United States

2022 AMA Research Challenge

Effect on Recurrent Emergency Room Visits and Hospitalizations in Atrial Fibrillation Patients in a Dedicated Nurse Practitioner Led Atrial Fibrillation Clinic 


The OWSD General Assembly and international conference will be held entirely online for the first time in OWSD's 28-year history, allowing as many of OWSD's 7600+ members to participate as possible.

The conference theme is 'Women, science and development', exploring three areas of relevance: 1) the importance of basic sciences for development; 2) the impact of applied sciences on development and 3) including sex and gender as variables in scientific research.


**Keynote speakers include:** 
* Fabiola Gianotti, Director-General of CERN; 
* Bina Agarwal, an internationally celebrated economist specializing in the political economy of gender, poverty and inequality; and 
* Angela Saini, award-winning author of Inferior: How Science Got Women Wrong and the New Research That’s Rewriting the Story, Superior: The Return of Race Science, and other books. 

OWSD members will present their own research in the three themes during poster sessions throughout the conference. In addition, members will also present their own scientific and personal responses to the COVID-19 pandemic. All members will also have the opportunity to take part in a workshop on increasing their visibility and impact as a scientist, with a session on using podcasts for storytelling by Joy Owango and Adelle Onyango of the Training Centre in Communication (TCC Africa), followed by a session on filmmaking for impact by Nicole Leghissa, OWSD video consultant.

The conference will include a handover of the previous OWSD Executive Board to the new members, elected in June-July 2021. On the last day of the conference (19 November), the OWSD Italy Country Network will be launched. **This will be an in-person event in Trieste.** Italian government representatives and donors are invited to attend. The Trieste event will be coordinated with similar in person events being held in OWSD countries throughout the developing world and streamed online. At least 2,000 OWSD members, women scientists from developing countries around the world, are expected to participate online in the General Assembly and conference.

 

**ABOUT THE PROGRAMME**

In order to approach the complex and wide-ranging challenges of the 2030 Agenda for Sustainable Development, societies around the world must access and harness all the talent and experience available to them. The concerns and perceptions of the greatest number of all possible actors and recipients must be considered in order that the most relevant issues and effective solutions are found. Women are considerably underrepresented as researchers in STEM subjects around the globe; according to UNESCO Institute of Statistics (UIS) data, in 2019 the global average percentage of women researchers was still below 30%. Yet women typically have first hand specialist knowledge of the day-to-day challenges diverse individuals face within communities, and can be key informers in the design and development of their solutions. Moreover, since women are most often the providers of informal community support, if they are not fully informed—and if solutions are developed without their consultation—it may be the case that products, services and solutions are not relevant or appropriate. Technological advances may mean improved machines on large farms, for example, potentially increasing food production, but since the key points of food insecurity in the world are on small-scale farms managed by women throughout the Global South, such capital investments will have little impact in the areas where food production is most critical—and where women’s knowledgeable implementation of appropriate innovative technologies could make the most difference.

 
 


**Keynote Speakers:**
* Fabiola Gianotti, Director-General of CERN; 
* Bina Agarwal, an internationally celebrated economist specializing in the political economy of gender, poverty and inequality; and 
* Angela Saini, award-winning author of Inferior: How Science Got Women Wrong and the New Research That’s Rewriting the Story, Superior: The Return of Race Science, and other books. 

**Eminent Guests:**
* Elena Bonetti, Italian Minister for Family and Equal Opportunities
* Maria Cristina Messa,	Italian Minister of Universities and Research
* Shamila Nair-Bedouelle,	Assistant Director General for Natural Sciences, UNESCO
* Maria Chiara Carrozza,	President, National Research Council of Italy
* Kerstin Jonsson Cisse,	Head of Unit for Globally Sustainable Economic Development, Sida - Sweden
* Naser Faruqui,	Director of Education and Science at IDRC - Canada
* Ylann Schemm,	Director, Elsevier Foundation
* Alberto Quadrio Curzio,	President Emeritus of the Italian Academy of Sciences and Humanities 
* Mohamed Hassan,	President, TWAS the World Academy of Sciences

