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Article: Calorie Restriction and Intermittent Fasting: Impact on Glycemic Control in People With Diabetes.

Ganesan, Kavitha / Habboush, Yacob / Dagogo-Jack, Samuel

Diabetes spectrum : a publication of the American Diabetes Association

2020 Volume 33, Issue 2, Page(s) 143–148

Abstract: Intermittent fasting has been suggested as an option for managing overweight and obesity. The purpose of this article is to present a balanced review of the practice of intermittent fasting and its impact on glycemic control in people with diabetes. ...

Abstract	Intermittent fasting has been suggested as an option for managing overweight and obesity. The purpose of this article is to present a balanced review of the practice of intermittent fasting and its impact on glycemic control in people with diabetes.
Language	English
Publishing date	2020-05-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2211544-4
ISSN	1040-9165
ISSN	1040-9165
DOI	10.2337/ds19-0064
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: An integrated public health approach for a successful strategy against HIV

Yacob Habboush / Noor Daoud

Journal of Health and Social Sciences, Vol 3, Iss 3, Pp 215-

The case of Swaziland

2018 Volume 222

Abstract: Swaziland is an inland country in the southern Africa with a population of less than 1.5 million. Human immunodeficiency virus (HIV) is the main public health concern in Swaziland as 27.2% of adults are living with HIV infection. Swaziland is known to ... ...

Abstract	Swaziland is an inland country in the southern Africa with a population of less than 1.5 million. Human immunodeficiency virus (HIV) is the main public health concern in Swaziland as 27.2% of adults are living with HIV infection. Swaziland is known to have the highest prevalence of HIV infected people in the world. However, this might be changing soon as the incidents of new HIV infection are decreasing and the prevalence of HIV infection are stabilizing. This is due to the multiple well-implemented programs that are targeting the different components of HIV transmission including condom availability, HIV education, sex education, male circumcision, and pre-exposure prophylaxis. Although the prevalence of HIV is stabilizing, there are multiple gaps that need to be addressed by new programs to ensure that the prevalence remains stable and aim to decrease it in the future by providing the appropriate antiretroviral treatment and better access to healthcare. However, such programmes cannot be effective without improving the socio-economic and educational levels of people, understanding their beliefs and meeting their needs.
Keywords	Africa ; education ; incidence ; health policy ; HIV ; Swaziland ; Medicine (General) ; R5-920 ; Social sciences (General) ; H1-99
Subject code	360
Language	English
Publishing date	2018-11-01T00:00:00Z
Publisher	Edizioni FS
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Implementing a clinical-educator curriculum to enrich internal medicine residents' teaching capacity.

Habboush, Yacob / Stoner, Alexis / Torres, Claribel / Beidas, Sary

BMC medical education

2019 Volume 19, Issue 1, Page(s) 459

Abstract: Introduction: Physicians-in-training (residents) are typically the primary educators for medical students during clinical clerkships. However, residents are not formally trained to teach or to assess their teaching. The aim of this study was to assess ... ...

Abstract	Introduction: Physicians-in-training (residents) are typically the primary educators for medical students during clinical clerkships. However, residents are not formally trained to teach or to assess their teaching. The aim of this study was to assess the implementation of a clinical educator rotation aimed at developing residents' competencies related to clinical teaching. Methods: A mixed-methods approach was used to develop and assess the clinical educator rotation at a teaching community hospital. Internal medicine residents who participated in the rotation and consented to the research were assigned to the clinical educator trainee (CET) group, the remaining residents were assigned to the control group. Osteopathic medical students rotating in the medicine service line were invited to participate. The study used descriptive and qualitative analyses to measure primary and secondary outcomes. Results: The primary outcome measure showed a positive change in resident knowledge, skills and behaviors in communication, reflection, feedback, precepting, and facilitation. Medical student perceptions of resident teaching skills confirmed the observed changes in CETs. Some CETs continued to practice and build their capacity for teaching after completing the rotation. Qualitatively, we derived four common themes among the data; communication, professional engagement, practice-based learning, and systems-based learning. Conclusion: Resident teaching capacity was enriched after completing the clinical educator rotation. Other benefits included: enhanced patient communication and education, increased resident confidence, personal satisfaction with training, work life-balance and enhanced career satisfaction. Future research should focus on curricular content, faculty development, and delivery assessment. In addition, research efforts should identify appropriate emerging technologies to include in the curriculum for enhancing teaching capacity.
MeSH term(s)	Clinical Competence ; Curriculum ; Education, Medical, Graduate ; Focus Groups ; Humans ; Internal Medicine/education ; Internship and Residency ; Program Evaluation ; Prospective Studies ; Surveys and Questionnaires ; Teaching
Language	English
Publishing date	2019-12-11
Publishing country	England
Document type	Evaluation Study ; Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-019-1888-0
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Implementing a clinical-educator curriculum to enrich internal medicine residents’ teaching capacity

