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Article ; Online: Do Dictation Privileges Add Value to Radiology Electives If Medical Students Have Access to Online Modules?

Harris, Katie M / Hartery, Angus

Current problems in diagnostic radiology

2023 Volume 53, Issue 1, Page(s) 27–30

Abstract: Rationale and objectives: Traditional in-person medical student radiology electives are predominantly observerships. However, during the COVID-19 restrictions, many schools across Canada and the United States moved their radiology electives to an online ...

Abstract	Rationale and objectives: Traditional in-person medical student radiology electives are predominantly observerships. However, during the COVID-19 restrictions, many schools across Canada and the United States moved their radiology electives to an online format with great success. To the best of our knowledge, an evaluation of student experiences at a site where the 2-week on-site elective has both dictation privileges and an online component has not been completed. Materials and methods: We analyzed the pre- and post-test data from the online component of a radiology elective, retrieved the total number of dictation reports, and reviewed qualitative student feedback to gauge student engagement and learning. We used a generalized linear mixed model (GLMM) to compare the difference between the student scores on pre- and postmodule section quizzes, accounting for individual and section-specific variation in performance. A second GLMM was fit to assess improvement in the cumulative test taken before and after the entire elective. Both models accounted for the potential benefit of dictation. Results: Student score improved significantly on the postsection tests (β Conclusion: This retrospective study suggests that resources should be directed to the development of mixed online/in-person electives for ideal student engagement at the senior medical student level. Further work must be completed to understand the potential benefits of, and barriers to, student dictation at the medical student level.
MeSH term(s)	Humans ; Students, Medical ; Retrospective Studies ; Radiology/education ; Radiography ; COVID-19 ; Curriculum ; Education, Medical, Undergraduate
Language	English
Publishing date	2023-08-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	198954-6
ISSN	1535-6302 ; 0363-0188
ISSN (online)	1535-6302
ISSN	0363-0188
DOI	10.1067/j.cpradiol.2023.08.014
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Article ; Online: Sex hormones and the risk of myocardial infarction in women and men: a prospective cohort study in the UK Biobank.

Harris, Katie / Peters, Sanne A E / Woodward, Mark

Biology of sex differences

2023 Volume 14, Issue 1, Page(s) 61

Abstract: Objectives: There is conflicting evidence around the role of sex hormones with cardiovascular outcomes. The aim of this study was to examine the association of sex hormones with the risk of myocardial infarction (MI) in pre- and post-menopausal women, ... ...

Abstract	Objectives: There is conflicting evidence around the role of sex hormones with cardiovascular outcomes. The aim of this study was to examine the association of sex hormones with the risk of myocardial infarction (MI) in pre- and post-menopausal women, and men in the UK Biobank. Methods: The UK Biobank is a prospective population-based cohort study, that recruited over 500,000 (aged 40-69 years) women and men between 2006 and 2010. Sex specific cox regression models, estimating hazard ratios (HRs) and women to men ratio of HRs (RHR) with respective 95% confidence intervals (CI), were used to model the association of sex hormones [oestrogen, testosterone, oestrogen: testosterone (O/T) ratio, sex hormone-binding globulin (SHBG) and the free androgen index (FAI)], measured at study baseline, with incident MI for women and men. Results: Data were from 479,797 participants [264,282 (55.1%) women] without a history of MI at study baseline. Over 12.5 years of follow-up, there were 4,908 MI events in women and 10,517 in men. Neither oestrogen nor testosterone were associated with MI in women and men after multiple adjustment. For men, but not women, a unit higher log-transformed O/T ratio was associated with a lower risk of MI 0.79 (0.65, 0.95) after adjustment for traditional CVD risk factors. The corresponding women to men RHR (95% CI) was 1.24 (0.99, 1.56). Higher SHBG (per unit) was also associated with a lower risk of MI in men 0.94 (0.89, 0.99), and not in women 1.02 (0.95, 1.09) after multiple adjustment, the corresponding women to men RHR (95% CI) was 1.09 (1.00, 1.18). Higher FAI was associated with a higher risk of MI in men 1.09 (1.02, 1.15), though not in women 0.97 (0.92, 1.02), the corresponding women to men RHR was 0.89 (0.82, 0.97). Finally, there were differential effects in the association of SHBG and FAI between pre- and post-menopausal women. Conclusions: A higher O/T ratio was associated with a lower risk of MI, and a higher FAI with a higher risk of MI after adjustment for CVD risk factors in men, but not in women. Thus, hormone ratios, rather than each alone, may play an important role in modulating the effect of MI.
MeSH term(s)	Male ; Female ; Humans ; Prospective Studies ; Biological Specimen Banks ; Cohort Studies ; Gonadal Steroid Hormones ; Estrogens ; Myocardial Infarction/epidemiology ; Testosterone ; United Kingdom/epidemiology
Chemical Substances	Gonadal Steroid Hormones ; Estrogens ; Testosterone (3XMK78S47O)
Language	English
Publishing date	2023-09-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2587352-0
ISSN	2042-6410 ; 2042-6410
ISSN (online)	2042-6410
ISSN	2042-6410
DOI	10.1186/s13293-023-00546-3
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Article: Sex hormones and risk of coronary artery disease in women.