**Chairs, panelists, interviewers and other speakers:**
Jennifer Thomson, Tonya Blowers, Rana Dajani, Shobhana Narasimhan, Joy Owango, Elizabeth Pollitzer, Kausila Timsina, Elizabeth Bandason, Susana Arrechea, Reinabelle Reyes, Dorine Odongo, Elizabeth Pollitzer, Adelle Onyango, Nicole Leghissa, Jana Rodriguez Hertz, Maryse Nkoua Ngavouka, Kate Shaw, Chao Mbogo, Prativa Pandey, Edna Patricia Matta-Camacho, Amira Shaheen, Wezi Nyambili, Ana Lucía Martinez Abarca, Mashura Shammi, Therese Umuhoza, Dionica Gamboa, Marian Nkansah, Babalola Olubukola Oluranti, Esi Awuah, Fortunate Farirai, Atya Kapley, Hasin Anupama Azhari, Huda Basaleem, Nashwa Eassa, Shymaa Enany, Kleinsy Bonilla, Patricia Castillo-Briceno, Fang Xin

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OWSD 6th GENERAL ASSEMBLY AND INTERNATIONAL CONFERENCE

OWSD, the Organization for Women in Science for the Developing World, announces its 6th General Assembly and International Conference, which will be held from November 8-19, 2021. The conference theme is **'Women, science and development'**, exploring three areas of relevance: 1) the importance of basic sciences for development; 2) the impact of applied sciences on development and 3) including sex and gender as variables in scientific research.

poster

Welcome to the largest national, multi-specialty research event **featuring research from 750 medical students, residents and fellows, and international medical graduates.**


#### Event Details
The 2022 American Medical Association Research Challenge includes a poster symposium hall and a semifinals hall with the top scored research. Log in at any time throughout the event to:
* **View posters and presentations** on a variety of topics and specialties
* **Score posters in the semifinals** to help decide the top five finalists (AMA member exclusive opportunity)
* **Connect with participants** and provide feedback to help advance their research

At the conclusion of this event, the AMA will announce the top five finalists who will advance to the AMA Research Challenge finals, present their research to an elite panel of judges and compete to win a $10,000 grand prize sponsored by Laurel Road.
 

#### Attend Live Forums
**Oct. 20, 6 — 7 p.m. Central**
 **How to plan a career in academic medicine** 
 Learn how to plan a career in academic medicine and get your questions answered. [Access Here](https://underline.io/events/363/lounge)
 
 **Speakers**
![](https://assets.underline.io/uploads/markdown_image/1/image/d5adb133dfc58eb0a6d469e9cedcd5d4.jpg)
Ricardo Correa, MD, EdD
![](https://assets.underline.io/uploads/markdown_image/1/image/5f9437ab87861538bf02b9ca7c0d926e.jpg)
Stuart M. Greenstein, MD
![](https://assets.underline.io/uploads/markdown_image/1/image/05b1b637c99286d558c371f8e8b185ce.jpg)
Stephanie Strohbeen, MD
 
 **Oct. 22, 11 a.m. — Noon Central**
 **How to get published**
 Learn tips to get your research published and get your questions answered. [Access Here](https://underline.io/events/363/lounge)
 
 **Speakers**
![](https://assets.underline.io/uploads/markdown_image/1/image/8ce6235e957d31cb5e6f9097cc6f6972.jpg)
Jessica Li, MD/PhD Candidate
![](https://assets.underline.io/uploads/markdown_image/1/image/9950ef2e0237f54cb3d8280334d42491.jpg)
Charles Lopresto, DO

### Sponsor
AMA would like to thank Laurel Road for sponsoring a $10,000 grand prize for the winner of the AMA Research Challenge. Laurel Road is not involved in the judging or scoring process to select the winner. The winner will be announced on Dec. 7 during the AMA Research Challenge finals. Payment of the grand prize will be directly from Laurel Road. See the AMA Research Challenge Official Rules for terms and conditions.

![](https://assets.underline.io/uploads/markdown_image/1/image/611e331d4a0eba0920f240cfc04b4d77.png)

**There is no registration fee for this event! **

Register to explore research in a variety of topics. AMA members get exclusive access to score posters in the semifinals.

