial morphology. Western blots were used to detect protein levels. Results: Basal respiration of CMs were unchanged, however the maximal respiratory capacity of Arg222Gln males was significantly lower (116.9±13.5pmol O2/min, p<0.05) compared to WT males (407.3±16.4pmol O2/min). There were no differences between WT females (451.4±22.4pmol O2/min) and Arg222Gln females (463.2±33.7pmol O2/min). JC-1 dye revealed that the Arg222Gln males (0.6213±0.0172 red/green ratio, p<0.001) have significantly lowered mitochondrial polarization compared to WT males (0.7550 ±0.0257). There were no differences between WT females (0.6236±0.0154) and Arg222Gln females (0.6466±0.0139). Arg222Gln males have reduced mitochondria area (1.155±0.052μm2, p<0.05) compared to WT males (1.332±0.060μm2) and are more fragmented (p<0.05). Electron transport chain complex protein levels and mitochondrial biomass measured by voltage dependent anion channel protein levels remain unchanged between WT males and Arg222Gln males (P>0.05). The ratio of phosphorylated dynamin related (DRP) / total DRP protein levels were significantly higher in Arg222Gln males compared to WT males, indicative of mitochondrial fission (p<0.05). Conclusion: We demonstrate evidence of a mitochondrial dysfunction in a murine model of arrhythmia caused by a gain of function Nav1.5 variant, adversely affecting overall cellular metabolism and mitochondrial quality. Our data suggests that the difference in metabolic reprogramming could play a role in the cardioprotection against arrhythmia in Arg222Gln females or explain why Arg222Gln males are severely affected by the arrhythmia. Future experiments will aim to elucidate how the difference in sex affects cardiac metabolism in the context of Arg222Gln Nav1.5 variant. This work was supported by a Canadian Institutes of Health Research Project Grant, the SickKids Foundation through the Curtis Joseph and Harold Groves Chair in Anesthesia and Pain Medicine (JTM) and the Department of Anesthesiology and Pain Medicine, University of Toronto through a Merit Award (JTM). TYTL is supported by the CIHR Canadian Graduate Scholarship — Doctoral Award. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Из опыта преподавания дисциплины «Первая помощь» студентам 2-го курса на кафедре медицины катастроф и скорой медицинской помощи Рязанского государственного медицинского университета им. акад. И.П.Павлова

Summary. The experience of teaching the “First aid” subject with 2nd year students at the emergency and disaster medicine chair of Ryazan State Medical University named after acad. I.P. Pavlov. It is noted that “First aid” is taught with several goals in mind, the main of which is to teach practical skills and to check their mastering by each student. The author considers three variants of teaching “First Aid”, stipulates lessons themes and the list of activities (16 lessons in a semester).

‘Ghost Networks’ Put Patients at Risk of Becoming More Ill

‘Ghost Networks’ Put Patients at Risk of Becoming More Ill

Strategies for Patients With Sarcomas & Merkel Cell Carcinoma

Strategies for Patients With Sarcomas & Merkel Cell Carcinoma

Laveran, the military doctor

Son of Louis-Theodore Laveran, holder of the Chair of Diseases and Epidemics in the Armies at the Val-de-Grâce and grandson of an artillery commander through his mother, Alphonse, born in Paris on June 18, 1845, follows in his father's footsteps by entering the Imperial School of Military Health in Strasbourg at the age of 18.After his thesis, he participated in 1870 in the war against Prussia. He was taken prisoner in Metz. He then prepared for the competitive examination to become a professor, which he passed in 1874. He was appointed to the Chair of the Val-de-Grâce, which his father had created. He then went to Algeria. It was at the military hospital in Constantine on November 6, 1880 that he indisputably discovered the haematozoa responsible for malaria in the blood of a soldier in the crew train.In 1884, he was appointed to the Chair of Military Hygiene and Legal Medicine at Val-de-Grâce. At the end of his professorship in 1894, after being refused a posting to Paris to continue his research and not being consulted for the preparation of the Madagascar expedition, which turned into a health disaster in 1895, he retired prematurely in 1897. Hosted by Émile Duclaux and Émile Roux at the Pasteur Institute in Paris, he continued his research mainly on protozoa as agents of human and animal diseases until his death. His work in medical protozoology earned him the Nobel Prize in Physiology or Medicine in 1907. During the Great War, with the benefit of his experience, he warned the Minister of War in January 1916 about the risk of malaria incurred by the army of the East in the delta of the Vardar River in Salonika. The spring would prove him right.An illustrious military doctor and scientist of international renown, Laveran died on May 18, 1922 in Paris.