Harris, Katie / Peters, Sanne Ae / Woodward, Mark

Australian prescriber

2023 Volume 46, Issue 1, Page(s) 3–4

Language	English
Publishing date	2023-11-20
Publishing country	Australia
Document type	Journal Article ; Comment
ZDB-ID	1075442-8
ISSN	0312-8008
ISSN	0312-8008
DOI	10.18773/austprescr.2023.009
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Article: The Big Bang: A Virtual Subarachnoid Hemorrhage Simulation for Preclinical Medical Students.

Harris, Katie M / Sheppard, Gillian

Cureus

2021 Volume 13, Issue 5, Page(s) e14919

Abstract: Simulation-based learning is important for rare, high mortality cases, which are unlikely to be witnessed during clinical rotations but are likely to be encountered during future practice such as a subarachnoid hemorrhage. Neurology case simulations, ... ...

Abstract	Simulation-based learning is important for rare, high mortality cases, which are unlikely to be witnessed during clinical rotations but are likely to be encountered during future practice such as a subarachnoid hemorrhage. Neurology case simulations, especially those targeted at preclinical learners, are underrepresented in simulation pedagogy, and preclinical learners are underrepresented in a meta-analysis of the efficacy of simulation-based medical education. We designed a virtual simulation of subarachnoid hemorrhage for preclinical medical students, which can be implemented during restricted access to clinical learning. The simulation is 15 minutes long and requires only one standardized patient and one evaluator, which makes this simulation accessible to institutions with limited simulation resources. We adapted the validated questions from the "Simulation Evaluation Tool - Modified" for our post-simulation survey, which will detect the students' level of confidence and their perceived learning post-simulation. The analysis of student experiences using this validated tool will contribute to the literature base surrounding the efficacy of virtual simulation as a training tool for preclinical learners.
Language	English
Publishing date	2021-05-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.14919
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Article ; Online: Hypertension and mild cognitive impairment: state-of-the-art review.

Shajahan, Sultana / Peters, Ruth / Carcel, Cheryl / Woodward, Mark / Harris, Katie / Anderson, Craig S

American journal of hypertension

2024

Abstract: Background: Mid-life hypertension is associated with cognitive decline and dementia in later life. Reducing high blood pressure (BP) with antihypertensive agents is a well-researched strategy to prevent dementia and mild cognitive impairment (MCI). ... ...

Abstract	Background: Mid-life hypertension is associated with cognitive decline and dementia in later life. Reducing high blood pressure (BP) with antihypertensive agents is a well-researched strategy to prevent dementia and mild cognitive impairment (MCI). However, there is still limited direct evidence to support the approach, and particularly for the treatment of the very old and those with existing MCI. Methods: This review presents an overview of the current evidence for the relationship between MCI and hypertension, and of the potential pathophysiological mechanisms related to cognitive decline and incidence dementia in relation to aging. Results: Although observational data are near consistent in showing an association between mid-life hypertension and MCI and/or dementia, the evidence in relation to hypertension in younger adults and the very old (age >80 years) is much more limited. Most of the commonly available antihypertensive agents appear to provide beneficial effects in reducing the risk dementia, but there is limited evidence to support such treatment in those with existing MCI. Conclusions: Further studies are needed to determine the optimal levels of BP control across different age groups, especially in adults with MCI, and which class(es) of antihypertensive agents and duration of treatment best preserve cognitive function in those at risk of, or with established, MCI.
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	639383-4
ISSN	1941-7225 ; 1879-1905 ; 0895-7061
ISSN (online)	1941-7225 ; 1879-1905
ISSN	0895-7061
DOI	10.1093/ajh/hpae007
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Article ; Online: Orthostatic Hypotension and Cognitive Function in Individuals 85 Years of Age: A Longitudinal Cohort Study in Sweden.

Geijerstam, Peder Af / Harris, Katie / Johansson, Maria M / Chalmers, John / Nägga, Katarina / Rådholm, Karin

Aging and disease

2024

Abstract: Orthostatic hypotension (OH) is more common in the elderly and associated with increased mortality. However, its implications for 85-year-olds are not known. In the prospective observational cohort study Elderly in Linköping Screening Assessment (ELSA 85) ...