**Please use the link below to register for free if you have not already done so:**

https://www.ama-assn.org/about/events/ama-research-challenge

Registration Is Required

Welcome to the largest national, multi-specialty research event featuring research from 750 medical students, residents and fellows, and international medical graduates.


Association of Cutaneous Manifestations with Admission Duration Among Dengue
Fever Patients in Rural, Underserved Philippines

Association of Cutaneous Manifestations with Admission Duration Among Dengue Fever Patients in Rural, Underserved Philippines

Background
Systemic isotretinoin is a highly effective treatment for severe and refractory acne but carries risk for serious adverse effects such as teratogenicity. The United States’ risk mitigation system, iPLEDGE, requires all patients on isotretinoin therapy to complete monthly tasks including follow-up visits with their prescriber, and patients with childbearing potential must additionally undergo monthly pregnancy testing. The onset of the COVID-19 pandemic presented an opportunity to reduce the isotretinoin gender gap, as updated regulations shifted to permit at-home pregnancy testing and telehealth visits for monthly follow-ups.

Methods
We performed a single-center analysis to determine whether gender differences in isotretinoin prescription changed at our institution during the initial months of the pandemic. Data was obtained from an institutional database. Inclusion criteria were dermatology encounters during which an adult patient (age>18) was prescribed isotretinoin or topical retinoids for acne. Gender identity originated from patient-reported demographics. Fisher’s exact tests with alpha set to 0.05 were used to compare odds of isotretinoin prescription for male and female patients, with control groups comprised of patients receiving topical retinoids for acne. Odds ratios were compared for the pandemic period (June 1, 2020 to January 22, 2021) versus the pre-pandemic period (June 1, 2019 to January 22, 2020). Odds ratios were also compared between telehealth visits and in-person visits during the pandemic period.

Results
We found that male predominance of isotretinoin prescriptions was greater during the pandemic compared to pre-pandemic (odds ratios: 4.13 vs. 2.86). Furthermore, male patients were more likely to utilize telehealth compared to in-person visits relative to female patients (odds ratios: 6.00 vs. 3.62).

Conclusion
Despite the newly introduced flexibilities of telehealth and remote pregnancy testing, gender inequity in receiving isotretinoin treatment persisted during the pandemic. Many factors may influence the relative decreased access to isotretinoin among female patients including patient and provider preference. Future work should examine factors influencing the prescription of isotretinoin to female patients, as well as identify opportunities to improve policies that promote safe isotretinoin use while minimizing gender inequity.

Differences in isotretinoin access by gender during the initial months of the COVID-19 pandemic

Extensive Risk Factor Evaluation and Long-Term Assessment of Actinic Keratosis

Abstract Title: Investigating and summarizing information resources for the clinical presentation and diagnosis of cutaneous manifestations of infectious diseases in patients with skin of color (SOC).

Background: Skin of color presents disease differently in many circumstances, yet we see a lack of information regarding the presentation and diagnosis of cutaneous manifestations, specifically of those with SOC who are experiencing infectious disease. Many studies have found that SOC is underrepresented in preclinical courses for medical students and may later lead to misdiagnosis of diseases in dark-skinned populations (Louie & Wilkes, 2018; Mangione-Smith et al., 2004; Martin et al., 2016; Tsai et al., 2016). Because SOC is less represented in medical textbooks, patients with diseases such as Lyme disease presenting with cutaneous manifestations such as Erythema migrans may experience a delay in diagnosis (Fix, 2000; Ly, 2021; Palmieri, 2019). 

Methods: The databases PubMed and ScienceDirect were used to acquire research and review articles. Only resources provided in English were considered in the literature search. Articles were reviewed if they addressed cutaneous manifestations of infectious diseases in patients with SOC as a key topic. Only articles after the year 1980 were included. For inclusion, articles needed to include information regarding cutaneous manifestations of infectious diseases, specifically in patients with SOC. Articles were excluded if they contained no information regarding both Infectious disease and SOC. Duplicates were also removed. 

