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BACKGROUND: Diversity in medicine improves mentorship and patient care. However, dermatology is one of the least diverse specialties. We analyzed the racial distributions across leadership positions at academic dermatology programs and explored potential influences on resident racial/ethnic composition. Methods: A list of ACGME-accredited dermatology programs was obtained. Residency program websites, hospital websites, and publicly available data were used to ascertain race and ethnicity of academic dermatology leadership and residents. SAS version 9.4 was used to calculate descriptive statistics and associations between racial/ethnic composition of dermatologists in leadership positions and residents. Results: URM individuals were significantly underrepresented across both leadership (6.9%) and resident (12.0%) positions. No statistically significant correlation was found between the percent of URM leadership and URM residents. Conclusion: Diversity among the US population, medical students, dermatology trainees, and faculty are not reflected in departmental leadership in academic dermatology. This may influence URM recruitment into the field, retention of URM faculty and residents, and mentorship opportunities for URM dermatologists interested in leadership positions. Efforts are needed to improve disparities in representation across leadership roles in academic dermatology. Fritsche M, Singh P, Zhou S, et al. Racial and ethnic disparities among US Academic Dermatology Leadership and its influence on resident diversity. J Drugs Dermatol. 2023;22(7):653-656. doi:10.36849/JDD.7114.
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Dermatología , Internado y Residencia , Humanos , Estados Unidos , Grupos Minoritarios , Liderazgo , Diversidad Cultural , EtnicidadRESUMEN
BACKGROUND: Previous reviews of rural physical activity interventions were focused on intervention effectiveness and had reported overall mixed findings. The purpose of this systematic review was to apply the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate the extent to which rural physical activity interventions in the U.S. have reported on dimensions of internal and external validity and to offer suggestions for future physical activity interventions for rural U.S. METHODS: Pubmed, PsychINFO, CINAHL, PAIS, and Web of Science were searched through February 2019 to identify physical activity intervention studies conducted in rural regions in the U.S. with adult populations. Titles, abstracts, and full texts of articles were reviewed against inclusion and exclusion criteria. Data extraction from included articles included a summary of study details, rural classification system used, and the presence or absence of a total 61 RE-AIM indicators, including reach (n = 13), efficacy/effectiveness (n = 10), adoption (n = 21), implementation (n = 9), and maintenance (n = 8). RESULTS: A total of 40 full-text articles representing 29 unique studies were included. Classifications of rurality included self-statements by authors (n = 19, 65.5%), population/census-based definitions (n = 3, 10.3%), Rural Urban Continuum Codes (n = 3, 10.3%), Rural Urban Commuting Area codes (n = 2, 6.9%), the 2014 Alabama Rural Health Association classification system (n = 1, 3.4%) and the U.S. Office of Management and Budget classification system (n = 1, 3.4%). Individual studies reported between 14.8 to 52.5% of total RE-AIM indicators. Studies reported 15.4 to 84.6% indicators for reach; 20.0 to 70.0% indicators for efficacy/effectiveness; 4.8 to 47.6% indicators for adoption; 11.1 to 88.9% indicators for implementation; and 0 to 25.0% indicators for maintenance. CONCLUSIONS: We found an overall poor reporting of components related to external validity, which hinders the generalizability of intervention findings, and a lack of consistency in the definition of rurality. Future research should focus on balancing factors of internal and external validity, and should aim to develop a greater understanding of how rurality influences health and behavior to provide contextual knowledge needed to advance the translation of physical activity interventions into practice in rural communities and reduce rural health disparities. TRIAL REGISTRATION: The review protocol was registered with PROSPERO: CRD42019116308.
