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(Re)Engaging Faculty During and After a Health Pandemic: Programmatic Strategies for Learning and Wellness

Savitzky, Diana C; Rekawek, Patricia; Shelov, Steven; Nonaillada, Jeannine
ORIGINAL:0015928
ISSN: 2153-1900
CID: 5309542

Fasting Serum IGFBP-1 as a Marker of Insulin Resistance in Diverse School Age Groups

Bhangoo, Amrit; Gupta, Rishi; Shelov, Steve P; Carey, Dennis E; Accacha, Siham; Fennoy, Ilene; Altshuler, Lisa; Lowell, Barbara; Rapaport, Robert; Rosenfeld, Warren; Speiser, Phyllis W; Ten, Svetlana; Rosenbaum, Michael
Introduction:The known markers of insulin resistance in obese children are well studied. However, they require serial measurements and complicated calculations. The objective is to study IGFBP-1 and its relation with other known risk measures. Materials and Methods:The study included 98 New York City school students of diverse ethnic/racial backgrounds (57 males and 41 females), 11-15 years of age. Subjects were enrolled in a cross-sectional study, and anthropometric measures were collected. They underwent fasting intravenous glucose tolerance tests (IVGTT), and glucose, insulin, lipids, IGFBP-1, adiponectin and inflammatory markers were collected. Results:The subjects were stratified into 3 groups based upon the BMI Z-score. Out of all the subjects, 65.3% were in the group with a BMI Z-score <1 SDS, 16.3% subjects were in the group with a BMI Z-score of 1 to 2 SDS, and 18.4% of the subjects were in the group with a BMI Z-score of more than 2 SDS. The group with a BMI Z-score of more than 2 SDS had increased waist circumference (WC), body fat, increased fasting insulin, and triglycerides (TG). This group had decreased levels of adiponectin and HDL and low IGFBP-1 as compared to the group with BMI <1 SDS. The group with a BMI Z-score of 1 to 2 SDS had a decreased level of IGFBP-1 as compared to the group with a BMI Z-score less than 1 SDS. IGFBP-1 inversely correlated with age, WC, BMI, body fat, TG, and insulin levels. IGFBP-1 positively correlated with adiponectin and HDL levels. Conclusion:IGFBP-1 in children can identify the presence of insulin resistance in the group with BMI 1 to 2 SDS, even before the known markers of insulin resistance such as elevated triglycerides and even before decreased HDL and adiponectin levels are identified.
PMCID:9108162
PMID: 35586622
ISSN: 1664-2392
CID: 5277472

Fostering student and faculty scholarship in an accelerated three-year medical school

Kasselman, Lora J; Ayala, Gladys; Shelov, Steven; Nonaillada, Jeannine
PMCID:9427079
PMID: 36168534
ISSN: 2312-7996
CID: 5334272

Correction to: Experiences of early graduate medical students working in New York hospitals during the COVID-19 pandemic: a mixed methods study

Pravder, Harrison D; Langdon-Embry, Liana; Hernandez, Rafael J; Berbari, Nicholas; Shelov, Steven P; Kinzler, Wendy L
PMID: 33731082
ISSN: 1472-6920
CID: 4817882

Experiences of early graduate medical students working in New York hospitals during the COVID-19 pandemic: a mixed methods study

Pravder, Harrison D; Langdon-Embry, Liana; Hernandez, Rafael J; Berbari, Nicholas; Shelov, Steven P; Kinzler, Wendy L
BACKGROUND:The coronavirus disease 2019 (COVID-19) pandemic presented the world with a sudden need for additional medical professionals. Senior medical students were identified as potential workers and many worldwide graduated early to serve as Junior Physicians in hospitals. The authors sought to identify factors that informed the decision to work, describe experiences in this capacity, and elucidate benefits for trainees. METHODS:The investigators conducted a mixed-methods observational cohort study of early medical graduates eligible to work as Junior Physicians at two New York medical centers in April/May 2020 during an initial surge in COVID-19 hospitalizations. Graduates were surveyed, and a sample of Junior Physicians participated in a focus group. Survey responses of those who worked were compared to those who did not. Focus group responses were transcribed, coded, and thematically analyzed. RESULTS:Fifty-nine graduates completed the study methods and 39 worked as Junior Physicians. Primary reasons for working included duty to help (39 [100%]), financial incentive (32 [82%]), desire to learn about pandemic response (25 [64%]), and educational incentive (24 [62%]). All had direct contact with COVID-19 patients, believed working was beneficial to their medical training, and were glad they worked. None contracted a symptomatic infection while working. Compared with non-Junior Physicians, Junior Physicians reported increased comfort levels in completing medical intern-level actions like transitions of care functions, such as writing transfer notes (P < 0.01), writing discharge orders (P = 0.01), and providing verbal sign out (P = 0.05), and they reported more comfort in managing COVID-19 patients. Sixteen themes emerged from the focus group and were placed into four categories: development of skills, patient care, safety, and wellness. CONCLUSIONS:Senior medical students chose to work as Junior Physicians for both personal and educational reasons. Experiences were beneficial to trainees and can inform future innovations in medical education.
PMID: 33602188
ISSN: 1472-6920
CID: 4787122

New York University Long Island School of Medicine

Ayala, Gladys M; Rapkiewicz, Amy V; Carsons, Steven E; Shelov, Steven P
PMID: 33626719
ISSN: 1938-808x
CID: 4794762

Demographics and anthropometrics impact benefits of health intervention: data from the Reduce Obesity and Diabetes Project