Yacob Habboush / Alexis Stoner / Claribel Torres / Sary Beidas

BMC Medical Education, Vol 19, Iss 1, Pp 1-

2019 Volume 12

Abstract: Abstract Introduction Physicians-in-training (residents) are typically the primary educators for medical students during clinical clerkships. However, residents are not formally trained to teach or to assess their teaching. The aim of this study was to ... ...

Abstract	Abstract Introduction Physicians-in-training (residents) are typically the primary educators for medical students during clinical clerkships. However, residents are not formally trained to teach or to assess their teaching. The aim of this study was to assess the implementation of a clinical educator rotation aimed at developing residents’ competencies related to clinical teaching. Methods A mixed-methods approach was used to develop and assess the clinical educator rotation at a teaching community hospital. Internal medicine residents who participated in the rotation and consented to the research were assigned to the clinical educator trainee (CET) group, the remaining residents were assigned to the control group. Osteopathic medical students rotating in the medicine service line were invited to participate. The study used descriptive and qualitative analyses to measure primary and secondary outcomes. Results The primary outcome measure showed a positive change in resident knowledge, skills and behaviors in communication, reflection, feedback, precepting, and facilitation. Medical student perceptions of resident teaching skills confirmed the observed changes in CETs. Some CETs continued to practice and build their capacity for teaching after completing the rotation. Qualitatively, we derived four common themes among the data; communication, professional engagement, practice-based learning, and systems-based learning. Conclusion Resident teaching capacity was enriched after completing the clinical educator rotation. Other benefits included: enhanced patient communication and education, increased resident confidence, personal satisfaction with training, work life-balance and enhanced career satisfaction. Future research should focus on curricular content, faculty development, and delivery assessment. In addition, research efforts should identify appropriate emerging technologies to include in the curriculum for enhancing teaching capacity.
Keywords	Clinical educator ; Graduate medical education ; Residents ; Medical students ; Special aspects of education ; LC8-6691 ; Medicine ; R
Subject code	370
Language	English
Publishing date	2019-12-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Intermittent Fasting: The Choice for a Healthier Lifestyle.

Ganesan, Kavitha / Habboush, Yacob / Sultan, Senan

Cureus

2018 Volume 10, Issue 7, Page(s) e2947

Abstract: Obesity is a worldwide epidemic due to the availability of many unhealthy food options and limited physical exercise. Restriction of the daily food intake results in weight loss, which is also associated with better health outcomes including ... ...

Abstract	Obesity is a worldwide epidemic due to the availability of many unhealthy food options and limited physical exercise. Restriction of the daily food intake results in weight loss, which is also associated with better health outcomes including triglycerides, total cholesterol, low-density lipoprotein cholesterol, blood pressure, glucose, insulin, and C-reactive protein. Our aim is to briefly discuss the effects of intermittent fasting on weight and other biochemical markers mentioned previously. The study is designed as a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. To assess the effectiveness of intermittent fasting, related studies were reviewed between 2000 and 2018 and 815 studies were identified. Only four articles met the preset inclusion and exclusion criteria. All four studies have shown a significant decrease in fat mass with P-values <0.01. It was also noted that some biochemical markers were significantly reduced such as the reduction in low-density lipoprotein and triglyceride with P-values < 0.05. Other biochemical markers had inconsistent results. Based on the qualitative analysis, intermittent fasting was found to be efficient in reducing weight, irrespective of the body mass index. Further studies are needed to assess the ability to maintain the lost weight without regaining it and the long-term effects of such dietary changes.
Language	English
Publishing date	2018-07-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.2947
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Electronic Health Records as an Educational Tool: Viewpoint.