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Ejercicio Físico/fisiología , Promoción de la Salud/métodos , Población Rural/estadística & datos numéricos , Humanos , Masculino , Estados UnidosRESUMEN
Withania somnifera is a highly valued medicinal plant in traditional home medicine and is known for a wide range of bioactivities. Its commercial cultivation is adversely affected by poor seed viability and germination. Infestation by various pests and pathogens, survival under unfavourable environmental conditions, narrow genetic base, and meager information regarding biosynthesis of secondary metabolites are some of the other existing challenges in the crop. Biotechnological interventions through organ, tissue, and cell culture provide promising options for addressing some of these issues. In vitro propagation facilitates conservation and sustainable utilization of the existing germplasms and broadening the genetic base. It would also provide means for efficient and rapid mass propagation of elite chemotypes and generating uniform plant material round the year for experimentation and industrial applications. The potential of in vitro cell/organ cultures for the production of therapeutically valuable compounds and their large-scale production in bioreactors has received significant attention in recent years. In vitro culture system further provides distinct advantage for studying various cellular and molecular processes leading to secondary metabolite accumulation and their regulation. Engineering plants through genetic transformation and development of hairy root culture system are powerful strategies for modulation of secondary metabolites. The present review highlights the developments and sketches current scenario in this field.
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Biotecnología/métodos , Técnicas de Cultivo de Célula/métodos , Fitoquímicos/química , Técnicas de Cultivo de Tejidos/métodos , Withania/química , Biomasa , Reactores Biológicos , Proliferación Celular , Germinación , Extractos Vegetales/química , Raíces de Plantas/química , Brotes de la Planta/química , Brotes de la Planta/crecimiento & desarrollo , Plantas Medicinales/química , Plantas Medicinales/crecimiento & desarrollo , Sustancias Protectoras/química , Withania/crecimiento & desarrollo , Witanólidos/químicaRESUMEN
Withania somnifera (L.) Dunal known as Ashwagandha is commonly used in traditional Indian medicine system. It possesses immense therapeutic value against a large number of ailments such as mental diseases, asthma, inflammation, arthritis, rheumatism, tuberculosis, and a variety of other diseases including cancer. The therapeutic potential of W. somnifera is due to the presence of secondary metabolites mainly, tropane alkaloids and withanolides (steroidal lactones). The growing realization of commercial value of the plant has initiated a new demand for in vitro propagation of elite chemotypes of Withania. Micropropagation which is an important tool for rapid multiplication requires optimization of number of factors such as nutrient medium, status of medium (solid and liquid), type of explant, and plant growth regulators. Similarly, an efficient and reproducible in vitro regeneration system which is a prerequisite for the development of genetic transformation protocol requires precise manipulation of various intrinsic and extrinsic factors.
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Técnicas de Cultivo/métodos , Withania/crecimiento & desarrollo , Medios de Cultivo/metabolismo , Técnicas Histológicas/métodos , Reguladores del Crecimiento de las Plantas/metabolismo , Raíces de Plantas/crecimiento & desarrollo , Raíces de Plantas/fisiología , Brotes de la Planta/crecimiento & desarrollo , Brotes de la Planta/fisiología , Regeneración , Withania/fisiología , Witanólidos/metabolismoRESUMEN
Context Dunaliella salina Teodoresco (Dunaliellaceae) is one of the promising microalgae consumed as food and medicine for many years. Objective Dunaliella salina was grown under different stress conditions for enhancing carotene production. The carotene enriched extract was evaluated for antioxidant and cytotoxic activity. Materials and methods Carotene content was calculated under salinity, nitrogen and temperature stress conditions. Antioxidant activity was determined through DPPH assay by incubating the samples for 45 min with 250 µg/mL of extract and reducing power assay was performed with 50, 100, 150 and 200 µg/mL of extract. Cytotoxicity was determined by incubating â¼2 × 10(4) MCF-7 (breast cancer) cells with 250 µg of extract in each well for 72 h by MTT assay. Result Carotene content was significantly increased to 9.8 (3.5 M NaCl), 13.9 (37 °C), 8.2 (250 mM KNO3) and 10.6 µg/mL (nitrogen-depleted medium) as compared with 3.2 µg/mL in normal conditions (1.7 M NaCl, 0.75 mM KNO3 and 28 °C). Free radical scavenging activity increased at 3.0 and 3.5 M NaCl (27.8 and 57.5%, respectively), 37 °C (31.4%) and in nitrogen-depleted medium (41.9%) compared with normal (15%) conditions. Carotene content and scavenging activity were positively correlated under salinity (r = 0.97), temperature (r = 0.85) and nitrogen (r = 0.7) stress conditions. Cytotoxicity against MCF-7 cell lines increased due to increase in carotene content suggesting that cytotoxicity may be associated with carotene accumulation. Discussion and conclusions Carotene content enhanced by D. salina under stress conditions increased the antioxidant and cytotoxic activity.