Inherent challenges in treating AUD temper hopes for major breakthrough

ADAW asked a number of national leaders to reflect on the coming months and assess what they foresee in the treatment of alcohol use disorder (AUD), and respondents took care to cast their responses in a positive light. But given the many challenges from a scientific and societal standpoint in achieving breakthroughs in AUD treatment, a comment from Rutgers Health Department of Emergency Medicine Chair Lewis S. Nelson, M.D., may have best summarized the complexity of the task ahead.

Race and Gender Disparities Among Leadership in Academic Family Medicine.

As the United States moves closer to a majority-minority, and a nearly equal male to female population, we should see a similar shift in the composition of leadership in the workplace. Family Medicine, while attempting to close the gaps, continues to fall short in producing women and minority leaders. METHODS: The demographic traits of Association of Departments of Family Medicine (ADFM) chairs in medical education institutions in the United States and Canada were analyzed. RESULTS: The majority of those in chair positions were male (67%) and White (53%) non-Hispanic. Male chairs have been in positions significantly longer than females (average 9 years and 6 years, respectively). There was also a significant difference between chairs in public versus private schools-public, that is, chairs at public institutions had a much longer average time of 9 years in current position compared with those in private institutions had an average of 5 years. While the comparison was not significant, 46% of those that self-reported as non-White held chair positions at private schools compared with 28% of those that self-reported as White. CONCLUSIONS: Despite the availability of leadership pathways, women and underrepresented minorities continue to be underrepresented in these positions. Future research would benefit from a more extensive evaluation of different characteristics such as disability, gender identity and sexual orientation.

The Future of Endowed Chairs in Academic Medicine.

As the landscape of philanthropy changes following the COVID-19 pandemic, this commentary considers the future of endowed chairs in academic medicine in the light of articles by Thorndyke and colleagues and by Chin-Hong and colleagues in this issue. The authors evaluate the traditional allocation of endowed chairs, which can attract and retain talented faculty and can support focused research far into the future, while other gifts may support more timely concerns, but over a shorter term. The authors weigh the benefits and challenges of allocation of endowed chairs, such as the need to improve representation, diversity, equity, and inclusion, and opportunities to support early-career investigators or research teams. New endowed positions can be challenging to establish, as there may be competition with learner scholarship programs and programmatic support. Leadership turnover of university presidents and deans can slow philanthropic growth and make recruitment and fundraising for new positions even more challenging. The authors discuss the balance of institutional priorities and ways to use endowed chairs for scholarship in evolving areas of medicine and science. They further suggest working with donors to develop more adaptable gift agreements, which will allow institutions to transform endowed positions to meet changing needs while preserving the intentions of the donor. To maintain endowed chairs as a worthwhile and relevant outlet for philanthropy, one which donors will enthusiastically support, it is essential to align them with the changing needs of the institution and the broader environment of academic medicine.

Letter to the Editor on "Training Characteristics, Academic Accomplishments, and Motivation of Current Chairs in Physical Medicine and Rehabilitation".

Letter to the Editor on "Training Characteristics, Academic Accomplishments, and Motivation of Current Chairs in Physical Medicine and Rehabilitation".

Editorial introductions.