Habboush, Yacob / Hoyt, Robert / Beidas, Sary

JMIR medical education

2018 Volume 4, Issue 2, Page(s) e10306

Abstract: Background: Electronic health records (EHRs) have been adopted by most hospitals and medical offices in the United States. Because of the rapidity of implementation, health care providers have not been able to leverage the full potential of the EHR for ... ...

Abstract	Background: Electronic health records (EHRs) have been adopted by most hospitals and medical offices in the United States. Because of the rapidity of implementation, health care providers have not been able to leverage the full potential of the EHR for enhancing clinical care, learning, and teaching. Physicians are spending an average of 49% of their working hours on EHR documentation, chart review, and other indirect tasks related to patient care, which translates into less face time with patients. Objective: The purpose of this article is to provide a preliminary framework to guide the use of EHRs in teaching and evaluation of residents. Methods: First we discuss EHR educational capabilities that have not been reviewed in sufficient detail in the literature and expand our discussion for each educational activity with examples. We emphasize quality improvement of clinical notes as a basic foundational skill using a spreadsheet-based application as an assessment tool. Next, we integrate the six Accreditation Council for Graduate Medical Education (ACGME) Core Competencies and Milestones (CCMs) framework with the Reporter-Interpreter-Manager-Educator (RIME) model to expand our assessments of other areas of resident performance related to EHR use. Finally, we discuss how clinical utility, clinical outcome, and clinical reasoning skills can be assessed in the EHR. Results: We describe a pilot conceptual framework-CCM framework-to guide and demonstrate the use of the EHR for education in a clinical setting. Conclusions: As EHRs and other supporting technologies evolve, medical educators should continue to look for new opportunities within the EHR for education. Our framework is flexible to allow adaptation and use in most training programs. Future research should assess the validity of such methods on trainees' education.
Language	English
Publishing date	2018-11-12
Publishing country	Canada
Document type	Journal Article
ISSN	2369-3762
ISSN	2369-3762
DOI	10.2196/10306
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Use of Grading of Recommendations, Assessment, Development, and Evaluation to Combat Fake News: A Case Study of Influenza Vaccination in Pregnancy.

Zafar, Sidra / Habboush, Yacob / Beidas, Sary

JMIR medical education

2018 Volume 4, Issue 2, Page(s) e10347

Abstract: Background: The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework is a validated evaluation tool used to assess the quality of scientific publications. It helps in enhancing clinicians' decision-making process and ... ...

Abstract	Background: The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework is a validated evaluation tool used to assess the quality of scientific publications. It helps in enhancing clinicians' decision-making process and supports production of informed healthy policy. Objective: The purpose of this report was two-fold. First, we reviewed the interpretation of observational studies. The second purpose was to share or provide an example using the GRADE criteria. Methods: To illustrate the use of the GRADE framework to assess publications, we selected a study evaluating the risk of spontaneous abortion (SAB) after influenza vaccine administration. Results: Since 2004, the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practice have recommended influenza vaccination of pregnant women. Previous studies have not found an association between influenza vaccination and SAB. However, in a recent case-control study by Donahue et al, a correlation with SAB in women who received the H1N1 influenza vaccine was identified. For women who received H1N1-containing vaccine in the previous and current influenza season, the adjusted odds ratio (aOR) for SAB was 7.7 (95% CI, 2.2-27.3), while the aOR for women not vaccinated in the previous season but vaccinated in the current season was 1.3 (95% CI, 0.7-2.7). Conclusions: Our goal is to enable the readers to critique published literature using appropriate evaluation tools such as GRADE.
Language	English
Publishing date	2018-11-07
Publishing country	Canada
Document type	Journal Article ; Review
ISSN	2369-3762
ISSN	2369-3762
DOI	10.2196/10347
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Transdermal Testosterone in Female Hypoactive Sexual Desire Disorder: A Rapid Qualitative Systematic Review Using Grading of Recommendations Assessment, Development and Evaluation.