Abstract	Orthostatic hypotension (OH) is more common in the elderly and associated with increased mortality. However, its implications for 85-year-olds are not known. In the prospective observational cohort study Elderly in Linköping Screening Assessment (ELSA 85), 496 individuals in Linköping, Sweden, were followed from age 85 years with cognitive assessments. Blood pressure (BP) was measured supine and after 1, 3, 5, and 10 minutes of standing. Participants with a BP fall of ≥20 mmHg systolic or ≥10 mmHg diastolic after 1 or 3 minutes were classified as classical continuous or classical transient OH depending on whether the BP fall was sustained or not, at subsequent measurements. Those with a BP fall of the same magnitude, but only after 5 or 10 minutes were classified as delayed OH. Of participants, 329 took part in BP measurements and were included. Of these, 156 (47.4%) had classical OH (113 [34.3%] continuous classical, 38 [11.6%] transient classical), and 15 (4.6%) had delayed OH. Cognitive assessments were not markedly different between groups. After 8.6 years, 195 (59.3%) of the participants had died, and delayed vs no OH was associated with twice the risk of all-cause mortality, HR 2.15 (95% CI 1.12-4.12). Transient classical OH was associated with reduced mortality, HR 0.58 (95% CI 0.33-0.99), but not after multiple adjustments, and continuous classical OH was not associated with mortality. OH may have different implications for morbidity and mortality in 85-year-olds compared with younger populations.
Language	English
Publishing date	2024-02-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2625789-0
ISSN	2152-5250 ; 2152-5250
ISSN (online)	2152-5250
ISSN	2152-5250
DOI	10.14336/AD.2024.0205
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Article ; Online: Smoking as a risk factor for lower extremity peripheral artery disease in women compared to men: A systematic review and meta-analysis.

Xu, Ying / Pouncey, Anna Louise / Zhou, Zien / Woodward, Mark / Harris, Katie

PloS one

2024 Volume 19, Issue 4, Page(s) e0300963

Abstract: Background: To investigate whether the relationship between smoking and peripheral artery disease (PAD) differs by sex (PROSPERO CRD42022352318).: Methods: PubMed, EMBASE, and CINAHL were searched (3 March 2024) for studies reporting associations ... ...

Abstract	Background: To investigate whether the relationship between smoking and peripheral artery disease (PAD) differs by sex (PROSPERO CRD42022352318). Methods: PubMed, EMBASE, and CINAHL were searched (3 March 2024) for studies reporting associations between smoking and PAD in both sexes, at least adjusted for age. Data were pooled using random effects. Between-study heterogeneity was examined using I2 statistic and Cochran's Q test. Newcastle-Ottowa Scale was adopted for quality assessment. Results: Four cohort studies (n = 2,117,860, 54.4% women) and thirteen cross-sectional studies (n = 230,436, 59.9% women) were included. In cohort studies, former and current smokers had higher risk of PAD than never smokers. Compared to those who never or previously smoked, women current smokers (relative risk (RR) 5.30 (95% confidence interval 3.17, 8.87)) had higher excess risk of PAD than men (RR 3.30 (2.46, 4.42)), women-to-men ratio of RR 1.45 (1.30, 1.62)(I2 = 0%, p = 0.328). In cross-sectional studies, risk of PAD was higher among former and current compared to never smokers, more so in men, women-to-men ratios of odds ratio: 0.64 (0.46, 0.90)(I2 = 30%, p = 0.192), 0.63 (0.50, 0.79)(I2 = 0%, p = 0.594), respectively. For both sexes, risk of PAD was higher among current smokers compared to those who were not currently smoking. Cohort studies and five cross-sectional studies were of good quality, scoring 6 to 8 of a possible maximum 9 points. Eight cross-sectional studies scored 2 to 5. Discussions: Further research is required to elucidate sex differences in the relationships between smoking and PAD, as the current evidence is limited and mixed. Tobacco-control programs should consider both sexes.
MeSH term(s)	Humans ; Peripheral Arterial Disease/epidemiology ; Peripheral Arterial Disease/etiology ; Male ; Female ; Risk Factors ; Smoking/adverse effects ; Lower Extremity/blood supply ; Sex Factors ; Cross-Sectional Studies
Language	English
Publishing date	2024-04-24
Publishing country	United States
Document type	Journal Article ; Systematic Review ; Meta-Analysis ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0300963
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Article ; Online: Reproductive factors and the risk of incident dementia: A cohort study of UK Biobank participants.