Results: Overall, 17 articles were identified out of 2,565 results. Searches regarding the general phrase “skin manifestations of infectious disease in “dark skin” and “HIV in "pigmented skin" yielded the most results. Many articles contained only a few sentences regarding infectious disease manifestations in patients with SOC. HIV had the highest representation of infectious disease cutaneous manifestations in patients with SOC, with five of the seventeen articles pertaining to the discussion of HIV in patients with SOC. 1,5,6,11,14,15. The most recent article discussed a study looking at the use of Perceptual and Adaptive Learning Modules (PALMs) to increase skin assessment in patients with SOC

Conclusion: This review identified significant gaps in the literature regarding cutaneous manifestations of infectious disease in SOC, such as lack of visual examples and representations of common infectious diseases in Skin of Color. Healthcare disparities in both Infectious Disease and Dermatology are present and affect the care of patients with skin of color. Increased research is needed in both fields, as well as collaboration between fields to help alleviate the barriers patients with skin of color face when obtaining care.


Investigating and summarizing information resources for the clinical presentation and diagnosis of cutaneous manifestations of infectious diseases in patients with Skin of Color.

Racial and ethnic factors associated with differences in the receipt of treatments for patients with mycosis fungoides, a type of cutaneous T-cell lymphoma

Jessica B. Brown-Korsah, BS1, Larissa De Souza, BS1, Kevin D. Cooper, MD1,2

1Case Western Reserve University School of Medicine, Cleveland, OH, USA

2 Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA

Background: Previous studies have demonstrated an association between Black race and poorer overall survival for patients with mycosis fungoides (MF). As for Hispanic patients (HPs) with MF, little is known within the literature.1–4 Due to the impact treatment may have on overall survival, we identified racial and ethnic factors associated with the receipt of treatment for MF.

Methods: A retrospective analysis of 8257 eligible patients diagnosed with MF between 2004 – 2017 within the National Cancer Database (NCDB) was performed. Multivariate logistic regression was used to identify sociodemographic factors, clinical factors, and the receipt of treatment (immunotherapy, chemotherapy, radiation, or other treatments) associated with non-Hispanic Black patients (NHBPs) and Hispanic patients (HPs), compared to non-Hispanic White patients (NHWPs). Covariates included age, sex, stage, median household income, facility type, insurance status, metro/non-metro, and Charlson-Deyo score.

Results: NHBPs and HPs consisted of 20.2% and 6.4% of patients within the study, respectively. NHBPs were less likely to receive radiation compared to NHWPs, adjusting for sociodemographic and clinical factors (aOR 0.71; 95% CI: 0.58 – 0.86; P= <.001). NHBPs were more likely to receive other treatments such as psoralen and long-wave ultraviolet radiation (PUVA) (aOR 1.39, 95% CI: 1.22 – 1.60, P = <.001). HPs were more likely to be diagnosed with Stage 4 disease (aOR 2.67; 95% CI: 1.73 – 4.03; P= <.001). No differences were noted in the receipt of treatment due to Hispanic ethnicity. 

Conclusions: NHBPs with MF were 29% less likely to receive radiation compared to NHWPs. NHBPs were 39% more likely to receive other treatments like PUVA, after adjusting for sociodemographic and clinical factors. HPs were nearly 3 times more likely to be diagnosed with Stage 4 disease compared to NHWPs, after adjusting for sociodemographic characteristics and stage. These results underline possible difficulties in accessing equitable therapies for NHBPs with MF.

References
1. Su C, Nguyen KA, Bai HX, et al. Racial disparity in mycosis fungoides: An analysis of 4495 cases from the US National Cancer Database. J Am Acad Dermatol. 
2017;77(3):497-502.e2. doi:10.1016/j.jaad.2017.04.1137 
2. Nath SK, Yu JB, Wilson LD. Poorer prognosis of African-American patients with mycosis fungoides: An analysis of the SEER dataset, 1988 to 2008. Clin Lymphoma, Myeloma Leuk. 2014;14(5):419-423. doi:10.1016/j.clml.2013.12.018
3. Sun G, Berthelot C, Li Y, et al. Poor prognosis in non-Caucasian patients with early-onset mycosis fungoides. J Am Acad Dermatol. 2009;60(2):231-235. doi:10.1016/j.jaad.2008.09.063
4. Choi J, Sutaria N, Roh YS, et al. Racial and ethnic disparities in inpatient health care utilization for mycosis fungoides: A cross-sectional analysis of the 2012-2017 National Inpatient Sample. J Am Acad Dermatol. 2022;86(6):1408-1410. doi:10.1016/j.jaad.2021.06.00