Ganesan, Kavitha / Habboush, Yacob / Sultan, Senan

Cureus

2018 Volume 10, Issue 3, Page(s) e2401

Abstract: Female hypoactive sexual desire disorder (HSDD) is a multifactorial sexual dysfunction disorder characterized by a decrease in sexual desire and personal distress. HSDD occurs in naturally occurring postmenopausal women or secondary to oophorectomy. ... ...

Abstract	Female hypoactive sexual desire disorder (HSDD) is a multifactorial sexual dysfunction disorder characterized by a decrease in sexual desire and personal distress. HSDD occurs in naturally occurring postmenopausal women or secondary to oophorectomy. Multiple studies have assessed the use of transdermal testosterone (TDT) as a management option for patients with HSDD. Our aim is to assess published studies using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for the quality of evidence regarding testosterone use as a short- and long-term therapy for HSDD. We implemented this qualitative systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. We set a GRADE score of 4 (high evidence) as a cutoff point for the quality measure of published studies assessing the use of TDT in HSDD. The outcomes of interest were the efficacy of TDT on the total number of satisfying sexual activity, number of orgasms, sexual desire and distress level in patients with HSDD. These outcomes were evaluated through Sexual Activity Log (SAL), Profile of Female Sexual Function (PFSF), and Personal Distress Scale (PDS) evaluation tools. Five randomized controlled trials were identified to meet the inclusion criteria. The selected studies were of high evidence based on the GRADE score as two of the studies scored 4 points, the other two studies scored 5 points and one study scored 6 points. All of the high quality selected studies had similar outcomes suggesting high effectiveness for the use of 300 µg/d TDT with or without estrogen for the management of HSDD with minimal side effects. One study showed a trend for higher risk of breast cancer in long-term use (0.37%). The use of 300 µg/d of TDT in surgical and natural menopause is an effective plan to manage HSDD in the short- and long-term. Although side effects are minimal, further prospective research is needed to assess the more severe side effects such as breast cancer in the long-term use of TDT.
Language	English
Publishing date	2018-03-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.2401
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Response to Loco-Regional Therapy Predicts Outcomes After Liver Transplantation for Combined Hepatocellular-Cholangiocarcinoma.

Antwi, Samuel O / Habboush, Yacob Y / Chase, Lori A / Lee, David D / Patel, Tushar

Annals of hepatology

2018 Volume 17, Issue 6, Page(s) 969–979

Abstract: Introduction and aim: Combined hepatocellular-cholangiocarcinoma (HCC-CCA) is a rare liver malignancy distinct from either hepatocellular carcinoma (HCC) or cholangiocarcinoma. Liver transplantation (LT) is not recommended for HCC-CCA because of ... ...

