Medicine and Health Sciences Commons^™

Difelikefalin Suppresses Itch And Reduces Scratching Independent Of Inflammation In A Murine Model Of Atopic Dermatitis, Masato Tamari, Lydia Zamidar, Aaron M Ver Heul, Kristine Nograles, Joana Goncalves, Emma Guttman-Yassky, Mark Lebwohl, Brian S Kim

2020-Current year OA Pubs

BACKGROUND: Therapies specifically targeting nonhistaminergic pruritus are largely lacking. Difelikefalin (DFK) has been found to reduce itch in various chronic pruritic conditions, including atopic dermatitis (AD).

OBJECTIVE: We sought to investigate the ability of DFK to impact scratching behavior, inflammatory mediators, and neuronal signaling in a murine model of AD.

METHODS: The ears of C57BL/6 mice were topically treated with MC903 for 12 consecutive days to induce AD-like inflammation and itch. Before MC903 treatment, mice were treated with either DFK (0.5 mg/kg, intraperitoneal injection twice daily) or vehicle (saline). Skin ear thickness, histological analysis, flow cytometry, RNA-sequencing, and differential gene …

Identifying And Addressing Barriers To Implementing Core Electronic Health Record Use Metrics For Ambulatory Care: Virtual Consensus Conference Proceedings, Deborah R. Levy, Amanda J. Moy, Nate Apathy, Julia Adler-Milstein, Lisa Rotenstein, Bidisha Nath, S. Trent Rosenbloom, Thomas Kannampallil, Rebecca G. Mishuris, Aram Alexanian, Amber Sieja, Michelle R. Hribar, Jigar S. Patel, Christine A. Sinsky, Edward R. Melnick

2020-Current year OA Pubs

Precise, reliable, valid metrics that are cost-effective and require reasonable implementation time and effort are needed to drive electronic health record (EHR) improvements and decrease EHR burden. Differences exist between research and vendor definitions of metrics. PROCESS:  We convened three stakeholder groups (health system informatics leaders, EHR vendor representatives, and researchers) in a virtual workshop series to achieve consensus on barriers, solutions, and next steps to implementing the core EHR use metrics in ambulatory care. CONCLUSION:  Actionable solutions identified to address core categories of EHR metric implementation challenges include: (1) maintaining broad stakeholder engagement, (2) reaching agreement on standardized measure …

Tox3 Rs3803662 Polymorphism Is Associated With Breast Cancer Protection In Northeastern Mexican Woman, Orlando D. Solis-Coronado, Hazyadee F. Rodríguez-Gutiérrez, Monica P. Villarreal-Vela, Ricardo M. Cerda-Flores, Juan F. González-Guerrero, Oscar Vidal-Gutiérrez, Diana C. Pérez-Ibave, Maria Lourdes Garza-Rodríguez

Research Symposium

Introduction: Low penetrance genes are involved in breast cancer (BC) and confer risk for the development of this neoplasia. Different single nucleotide polymorphisms (SNPs) associated with BC have been identified, such as rs3803662 (TOX3), which is related to estrogen receptors in European and African-American women. The contribution of this variant in the Mexican population is unknown. The objective of this study was to evaluate, through a case-control design, the association of the SNP rs3803662 (TOX3), with the risk of BC in women from northeastern Mexico.

Methods: We included 434 cases and 228 controls. Genotyping was carried out using RFLPs. The …

Counselors’ Stigma Toward Addictions: Increasing Awareness And Decreasing Stigma, Natalie M. Ricciutti

Journal of Counselor Preparation and Supervision

The purpose of this study was to explore licensed counselors’ level of stigma toward individuals with substance use disorders (SUDs) and process/behavioral addictions (PBAs) and note any differences. A total of 138 licensed mental health counselors from one Midwestern state completed the SRTSS and the BRTSS to determine levels of stigma toward SUDs and PBAs, respectively. Participant scores from the SRTSS and BRTSS were normally distributed, and 15% to 32% of participants’ scores were reflective of stigma toward individuals with either SUDs or PBAs. A significant difference was not found between participants’ stigma toward individuals with SUDs or PBAs. Hypotheses …

Pspa-Mediated Aggregation Protects Streptococcus Pneumoniae Against Desiccation On Fomites, Jessica R. Lane, Muralidhar Tata, Rahena Yasmin, Hansol Im, David E. Briles, Carlos J. Orihuela

APC Fund

Streptococcus pneumoniae (Spn) resides in the nasopharynx where it can disseminate to cause disease. One key Spn virulence factor is pneumococcal surface protein A (PspA), which promotes survival by blocking the antimicrobial peptide lactoferricin. PspA has also been shown to mediate attachment to dying epithelial cells in the lower airway due to its binding of cell surface-bound mammalian (m)GAPDH. Importantly, the role of PspA during colonization is not well understood. Wildtype Spn was present in nasal lavage elutes collected from asymptomatically colonized mice at levels ∼10-fold higher that its isogenic PspA-deficient mutant (ΔpspA). Wildtype Spn also …