Gong, Jessica / Harris, Katie / Peters, Sanne A E / Woodward, Mark

PLoS medicine

2022 Volume 19, Issue 4, Page(s) e1003955

Abstract: Background: Women's reproductive factors have been associated with the risk of dementia; however, these findings remain uncertain. This study aimed to examine the risk of incident all-cause dementia associated with reproductive factors in women and the ... ...

Abstract	Background: Women's reproductive factors have been associated with the risk of dementia; however, these findings remain uncertain. This study aimed to examine the risk of incident all-cause dementia associated with reproductive factors in women and the number of children in both sexes and whether the associations vary by age, socioeconomic status (SES), smoking status, and body mass index (BMI) in the UK Biobank. Methods and findings: A total of 273,240 women and 228,957 men without prevalent dementia from the UK Biobank were included in the analyses. Cox proportional hazard regressions estimated hazard ratios (HRs) for reproductive factors with incident all-cause dementia. Multiple adjusted models included age at study entry, SES, ethnicity, smoking status, systolic blood pressure, BMI, history of diabetes mellitus, total cholesterol, antihypertensive drugs, and lipid-lowering drugs. Over a median of 11.8 years follow-up, 1,866 dementia cases were recorded in women and 2,202 in men. Multiple adjusted HRs ((95% confidence intervals (CIs)), p-value) for dementia were 1.20 (1.08, 1.34) (p = 0.016) for menarche <12 years and 1.19 (1.07, 1.34) (p = 0.024) for menarche >14 years compared to 13 years; 0.85 (0.74, 0.98) (p = 0.026) for ever been pregnant; 1.43 (1.26, 1.62) (p < 0.001) for age at first live birth <21 compared to 25 to 26 years; 0.82 (0.71, 0.94) (p = 0.006) for each abortion; 1.32 (1.15, 1.51) (p = 0.008) for natural menopause at <47 compared to 50 years; 1.12 (1.01, 1.25) (p = 0.039) for hysterectomy; 2.35 (1.06, 5.23) (p = 0.037) for hysterectomy with previous oophorectomy; and 0.80 (0.72, 0.88) (p < 0.001) for oral contraceptive pills use. The U-shaped associations between the number of children and the risk of dementia were similar for both sexes: Compared with those with 2 children, for those without children, the multiple adjusted HR ((95% CIs), p-value) was 1.18 (1.04, 1.33) (p = 0.027) for women and 1.10 (0.98, 1.23) (p = 0.164) for men, and the women-to-men ratio of HRs was 1.09 (0.92, 1.28) (p = 0.403); for those with 4 or more children, the HR was 1.14 (0.98, 1.33) (p = 0.132) for women and 1.26 (1.10, 1.45) (p = 0.003) for men, and the women-to-men ratio of HRs was 0.93 (0.76, 1.14) (p = 0.530). There was evidence that hysterectomy (HR, 1.31 (1.09, 1.59), p = 0.013) and oophorectomy (HR, 1.39 (1.08, 1.78), p = 0.002) were associated with a higher risk of dementia among women of relatively lower SES only. Limitations of the study include potential residual confounding and self-reported measures of reproductive factors, as well as the limited representativeness of the UK Biobank population. Conclusions: In this study, we observed that some reproductive events related to shorter cumulative endogenous estrogen exposure in women were associated with higher dementia risk, and there was a similar association between the number of children and dementia risk between women and men.
MeSH term(s)	Biological Specimen Banks ; Child ; Cohort Studies ; Dementia/epidemiology ; Dementia/etiology ; Female ; Humans ; Male ; Pregnancy ; Prospective Studies ; Risk Factors ; United Kingdom/epidemiology
Language	English
Publishing date	2022-04-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2185925-5
ISSN	1549-1676 ; 1549-1277
ISSN (online)	1549-1676
ISSN	1549-1277
DOI	10.1371/journal.pmed.1003955
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Article ; Online: Serum lipid traits and the risk of dementia: A cohort study of 254,575 women and 214,891 men in the UK Biobank.

Gong, Jessica / Harris, Katie / Peters, Sanne A E / Woodward, Mark

EClinicalMedicine

2022 Volume 54, Page(s) 101695

Abstract: Background: Serum lipid traits are associated with cardiovascular disease, but uncertainty remains regarding their associations with dementia.: Methods: From 2006 to 2010, 254,575 women and 214,891 men were included from the UK Biobank. Cox ... ...