Abstract	Introduction and aim: Combined hepatocellular-cholangiocarcinoma (HCC-CCA) is a rare liver malignancy distinct from either hepatocellular carcinoma (HCC) or cholangiocarcinoma. Liver transplantation (LT) is not recommended for HCC-CCA because of suboptimal outcomes. Non-invasive diagnosis of HCC-CCA is extremely challenging; thus, some HCC-CCAs are presumed as HCC on imaging and listed for LT with the correct diagnosis ultimately made on explant pathology. We compared HCC-CCA with HCC to determine the utility of response to pre-transplant loco-regional therapy (LRT) in predicting outcomes for HCC-CCA after LT as a potential means of identifying appropriate HCC-CCA patients for LT. Material and methods: Retrospective review of 19 patients with pathologically confirmed HCC-CCA were individually matched to 38 HCC patients (1:2) based on age, sex, and Milan criteria at listing was performed. The modified response evaluation criteria in solid tumors was used to categorize patients as responders or non-responders to pre-transplant LRT based on imaging performed before and after LRT. Overall survival (OS) and recurrence-free survival (RFS) were examined. Results: OS at 3 years post-transplant was 74% for HCC-CCA and 87% for HCC. RFS at 3 years was 74% for HCC-CCA, and 87% for HCC. Among responders to LRT, the 3-year OS was 92% for HCC-CCA and 88% for HCC; among non-responders, 3-year OS was 43% for HCC-CCA and 83% for HCC. Higher 3-year OS was observed among HCC-CCA responders (77%) compared with HCC-CCA non-responders (23%). Conclusions: OS was similarly high among.
MeSH term(s)	Aged ; Bile Duct Neoplasms/diagnostic imaging ; Bile Duct Neoplasms/mortality ; Bile Duct Neoplasms/pathology ; Bile Duct Neoplasms/therapy ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/therapy ; Cholangiocarcinoma/diagnostic imaging ; Cholangiocarcinoma/mortality ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/therapy ; Clinical Decision-Making ; Disease Progression ; Female ; Humans ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Liver Neoplasms/therapy ; Liver Transplantation/adverse effects ; Liver Transplantation/mortality ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoadjuvant Therapy/adverse effects ; Neoadjuvant Therapy/mortality ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neoplasms, Complex and Mixed/diagnostic imaging ; Neoplasms, Complex and Mixed/mortality ; Neoplasms, Complex and Mixed/pathology ; Neoplasms, Complex and Mixed/therapy ; Patient Selection ; Progression-Free Survival ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; Tumor Burden
Language	English
Publishing date	2018-05-25
Publishing country	Mexico
Document type	Comparative Study ; Journal Article
ZDB-ID	2188733-0
ISSN	1665-2681
ISSN	1665-2681
DOI	10.5604/01.3001.0012.7197
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Response to Loco-Regional Therapy Predicts Outcomes After Liver Transplantation for Combined Hepatocellular-Cholangiocarcinoma

Samuel O. Antwi / Yacob Y. Habboush / Lori A. Chase / David D. Lee / Tushar Patel

Annals of Hepatology, Vol 17, Iss 6, Pp 969-

2018 Volume 979

Abstract: Introduction and aim. Combined hepatocellular-cholangiocarcinoma (HCC-CCA) is a rare liver malignancy distinct from either hepatocellular carcinoma (HCC) or cholangiocarcinoma. Liver transplantation (LT) is not recommended for HCC-CCA because of ... ...

Abstract	Introduction and aim. Combined hepatocellular-cholangiocarcinoma (HCC-CCA) is a rare liver malignancy distinct from either hepatocellular carcinoma (HCC) or cholangiocarcinoma. Liver transplantation (LT) is not recommended for HCC-CCA because of suboptimal outcomes. Non-invasive diagnosis of HCC-CCA is extremely challenging; thus, some HCC-CCAs are presumed as HCC on imaging and listed for LT with the correct diagnosis ultimately made on explant pathology. We compared HCC-CCA with HCC to determine the utility of response to pre-transplant loco-regional therapy (LRT) in predicting outcomes for HCC-CCA after LT as a potential means of identifying appropriate HCC-CCA patients for LT.Material and methods. Retrospective review of 19 patients with pathologically confirmed HCC-CCA were individually matched to 38 HCC patients (1:2) based on age, sex, and Milan criteria at listing was performed. The modified response evaluation criteria in solid tumors was used to categorize patients as responders or non-responders to pre-transplant LRT based on imaging performed before and after LRT. Overall survival (OS) and recurrence-free survival (RFS) were examined.Results. OS at 3 years post-transplant was 74% for HCC-CCA and 87% for HCC. RFS at 3 years was 74% for HCC-CCA, and 87% for HCC. Among responders to LRT, the 3-year OS was 92% for HCC-CCA and 88% for HCC; among non-responders, 3-year OS was 43% for HCC-CCA and 83% for HCC. Higher 3-year OS was observed among HCC-CCA responders (77%) compared with HCC-CCA non-responders (23%).Conclusions. OS was similarly high among responders to pre-transplant LRT irrespective of tumor type. Radiologic response to LRT could potentially be used to select appropriate HCC-CCA patients for LT if the findings are validated in independent studies.
Keywords	Loco-regional therapy ; LRT ; combined hepatocellular and cholangiocarcinoma ; HCC ; Overall survival ; Recurrence-free survival ; Specialties of internal medicine ; RC581-951
Subject code	610
Language	English
Publishing date	2018-11-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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