Current Opinion in Infectious Diseases was launched in 1988. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of infectious diseases is divided into 11 sections that are reviewed once a year. Each section is assigned to a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Genovefa A. PapanicolaouGenovefa A. PapanicolaouDr Genovefa A. Papanicolaou is the Director of Clinical Trials in the Infectious Disease Service at Memorial Sloan Kettering Cancer Center and Professor at Weill Cornell Medical College of Cornell University in New York, USA. Dr Papanicolaou is the current Chair of the Infectious Disease special Interest Group (ID-SIG) of the American Society for Transplantation and Cellular Therapy (ASTCT). Her research focuses on viral infections after stem cell transplantation and particularly cytomegalovirus (CMV). Her areas of interest are novel therapeutics, biomarkers and personalized infection management. Dionysios NeofytosDionysios NeofytosDionysios Neofytos is an Infectious Disease specialist with expertise in infectious disease complications in patients with hematologic malignancies and bone marrow and solid organ transplant recipients. Since the completion of his training in Infectious Diseases at Thomas Jefferson University Hospital in Philadelphia, PA, USA, in 2006 he has joined the Faculty and worked as an attending physician with the Transplant Infectious Disease Services at the Johns Hopkins University in Baltimore, MD, USA, and the Memorial Sloan Kettering Cancer Center in New York, NY, USA. Since 2016, he joined the Division f Infectious Diseases at the University Hospital of Geneva, in Geneva, Switzerland. His research and area of expertise are focusing on the epidemiology, diagnosis and management of viral and invasive fungal infections in immunocompromised hosts. Trish M. PerlTrish M. PerlTrish M. Perl, MD, MSc, is the H. Ben and Isabelle T. Decherd Chair in Internal Medicine (Infectious Diseases and Geographic Medicine) at UT Southwestern Medical Center in Dallas TX, USA. Dr Perl received her Medical Degree from the University of North Carolina (Chapel Hill), USA, and a Master of Science from McGill University in Montreal, Canada. She trained in Internal Medicine at the Royal Victoria Hospital and in Infectious Diseases and Clinical Epidemiology at the University of Iowa, USA. She rose through the ranks to Professor of Medicine at Johns Hopkins University School of Medicine, USA, and Epidemiology at the Bloomberg School of Public Health and is recognized globally for her innovation and research in healthcare associated infections, antimicrobial resistance, and their transmission and prevention. As the Hospital Epidemiologist at Johns Hopkins Hospital and Health System Epidemiologist, she developed extensive practical and research experience. Internationally, she has helped with outbreak management and mitigation including SARS, MERS CoV, Ebola and consults on guideline development and strategies to prevent emerging threats in healthcare. She is actively involved in monitoring the COVID-19 pandemic and supporting the national and local response.

Current State of Point-of-Care Ultrasound Use Within Family Medicine.

Following the publication of Point-of-Care-Ultrasound (POCUS) curriculum guidelines from the American Academy of Family Physicians in 2016, there has been a rapid expansion in POCUS curricula across family medicine departments in the US. There is growing appreciation for the potential role of POCUS in enhancing the clinical care family physicians provide to patients. The primary aim of our study was to evaluate the utilization of POCUS in outpatient clinic care across Family Medicine departments nationwide and to identify perceived or realized barriers in integrating POCUS use for clinic care. The questions were part of a larger omnibus survey of US Department of Family Medicine chairs, conducted by the Council of Academic Family Medicine Educational Research Alliance (CERA) between August 6 to August 31, 2021. 81% of departments have at least 1 POCUS-trained faculty, with 44% of departments using POCUS in some ambulatory clinical care. Currently, only 6% have established billing for the POCUS they perform. Faculty time, as well as funding, for POCUS training were seen as 2 primary barriers. The purchasing of equipment and billing for POCUS were described by FMCs as difficult. As POCUS use continues to rise in Family Medicine, it is imperative to create a more efficient and less hindered road to growth. Collaboration across departments to share best practices in training, purchasing equipment and billing for POCUS will be important to facilitate high-quality POCUS access for our patients.

Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine.

Recent attention and focus on, antiracism training in health care has potential to accelerate our path to social justice and achieve health equity on a national scale. However, theoretical frameworks and empirical data have yet to emerge that explain the uptake of antiracism trainings and their efficacy. This goal of this study was to test hypotheses regarding uptake of antiracism training in Family Medicine departments using Diffusion of Innovation Theory. In 2021, we incorporated 10 survey items in the Council of Academic Family Medicine Educational Research Alliance's national omnibus survey for Department of Family Medicine Chairs (n = 104). We used DOI (Diffusion of Innovation) attributes (ie, relative advantage, compatibility, complexity, trialability, and observability) as a guiding framework to assess perceived innovation of antiracism training. We also evaluated the mode of training (eg, didactic, experiential) and whether any subsequent policy or practice-level antiracist actions occurred. We used c2 tests to examine associations between DOI attributes and antiracist actions; and logistic regression to determine odds of association. Ninety-two percent of respondents indicated antiracism training was happening in their department. Relative advantage, compatibility and observability were positively associated with antiracist actions, P < .05. Perceived relative advantage was associated with implementation of antiracist action (OR 1.94, 1.27-2.99). Complexity and trialability were not statistically significantly associated with action. Our findings provide evidence of DOIs influence on antiracism uptake in Departments of Family Medicine. We believe our findings can facilitate the future implementation of antiracism training activities and actionable antiracist policies and practices.

Barriers, Challenges, and Solutions: What Can We Learn About Leadership in Academic Medicine From a Qualitative Study of Emergency Medicine Women Chairs?