Abstract	Background: Serum lipid traits are associated with cardiovascular disease, but uncertainty remains regarding their associations with dementia. Methods: From 2006 to 2010, 254,575 women and 214,891 men were included from the UK Biobank. Cox regression estimated overall and sex-specific hazard ratios (HRs) for apolipoprotein A (ApoA), apolipoprotein B (ApoB), HDL, LDL, total cholesterol, triglycerides, lipoprotein A, and various lipid ratios, by quarters and standard deviation (SD) higher, associated with all-cause dementia, Alzheimer's disease (AD) and vascular dementia (VaD). Subgroup analyses by age and social deprivation were conducted. Findings: Over 11·8 years (median), 3734 all-cause dementia (1,716 women), 1231 AD and 929 VaD were recorded. Compared to respective lowest quarters, highest quarter of ApoA was associated with lower dementia risk (HR, [95% confidence interval (95% CI)]: 0·77 [0·69, 0·86]) while the highest quarter of ApoB was associated with greater risk (HR, 1·12 [1·01, 1·24]). Higher HDL/ApoA and ApoB/ApoA, were associated with greater risk of dementia (HR, 1·12 [1·00, 1·25], per standard deviation (SD), 1.23 [1·11, 1·37], per SD, respectively), LDL/ApoB was inversely associated (HR, 0·85 [0·76, 0·94], per SD. Higher triglycerides was associated with higher dementia risk in <60 years, but the inverse was observed for ≥60 years. Similar associations were observed for VaD and AD. Interpretation: Apolipoproteins, and their ratios, were associated with the risk of dementia. It may be prudent to consider apolipoproteins, along with circulating cholesterol, when assessing dementia risk. Funding: University of New South Wales, UK Medical Research Council, and the Australian National Health and Medical Research Council.
Language	English
Publishing date	2022-10-06
Publishing country	England
Document type	Journal Article
ISSN	2589-5370
ISSN (online)	2589-5370
DOI	10.1016/j.eclinm.2022.101695
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Article ; Online: Social deprivation as a risk factor for COVID-19 mortality among women and men in the UK Biobank: nature of risk and context suggests that social interventions are essential to mitigate the effects of future pandemics.

Woodward, Mark / Peters, Sanne A E / Harris, Katie

Journal of epidemiology and community health

2021 Volume 75, Issue 11, Page(s) 1050–1055

Abstract: Objectives: To investigate sex differences in the effects of social deprivation on COVID-19 mortality and to place these effects in context with other diseases.: Design: Prospective population-based study.: Setting: UK Biobank.: Participants: ... ...

Abstract	Objectives: To investigate sex differences in the effects of social deprivation on COVID-19 mortality and to place these effects in context with other diseases. Design: Prospective population-based study. Setting: UK Biobank. Participants: 501 865 participants (54% women). Main outcome measure: COVID-19 as the underlying cause of death. Results: Of 472 946 participants alive when COVID-19 was first apparent in the UK (taken as 1 February 2020), 217 (34% women) died from COVID-19 over the next 10 months, resulting in an incidence, per 100 000 person years, of 100.65 (95% CI 79.47 to 121.84) for women and 228.59 (95% CI 194.88 to 262.30) for men. Greater social deprivation, quantified using the Townsend Deprivation Score, was associated with greater risk of fatal COVD-19. Adjusted for age and ethnicity, HRs for women and men, comparing those in the most with the least deprived national fifths, were 3.66 (2.82 to 4.75) for women and 3.00 (2.46 to 3.66) for men. Adjustments for key baseline lifestyle factors attenuated these HRs to 2.20 (1.63 to 2.96) and 2.62 (2.12 to 3.24), respectively. There was evidence of a log-linear trend in the deprivation-fatal COVID-19 association, of similar magnitude to the equivalent trends for the associations between deprivation and fatal influenza or pneumonia and fatal cardiovascular disease. For all three causes of death, there was no evidence of a sex difference in the associations. Conclusions: Higher social deprivation is a risk factor for death from COVID-19 on a continuous scale, with two to three times the risk in the most disadvantaged 20% compared with the least. Similarities between the social gradients in COVID-19, influenza/pneumonia and cardiovascular disease mortality, the lack of sex differences in these effects, and the partial mediation of lifestyle factors suggest that better social policies are crucial to alleviate the general medical burden, including from the current, and potential future, viral pandemics.
MeSH term(s)	Biological Specimen Banks ; COVID-19 ; Female ; Humans ; Male ; Pandemics ; Prospective Studies ; Risk Factors ; SARS-CoV-2 ; United Kingdom/epidemiology
Language	English
Publishing date	2021-04-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	391868-3
ISSN	1470-2738 ; 0142-467X ; 0141-7681 ; 0143-005X
ISSN (online)	1470-2738
ISSN	0142-467X ; 0141-7681 ; 0143-005X
DOI	10.1136/jech-2020-215810
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