2020 Medical Student Research Conference Abstracts

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2020 Medical Student Research Conference Abstracts ABSTRACTS Medical Student Virtual Research Conference September 16-17, 2020 University of Iowa Roy J. & Lucille A. Carver College of Medicine Sponsored by: Medical Student Research Council Free to University of Iowa Students Diversity in Academic Dermatology: Taking a closer look at the distribution of underrepresented minorities in academic dermatology 1 2 3 4 5 Roshan Abid, BA ,​ Zakariyah Sharif-Sidi, BS ,​ Edgar Martinez BS ,​ Rithu Srikantha, MD ,​ Amit G. Pandya, MD ,​ Amy 6​ ​ 1 ​ ​ ​ McMichael, MD ,​ Nkanyezi K. Ferguson, MD ​ ​ 1 2 3 U​ niversity of Iowa Hospitals and Clinics, Iowa City, IA, M​ edical College of Wisconsin, Milwaukee, WI, U​ niversity 4 ​ 5 ​ of Texas Southwestern Medical Center, Dallas, TX, A​ lbert Einstein College of Medicine, Bronx, NY, P​ alo Alto 6 ​ ​ Medical Foundation, Mountain View, CA, W​ ake Forest University, Winston-Salem, NC ​ Abstract: The United States population is becoming increasingly diverse, with 39.6% of the population identifying ​ as a race other than non-Hispanic white in 2018. The U.S. Census Bureau estimates that this number will rise to over half the country’s population by 2045. However, these rising population trends are not observed in many medical specialties– particularly at academic training centers. Among all U.S medical school full-time faculty in 2019, only 3.8% identified as Black and 5.8% identified as Hispanic. For academic dermatology, the numbers are even more staggering, with 2.7% identifying as Black and 4.9% identifying as Hispanic. Additional demographic data for fellowship-trained dermatologists at academic institutions is virtually nonexistent, making it difficult to identify barriers within the field. We know from previous studies examining patient-physician relations that in race-concordant visits, a more diverse physician workforce results in increasingly satisfied patients– an important link in achieving higher rates of continuity of care. T​ o date, most studies exploring diversity in academic ​ dermatology have focused on sex, race, ethnicity, and academic rank at the national level. The purpose of this study was to further characterize underrepresented minorities (URMs) in academic dermatology. We designed a cross-sectional study to analyze the representation of URM faculty in academic dermatology during the 2019 – 2020 academic year. Race, ethnicity, gender, and fellowship training of URM dermatology faculty were collected using publicly available information on program websites and professional websites, such as LinkedIn. For the purposes of this study, faculty images, names, and personal biographies were used at the discretion of data collectors to determine faculty race and ethnicity. The list of faculty with URM race or ethnicity designations were then reviewed by a panel of three senior academic dermatologists, who cross-referenced the data with local faculty members in each region. For geographic comparison, United States Census regional population projections for 2019 were also collected by race and ethnicity for comparison Publicly available data from 112 academic dermatology program websites demonstrated a total of 168 URM academic dermatologists. Geographic breakdown showed that all regions exhibited larger disparities in both Black and Latino representation among academic dermatologists when compared with Black and Latino representation of the respective regional populations. Moreover, roughly one fourth of Black academic dermatologists and Hispanic academic dermatologists achieved relevant fellowship training. This study has allowed for further characterization of URM dermatologists in academic settings beyond limited self-reported data available through AAMC. Limitations of this study include reliance of program websites to be up-to-date and difficulty in accurately determining faculty race and ethnicity based on name and photograph. Future studies are needed to identify barriers to entry for URM dermatologists into academics and effective strategies to increase representation. The results of this study will hopefully provide a better understanding of the current state of diversity in academic dermatology, as barriers to entry and other factors affecting diversity are further explored. AUTOMATIC VOLUMETRIC ANALYSYS OF THE DISTAL TIBIOFIBULAR SYNDESMOTIC INCISURA. A CASE-CONTROL STUDY OF SUBTLE CHRONIC SYNDESMOTIC INSTABILITY. Authors Samuel Ahrenholz (University of Iowa, Department of Orthopaedics and Rehabilitation) Cesar de Cesar Netto, MD, PhD (University of Iowa, Department of Orthopaedics and Rehabilitation) Introduction Chronic subtle distal tibiofibular syndesmotic instability (DTFSI) is relatively common, and consequences of undiagnosed injuries can be