Associations of the Informal Curriculum and Student Perceptions of Research With Family Medicine Career Choice.

BACKGROUND: The United States is facing a primary care physician shortage that is predicted to continue through the next decade. Determining why graduating medical students pursue a career in family medicine may inform efforts to help address this shortage. METHODS: Medical student responses to the Family Medicine Attitudes Questionnaire (FMAQ), a 14-item validated questionnaire developed to assess student attitudes toward family medicine, were collected at 16 US medical schools and compared to each institution's proportion of graduates entering family medicine. We also analyzed subscales of the FMAQ, including attitudes toward family medicine lifestyle, research, importance, and shortages, with respect to student choice of family medicine. We used Pearson coefficients to calculate correlations. RESULTS: Student attitudes toward family medicine careers were strongly correlated with an institution's proportion of graduates entering family medicine. Positive perceptions of family medicine research by students was the factor most strongly correlated with matching into a family medicine residency. CONCLUSION: Strengthening students' exposures and perceptions of family medicine and family medicine research may create viable opportunities for intervention by departments of family medicine and medical schools seeking to increase the number of graduates entering family medicine.

No Geographic Distribution Change Among Residency Applicants in the Neurology Match During COVID-19.

Objectives The COVID-19 pandemic posed a novel challenge for the 2020-2021 Match cycle resulting in a virtual interview season. The advent of virtual interviews raised concerns for both programs and medical students. The possibility of an impact on the application strategies for medical students resulting in students being more likely to remain in the region or state of their medical school was considered. We investigated whether there was a change in the geographic distribution of residency applicants for the class of 2025 (matched in 2021) as compared to the previous three application cycles (classes of 2022-2024) across all 168 neurology residency programs within the United States. Methods Publicly available data from neurology program websites were compiled to record the location of resident medical schools and matched programs for the residency classes of 2022-2025. Missing or ambiguous information was cross-referenced to social media, (e.g. LinkedIn and Twitter). Statistical analyses were conducted utilizing SPSS 26 (IBM SPSS 26 Statistics for Windows, Armonk, NY).  Results Across all four classes, regional retention (students matching in the same region) was 70.2% for the Northeast, 59.6% for the Midwest, 52.9% for the South, and 59.4% for the West. No significant change between the residency class of 2025 and the previous three classes was present. Discussion No significant change to the geographic trends for candidates was seen with the virtual interview process for the 2020-2021 neurology Match. As has been seen in other fields, a strong regional preference, with the majority of residents matching to programs in the same regions as their medical school, was seen for neurology.

Second-Generation Jak2 Inhibitors for Advanced Prostate Cancer: Are We Ready for Clinical Development?

Androgen deprivation therapy (ADT) for metastatic and high-risk prostate cancer (PC) inhibits growth pathways driven by the androgen receptor (AR). Over time, ADT leads to the emergence of lethal castrate-resistant PC (CRPC), which is consistently caused by an acquired ability of tumors to re-activate AR. This has led to the development of second-generation anti-androgens that more effectively antagonize AR, such as enzalutamide (ENZ). However, the resistance of CRPC to ENZ develops rapidly. Studies utilizing preclinical models of PC have established that inhibition of the Jak2-Stat5 signaling leads to extensive PC cell apoptosis and decreased tumor growth. In large clinical cohorts, Jak2-Stat5 activity predicts PC progression and recurrence. Recently, Jak2-Stat5 signaling was demonstrated to induce ENZ-resistant PC growth in preclinical PC models, further emphasizing the importance of Jak2-Stat5 for therapeutic targeting for advanced PC. The discovery of the Jak2V617F somatic mutation in myeloproliferative disorders triggered the rapid development of Jak1/2-specific inhibitors for a variety of myeloproliferative and auto-immune disorders as well as hematological malignancies. Here, we review Jak2 inhibitors targeting the mutated Jak2V617F vs. wild type (WT)-Jak2 that are currently in the development pipeline. Among these 35 compounds with documented Jak2 inhibitory activity, those with potency against WT-Jak2 hold strong potential for advanced PC therapy.

Rural Residence Predicts Lower Cardiac Mortality and Better Mental Health Outcomes.

INTRODUCTION: Previous studies have found higher rates of heart disease and worse mental health outcomes among individuals residing in rural areas. To our knowledge, no research has used county-level data to measure the effect of "ruralness" (the degree to which a county is rural) on heart disease and mentally unhealthy days while controlling for other sociodemographic factors. This study analyzes the effect of ruralness on heart disease death rates and the average number of mentally unhealthy days on a county-level. METHODS: Linear regressions were performed using county-level data to analyze the effect of "Ruralness" on heart disease death rates and mental unhealthiness while controlling for confounding variables. Geographic analysis was also used. RESULTS: Higher rural-urban continuum codes predict lower rates of cardiac mortality (ß = -.075 deaths per 100,000 people/continuum code, t = -4.36, P <.001) and fewer mentally unhealthy days (ß = -.265 monthly mentally unhealthy days/continuum code, t = -16.45, P < .001). CONCLUSION: Being from a rural area correlates with lower rates of heart disease death and mental unhealthiness after controlling for sociodemographic confounders. This adds nuance to the previously reported trend of heart disease being more prevalent in rural areas.

Atypical Blue Rubber Bleb Nevus in an African-American Male.

Blue Rubber Bleb Nevus Syndrome (BRBNS), also known as Bean Syndrome, is a rare condition characterized by vascular ectasias that typically present systemically. Most diagnoses are made in early childhood due to cutaneous lesions in Caucasians with familial inheritance. Treatment is usually patient centered due to the wide variance in clinical presentation of the disease. Here, we present a case of BRBNS in a 65-year-old African-American patient with episodic gastrointestinal (GI) bleeding with no previous history. This case emphasizes the need for a higher clinical suspicion of the disease in patients with recurrent GI bleeding.

Acute Pericarditis Due to SARS-COV-2 in a Kidney Transplant Recipient.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly contagious and typically presents with respiratory complications. Non-respiratory etiology has been increasingly identified in the literature, including cardiac manifestations. Here, we discuss an atypical case recently treated for SARS-CoV-2 presenting with acute pericarditis. Our patient's medical history of autoimmune disease and renal transplant further complicated her care. There is currently no standard of therapy for SARS-CoV-2-related pericarditis. We would like to highlight increased awareness of this rare complication as well as successful treatment regimens for acute management of the disease.