Women have made significant gains in leadership across all disciplines in academic medicine but have not yet achieved leadership parity as department chairs. The authors investigated the challenges experienced by one cohort of women department chairs in emergency medicine (EM) and the solutions they proposed to address these challenges. The authors conducted a qualitative descriptive study of 19 of 20 possible current and emeritus emergency medicine women department chairs at academic medical centers between April and December 2020. Participant interviews elicited self-reported demographic characteristics and narrative responses to a semistructured interview template that focused on the role of gender in their leadership and career trajectories. Interviews were transcribed, blinded, and iteratively coded and categorized. The analysis demonstrated 4 common challenges and 5 enacted or proposed solutions. The challenges discussed by the participants were: feeling unprepared for the role of department chair, being one of few women in leadership, inheriting unhealthy department cultures, and facing negative faculty reactions. The individual- and institutional-level solutions discussed by the participants were: gaining and maintaining confidence (individual), maintaining accountability and mission alignment (individual), facilitating teamwork (individual), supporting women's leadership (institution), and creating safe leadership cultures (institution). Women department chairs in EM were successful academic leaders despite confronting several challenges to their leadership. Considering the study findings through the lens of the concept of second-generation gender bias further illuminates the influence of gender on leadership in academic medicine. These findings suggest several possible strategies that can combat gender bias, increase gender parity among academic medicine's leadership, and improve the leadership experience for women leaders.

Members Report Uptick in Plans’ Claims Denials, Scrutiny, and Hassles

Members Report Uptick in Plans’ Claims Denials, Scrutiny, and Hassles

A Letter from Ukraine

March 30th, 2022 Dear All, My name is Ken Herrmann and I’m a nuclear medicine physician from Germany. I also chair the EANM Oncology and Theranostics Committee. I am reaching out to you today in my role as Chair of Nuclear Medicine in Essen. We are all shocked about the invasion of your country

Effects of a High Glycemic Diet and Soluble Epoxide Hydrolase Inhibitor on Hippocampal Microvascular Function, and Multigenomic Modifications

ObjectivesDiet is a modifiable risk factor for cardiovascular disease (CVD) and dementia, yet relatively little is known about the effect of a high glycemic diet (HGD) on the brain microvasculature. The objective of our study was to determine the multigenomic effects of a HGD on hippocampal microvessels, and to determine if a soluble epoxide hydrolase (sEH) inhibitor (sEHI), known to be vasculoprotective and anti-inflammatory, modulates these effects.MethodsWild type male and female mice were fed a low glycemic diet (LGD, 12% sucrose/weight) or a HGD (34% sucrose/weight) with/without the sEHI, trans-4-[4-(3-adamantan-1-yl-ureido)-cyclohexyloxy]-benzoic acid (t-AUCB), for 12 wks. Brain hippocampal microvascular gene expression was assessed by microarray and data analyzed using a multiomic approach for differential expression of protein and non-protein coding genes, gene networks, functional pathways, and transcription factors.ResultsGlobal hippocampal microvascular gene expression was fundamentally different for mice fed the HGD vs the LGD. The HGD modulated expression of genes involved in cell signaling, neurodegeneration, metabolism, and cell adhesion/inflammation/oxidation effects reversible by t-AUCB and hence sEH inhibitor correlated with protection against Alzheimer's dementia. However, in female, HGD had very minor genomic modifications, while sEHI presented significant effect in female mice on LGD.ConclusionsOurs is the first study to demonstrate that high dietary glycemia contributes to brain hippocampal microvascular inflammation, through sEH, effects that were sex-dependant.Funding SourcesThis work was supported by an award from the Richard A. and Nora Eccles Foundation (A20-0111), the Richard A. and Nora Eccles Harrison Endowed Chair in Diabetes Research (J.C.R.), and the Frances Lazda Endowed Chair in Women's Cardiovascular Medicine (A.C.V).

Trying to Be American: A Personal Reflection of the Pervasiveness of Systemic Racism and Possible Steps to Mitigate Its Impact

Tachi Yamada called to congratulate me when I accepted the role of Department Chair of Internal Medicine for the University of Utah. We spoke of the culture I would establish in the Department, which would need to balance American values of innovation, drive, and optimism, with Japanese values of giri (duty), omoiyari (caring for others), and gaman (enduring the unbearable with dignity). He reminded me that one could count on one hand the number of Medicine Department Chairs who were of Japanese descent, and that Asian American faculty remain underrepresented in leadership in medicine.

The Loss of a Great One.

The Loss of a Great One.

Editorial introductions.

Editorial introductions.