devastating. Diagnosing acute and chronic injuries is challenging, and the most commonly used diagnostic tools are physical exam, weightbearing conventional radiographs, non-weightbearing bilateral CT scans, and MRI. Arthroscopic assessment, an invasive method, is currently considered the gold standard. Weightbearing CT has just emerged as an excellent dynamic non-invasive diagnostic test. Recent literature highlighted the accuracy of syndesmotic incisura area measurements in diagnosing subtle DTFSI. Purpose of the Study The aim of our study was to develop and validate the use of a novel automatic 3D volumetric assessment of the tibiofibular incisura, and to compare the measurements between patients with surgically confirmed DTFSI and controls. Methods In this IRB-approved case-control study, patients with suspected unilateral chronic subtle DTFSI underwent bilateral standing weightbearing CT (WBCT) examination before surgical treatment. DTFSI was confirmed by arthroscopic assessment. We also included control patients that underwent WBCT tests for forefoot related problems and no history of syndesmotic injuries. The syndesmotic incisura volume (mm3) was measured starting at the level of the ankle joint to two proximal points, 10 and 15mm proximally to the joint. A 3D automatic measurement algorithm composed of automated segmentation of the distal tibia and fibula and recognition of the incisura volume based on Hounsfield units (HU) assessment was performed. Measurements were compared between DTFSI patients and controls. A partition prediction model, ROC curves and area under the curve (AUC) were performed to assess the diagnostic accuracy of the automatic volumetric analysis to detect DTFSI. P-values of less than 0.05 were considered statistically significant. Results In this preliminary report, four patients with DTFSI and seven controls were included. Mean value and 95% CI for 3D Syndesmotic Incisura 10mm/15mm volumetric measurements at 10 and 15mm points were: 1457 mm3 (1233 to 1680)/2241 mm3 (1951 to 2531) for controls, and 1679 mm3 (910 to 2447)/2425 mm3 (1408 to 3443) for patients with DTFSI (p- values of respectively 0.35 and 0.55). When comparing injured and uninjured DTFSI ankles, volume measurements at 10 and 15mm points were increased on injured ankles, with a Hodges-Lehmann difference of respectively 287 mm3 (p=0.19), and 186 mm3 (p=0.31). The partition model demonstrated that the volume of the first 10mm was the best predictor of DTFSI, with only a 3% chance of DTFSI when Figure 1. Example of measure methods and graphical plot representation of the results the incisura volume was below 1291 mm3 (AUC=0.71). Conclusion Our study aimed to describe and validate the use of a novel automatic 3D volumetric measurement of the distal tibiofibular incisura in patients with chronic subtle ankle syndesmotic instability and controls. Our preliminary results demonstrated increased volumes on injured ankles when compared to contralateral uninjured ankles and controls. Measurements performed within the first 10mm length of the syndesmosis were found to better predict the presence of syndesmotic instability, with a volume of 1291 mm3 representing an important diagnostic threshold. Automatic 3D WBCT volumetric measurements may represent a useful non-invasive diagnostic tool for subtle and chronic syndesmotic instability. Delayed Anterior Segment Complications After Treatment of Retinopathy of Prematurity with Laser Photocoagulation Aparna S. Ajjarapu, BA; Alina Dumitrescu, MD Introduction: Retinopathy of Prematurity (ROP) is a disease that affects the retinal vasculature of premature infants and is a leading cause of childhood blindness worldwide. Laser photocoagulation is recognized as the standard treatment for ROP but it has been reported to be associated with ocular complications such as complications of the anterior segment. The majority of studies have reported on anterior segment complications in the short-term after laser treatment for ROP but few studies have reported on anterior segment complications in the long-term. Furthermore, delayed onset anterior segment pathology, such as band keratopathy, changes of the iris and anterior chamber, and cataract formation in the absence of inflammation or other risk factors, have been observed at the Pediatric Ophthalmology and Adult Strabismus Clinic at the University of Iowa Hospitals and Clinics. Purpose: To report on the clinical characteristics and long-term visual outcomes in a cohort of premature infants who had long-term follow up and developed anterior segment complications after laser therapy for threshold ROP. Method: A retrospective review of the medical records of premature infants with a diagnosis of ROP undergoing laser therapy from February 23, 1988 to May 7, 2020 was conducted. All patients that developed delayed
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