Race and ethnicity associated with differences in the receipt of treatment for mycosis fungoides

Background: 
Although white patients have higher incidence of melanoma, clinical outcomes are worse among patients with skin of color. This disparity arises from delayed diagnoses and treatment that are largely due to clinical and sociodemographic factors. These include: atypical presentation, decreased skin health literacy, stereotype threat, limited access to dermatologists, and poverty rates. Investigating these disparities is crucial to decrease the disparity in melanoma-related mortality rates in minority communities.

Methods: An extensive search of current literature was conducted using PubMed Database. Articles focusing on melanoma diagnoses, treatment, and race were reviewed to determine the current state of literature on melanoma, racial disparities, and health literacy. A 16 question survey was designed and deployed via Qualtrics to measure whether the presence of racial disparities in dermatologic awareness exists and if they may be due to social and economic factors. The survey was distributed on various social media platforms, and sites related to skin cancer or melanoma. Over 300 results were recorded and the extracted data was analyzed using SPSS software.

Results: 
Of the 308 respondents, white patients were significantly more likely to have higher perceived risk of developing skin cancer, highest self reported understanding of UV scale, highest levels of sunscreen usage, and higher reported frequency of skin checks performed by primary care providers (PCPs). There was no difference in levels of melanoma education provided by PCPs among different racial groups, and no significance identified in the highest level of patient education perceived melanoma risk. 

Conclusion:
Initial literature analysis suggests attribution of racial disparities in skin cancer to inequity in primary care settings. As a result of differential presentation and lack of dermatologic access both geographically and financially, there is delayed diagnosis and treatment time. The survey findings above do not suggest inadequate dermatologic literacy as provided in healthcare settings, but rather inadequate dermatologic health literacy as a result of other outlets such as public health and skin product marketing. Outlets such as racial stereotypes in communities, implicit biases in marketing companies, and public health campaigns should be considered. Further studies should be conducted to determine these biases and improve education in communities of color. 



Racial Disparities in Melanoma: Barriers to Diagnosis, Treatment and Health Literacy

Background
Patients experiencing homelessness (PEH) are at high risk of skin cancers due to the amount of sun exposure they receive on a daily basis. Skin disease can be overlooked and underdiagnosed in PEH due to their lack of access to healthcare, and connecting patients to appropriate specialists is a major hurdle in bridging their health disparities. Miami Street Medicine (MSM) is an organization that connects PEH in the Miami Medical District with longitudinal care. This project aims to raise awareness about the risk of skin cancers in PEH and describe a way MSM was able to bridge care for an unhoused patient with melanoma.
Methods
PEH encountered during weekly mobile clinics from January - May 2022 were provided basic medical care (vitals, wound care, medications) followed by a skin survey. A board-certified dermatologist was consulted for conditions with low diagnostic certainty. Further, patients were provided with guided treatments for their condition. Patients with high-risk lesions were connected to low-income clinical resources for further management and were concurrently followed by Street Medicine teams to improve treatment access and adherence.
Results
Among 106 patients interviewed, 102 skin conditions were diagnosed. A total of 8 lesions (7.8%) found were suspicious for cancer or pre-cancer, with 1 pathology-confirmed melanoma. Numerous barriers to care were encountered such as insurance limitations, lack of health literacy, transport issues, and lack of social support which made appointment adherence challenging. The patient with a lesion suspicious for melanoma was followed closely and scheduled for further evaluation, with eventual pathology confirmation of melanoma-in-situ. He is currently being followed by a multidisciplinary team including mental health professionals, and surgically evaluated for excision and reconstruction.
Conclusion
Skin cancer is an area of concern for PEH because of their extensive sun exposure. For many PEH, inpatient hospitalization is often the only way to access specialty care. This means that a multifaceted approach is required to improve treatment adherence, which can also include point-of-care testing or telemedicine specialist consultations. Street medicine can be a valuable adjunct to improving longitudinal care among PEH by bridging the gaps that prevent follow-up in the current healthcare delivery model.