Ostrowski, L; Speiser, P W; Accacha, S; Altshuler, L; Fennoy, I; Lowell, B; Rapaport, R; Rosenfeld, W; Shelov, S P; Ten, S; Rosenbaum, M
Objective/UNASSIGNED:To determine the efficacy of a 4-month school-based health, nutrition and exercise intervention on body fatness and examine possible effects of demographic and anthropometric covariates. Methods/UNASSIGNED: = 469) received a 12-session classroom-based health and nutrition educational programme with an optional exercise intervention. Results/UNASSIGNED: = 0.005). Conclusion/UNASSIGNED:A 4-month school-based health intervention was effective in decreasing measures of adiposity in middle school students, particularly in men, participants who were obese and South Asians.
PMCID:6381301
PMID: 30847225
ISSN: 2055-2238
CID: 3724582

Normal Alanine Transferase: an Independent Indicator of Adiposity Related Comorbidity Risk in Youth

Klein, Michelle; Iazzettii, Loretta; Speiser, Phyllis; Carey, Dennis; Shelov, Steven; Accacha, Siham; Fennoy, Ilene; Rosenbaum, Michael; Rapaport, Robert
BACKGROUND/AIMS: Elevated levels of alanine aminotransferase (ALT) are associated with obesity and are often a consequence of non-alcoholic fatty liver disease (NAFLD). The aim of the present study was to assess the relationship between ALT and risk factors for adiposity-related co-morbidities in a diverse population of middle school children. METHODS: We measured height, weight, body fatness (bioelectrical impedance), waist circumference, insulin sensitivity, phase 1 insulin release (acute insulin response following intravenous glucose), beta-cell function (acute insulin response corrected for insulin sensitivity), ALT, lipid profiles, and circulating concentrations of IL-6, C-reactive protein, adiponectin, and TNF-alpha in a multi-ethnic/racial population of 106 middle school students (age 11-14 years, 45F) of varying BMI. RESULTS: ALT was significantly correlated with BMI, % body fat, fat mass, waist circumference, fasting insulin, insulin resistance, triglycerides, and was inversely correlated with HDL in children, even though all values of ALT were "normal" (range of 4.0-33.0 U/L). ALT was significantly higher in males than females even when corrected for body fatness. Significant correlations with lipids and insulin resistance persisted even when adjusted for age, gender, and body fatness. CONCLUSIONS: Even within the normative range, ALT levels were significantly correlated with anthropomorphic and biochemical risk factors for adiposity-related co-morbidities in youth. Therefore, because ALT is correlated with dyslipidemia, insulin resistance, and central fat distribution, it might also serve as a marker of risk for adiposity-related co-morbidities beyond NAFLD.
PMID: 25266069
ISSN: 1753-0407
CID: 1282802

Mentoring program design and implementation in new medical schools

Fornari, Alice; Murray, Thomas S; Menzin, Andrew W; Woo, Vivian A; Clifton, Maurice; Lombardi, Marion; Shelov, Steven
Purpose: Mentoring is considered a valuable component of undergraduate medical education with a variety of programs at established medical schools. This study presents how new medical schools have set up mentoring programs as they have developed their curricula. Methods: Administrators from 14 US medical schools established since 2006 were surveyed regarding the structure and implementation of their mentoring programs. Results: The majority of new medical schools had mentoring programs that varied in structure and implementation. Although the programs were viewed as valuable at each institution, challenges when creating and implementing mentoring programs in new medical schools included time constraints for faculty and students, and lack of financial and professional incentives for faculty. Conclusions: Similar to established medical schools, there was little uniformity among mentoring programs at new medical schools, likely reflecting differences in curriculum and program goals. Outcome measures are needed to determine whether a best practice for mentoring can be established.
PMCID:4069409
PMID: 24962112
ISSN: 1087-2981
CID: 1051142

Racial/ethnic Differences in Clinical and Biochemical Type 2 Diabetes Mellitus Risk Factors in Children

Rosenbaum, Michael; Fennoy, Ilene; Accacha, Siham; Altshuler, Lisa; Carey, Dennis E; Holleran, Steven; Rapaport, Robert; Shelov, Steven P; Speiser, Phyllis W; Ten, S; Bhangoo, Amrit; Boucher-Berry, Claudia; Espinal, Yomery; Gupta, Rishi; Hassoun, Abeer A; Iazetti, Loretta; Jacques, Fabien J; Jean, Amy M; Klein, Michelle L; Levine, Robert; Lowell, Barbara; Michel, Lesley; Rosenfeld, Warren
Objective: To examine whether peri-adolescent children demonstrate the significant racial/ethnic differences in body fatness relative to BMI and in the prevalence and relationship of body composition to risk factors for type 2 diabetes (T2DM) as in adults. Design and Methods: We examined family history of obesity and T2DM, anthropometry, insulin sensitivity and secretory capacity, lipids, and cytokines (IL-6, CRP, TNF-alpha, and adiponectin) in a cohort of 994 middle school students (47% male, 53%, female; 12% African American, 14% East Asian, 13% South Asian, 9% Caucasian, 44% Hispanic, and 8% other). Results: Fractional body fat content was significantly greater at any BMI among South Asians. There were racial/ethnic specific differences in lipid profiles, insulin secretory capacity, insulin sensitivity, and inflammatory markers corrected for body fatness that are similar to those seen in adults. Family history of T2DM was associated with lower insulin secretory capacity while family history of obesity was more associated with insulin resistance. Conclusion: Children show some of the same racial/ethnic differences in risk factors for adiposity-related co-morbidities as adults. BMI and waist circumference cutoffs to identify children at-risk for adiposity-related co-morbidities should be adjusted by racial/ethnic group as well as other variables such as birthweight and family history.
PMCID:3766484
PMID: 23596082
ISSN: 1930-7381
CID: 306552