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Antineoplásicos/farmacología , Antioxidantes/farmacología , Neoplasias de la Mama/tratamiento farmacológico , Carotenoides/farmacología , Microalgas/metabolismo , Estrés Fisiológico , Antineoplásicos/metabolismo , Antioxidantes/metabolismo , Neoplasias de la Mama/patología , Carotenoides/metabolismo , Supervivencia Celular/efectos de los fármacos , Femenino , Humanos , Células MCF-7 , Microalgas/crecimiento & desarrollo , Nitratos/metabolismo , Compuestos de Potasio/metabolismo , Salinidad , Cloruro de Sodio/metabolismo , Temperatura , Factores de TiempoRESUMEN
Withania somnifera is one of the most valued plants and is extensively used in Indian, Unani, and African systems of traditional medicine. It possess a wide array of therapeutic properties including anti-arthritic, anti-aging, anti-cancer, anti-inflammatory, immunoregulatory, chemoprotective, cardioprotective, and recovery from neurodegenerative disorders. With the growing realization of benefits and associated challenges in the improvement of W. somnifera, studies on exploration of genetic and chemotypic variations, identification and characterization of important genes, and understanding the secondary metabolites production and their modulation has gained significant momentum. In recent years, several in vitro and in vivo preclinical studies have facilitated the validation of therapeutic potential of the phytochemicals derived from W. somnifera and have provided necessary impetus for gaining deeper insight into the mechanistic aspects involved in the mode of action of these important pharmaceutically active constituents. The present review highlights some of the current developments and future prospects of biotechnological intervention in this important medicinal plant.
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Fitoquímicos/farmacología , Sustancias Protectoras/farmacología , Withania/genética , Witanólidos/metabolismo , Vías Biosintéticas , Humanos , Fitoquímicos/uso terapéutico , Proteínas de Plantas/genética , Plantas Medicinales/genética , Plantas Medicinales/metabolismo , Regiones Promotoras Genéticas , Sustancias Protectoras/uso terapéutico , Metabolismo Secundario , Withania/metabolismoRESUMEN
BACKGROUND: Good medication adherence is the cornerstone of therapeutic success. Alzheimer's disease (AD) is the most common type of dementia and most patients are old and on multiple drugs, and good compliance therefore is even more important in this population. Dementia of Alzheimer's type (DAT) at present is yet to find a cure. Anticholinesterases and N-methyl-D-aspartate blockers are specific anti-AD therapies available. Hypertension, diabetes, and dyslipidemia can contribute to cognitive worsening. Keeping hypertension, diabetes, and dyslipidemia in control can therefore possibly prevent further cognitive decline. METHODS: Patients with subjective memory complaints (n = 75) were chosen randomly. Upon thorough neurological diagnostic work up for dementia, those with mild cognitive impairment/questionable dementia (Clinical Dementia Rating = 0.5) or those with AD were recruited in this study (n = 67). Those with hypertension, diabetes, and deranged lipid profile were further interviewed if they were able to take medicines regularly or not. An attempt was made to know causes of non-compliance. RESULTS: Forty-one percent of patients were not taking the drugs that have potential to prevent cardiovascular complications or ability to slow down cognitive decline in AD on regular basis. The lack of awareness, ignorance, medicines being "too expensive," and the pressure of taking medicines regularly were cited as the reasons for non-compliance. Being illiterate and having low education contributed majorly to poor compliance in this study. CONCLUSION: Compliance to drugs that have potential or real ability to slow down cognitive decline is low in elderly people with DAT.