Skin cancers among the unsheltered: a Street Medicine perspective

Background: Wildfires are a worsening public health crisis, threatening human health and healthcare infrastructure. Of the largest wildfires in California since 1878, four occurred in 2021 and five in 2020. Despite the increasing frequency of healthcare facility and community evacuations due to wildfires, little is known regarding the extent of wildfire threat to healthcare access in California. We examine where inpatient healthcare facilities are at the greatest risk of potential structural damage or facility evacuation based on fire threat data.

Methods: Inpatient facility locations including i) general and acute care hospitals, ii) behavioral health facilities, and iii) long term care facilities were mapped in relation to CAL-FIRE Fire Threat Zones (FTZs), which combine expected fire frequency with potential fire behavior. The threat zones within a half-mile and one-mile radius of each facility were computed and recorded as a metric of potential threat to the physical structure, operation, or accessibility of the facility. Regional risk profiles to facilities and facility capacity were calculated.

Results: Of 3,096 inpatient healthcare facilities, 908 (29%) are within 0.5-miles of a “high”, “very high,” or “extreme” FTZ (‘higher’ FTZ), and 1,514 (49%) within one mile. In 18 counties, 100% of inpatient healthcare facilities are within 0.5 miles of higher FTZ; in 25 counties (population 2.6 million), 100% of inpatient healthcare facilities are within one mile of higher FTZs. 67% of the inpatient healthcare facility capacity in California is within one mile of a higher FTZ. 

Conclusion: A substantial proportion of California’s inpatient healthcare infrastructure is threatened by wildfire, and this risk is unevenly distributed. In northern counties – where two of California’s largest fires burned more than one million acres in the last two years – healthcare accessibility is a significant concern because of high levels of hazard exposure and limited total number of facilities, meaning loss of a single facility can substantially affect healthcare access. As climate change and other factors raise wildfire risk, it will be important to invest in measures to protect inpatient healthcare facilities and ensure that these facilities continue to meet the healthcare needs of their communities.


An Analysis of Wildfire Threat to Inpatient Healthcare Facilities in California

Background
Depression is a common mental disorder among the geriatric population that reduces the quality of life and increases morbidity and mortality. Vitamin D is a neurosteroid hormone involved in various brain functions. Vitamin D receptors (VDR) are expressed in many brain regions, such as the hippocampus, hypothalamus, and cerebellum. It regulates the gene expression of various neurotransmitters. Furthermore, Vit D enhances the production of serotonin which suppresses depressive symptoms. Vit D deficiency is relevant in older persons and associated with an 8-14% increase in the risk of depression, particularly in subjects with low serum 25-hydroxy-vitamin D (25OHD) levels. The objective of this study is to examine the effect of Vitamin D supplements in the management of depressive symptoms in the elderly.
Methods
We searched PubMed, Google Scholar, and Clinicaltrials.gov to collect the relevant studies that examined the effects of vitamin D supplementation on depression. We used a combination of the keywords; Depression, Vitamin D, Vitamin D supplements, and Elderly to search databases. The studies collected were randomized controlled trials (RCT) in the elderly population, published within the last decade. We excluded non-English articles, observational studies, and animal studies.
Results
We reviewed eight RCTs that matched our predetermined eligibility criteria. The studies included 55,451 male and female participants. The risk and clinical symptoms of depression were assessed between the Vitamin D3 supplement groups and the control groups. Six studies showed no significant reduction in depression symptoms after Vitamin D3 supplementation. The other two studies reported improvement in depressive symptoms and a significant decline in depression scores.
Conclusion
We found a clear association between low levels of 25-hydroxyvitamin D and increased risk of depression in elder persons. However, included clinical trials, except for two studies, did not show a significant correlation between vitamin D3 supplementation and amelioration of depression symptoms in the elderly. Few studies have a small sample size which might be a limitation of this review. Future clinical trials on larger populations and longer duration are needed to investigate the causal relationship and treatment recommendations.




Effect on Recurrent Emergency Room Visits and Hospitalizations in Atrial Fibrillation Patients in a Dedicated Nurse Practitioner Led Atrial Fibrillation Clinic

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Association of Cutaneous Manifestations with Admission Duration Among Dengue Fever Patients in Rural, Underserved Philippines

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