Profilaksis Vs. Terapi Preemtif Penyakit Cytomegalovirus (Cmv) Pada Pasien Transplantasi Ginjal Risiko Tinggi: Suatu Laporan Kasus Berbasis Bukti, Ariani Intan Wardhani, Rahajeng N. Tunjungputri, Erpryta Nurdia Tetrasiwi, Maruhum Bonar Marbun

Jurnal Penyakit Dalam Indonesia

Kidney transplant recipients require the use of immunosuppressive agents to prevent multiple organ rejection. Administration of immunosuppressive agents triggers an increased risk of impaired immunity and microbial infections, one of which is cytomegalovirus (CMV). Prevention of cytomegalovirus infection can be given as a prophylaxis or preemptive therapy. However, the efficacy of choosing prophylaxis or preemptive therapy is still under debate, thus we conducted this study to identify current approach in preventing CMV disease in clinical practice. A literature search was carried out using the PubMed, Cochrane Library, Embase and Scopus databases with the keywords “high risk …

Perbedaan Serotonin Plasma Dan Kortisol Saliva Terhadap Gejala Depresi Pada Pasien Pasca Sindrom Koroner Akut, Irman Firmansyah, Hamzah Shatri, Rudi Putranto, Yanuar Ardani, Eka Ginanjar, Sukamto Koesnoe, Aulia Rizka, Harry Isbagio, Em Yunir

Jurnal Penyakit Dalam Indonesia

Introduction. Psychological disorders are closely associated with hormonal factors, including cortisol and serotonin. In patients with acute coronary syndrome (ACS), autonomic dysfunction and dysregulation of the hypothalamic-pituitaryadrenal (HPA) axis can occur, leading to an increase in cortisol levels that may worsen the prognosis of ACS patients. Therefore, it is important to understand the hormonal impact, namely cortisol and serotonin levels, on depressive symptoms, which will be examined in this study.

Methods. This was a cross-sectional study to determine the impact of cortisol and serotonin in the incidence of depression in post-treatment ACS patients at the ICCU RSUPN dr. …

Perlemakan Hati Non-Alkoholik Dan Risiko Fibrosis Hati Pada Pasien Hepatitis B Kronik, Andri Sanityoso Sulaiman, Irsan Hasan, Cosmas Rinaldi A. Lesmana, Juferdy Kurniawan, Chyntia Olivia Maurine Jasirwan, Saut Horas H. Nababan, Kemal Fariz Kalista, Gita Aprilicia, Rino Alvani Gani

Jurnal Penyakit Dalam Indonesia

Introduction. Prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing throughout the world due to sedentary lifestyle and dietary habit, including in patients with chronic hepatitis B (CHB). In several studies, advanced of liver disease were more likely observed among those CHB patients with NAFLD. NAFLD might increase the risk of liver disease progression in CHB patients, but prior investigations were still limited. This study aimed to determine the association between NAFLD and risk of liver fibrosis in CHB patients.

Methods. All patients with positive serum hepatitis B surface antigen in the Hepatobilier Data Registry, Cipto Mangunkusumo Hospital, …

Faktor-Faktor Yang Memengaruhi Kesintasan Pasien Yang Dilakukan Intervensi Koroner Perkutan Primer, Birry Karim

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Perbedaan Kadar Insulin-Like Growth Factor-1 Dan Tumor Necrosis Factor-Α Serum Pada Berbagai Derajat Sarkopenia Pasien Lanjut Usia: Studi Potong Lintang, Auliangi Tamayo, Roza Mulyana, Rose Dinda Martini

Jurnal Penyakit Dalam Indonesia

Introduction. Sarcopenia is a phenomenon of progressive decline in muscle function that occurs due to the aging process. Insulin-like growth factor-1 (IGF-1) and tumor necrosis factor-α (TNF-α) have an important role in the occurrence of sarcopenia as a positive and negative regulator of muscle mass. Research shows differences in IGF-1 and TNF-α levels between sarcopenia and non-sarcopenia groups, but research on differences in severity of sarcopenia remains unclear. The purpose of this study was to determine the difference in levels of IGF-1 and TNF-α in various degrees of sarcopenia in elderly patients.

Methods. This was an analytical observational …

Sarkopenia Pada Lanjut Usia: Patogenesis, Diagnosis Dan Tata Laksana, Edwin Nugroho Njoto, I Gusti Putu Suka Aryana

Jurnal Penyakit Dalam Indonesia

‘Sarcopenia’ involves a progressive age-related loss of muscle mass and associated muscle weakness that renders frail elders susceptible to serious injury from sudden falls and fractures and losing their functional independence. This disease has a complex multifactorial pathogenesis, which involves not only age-related changes in neuromuscular function, muscle protein turnover, and hormone levels and sensitivity, but also a chronic pro-inflammatory state, oxidative stress, and behavioral factors – in particular, nutritional status and degree of physical activity. In the previous definition by the European Working Group on Sarcopenia in Older People (EWGSOP) in 2010, the diagnosis of sarcopenia requires the presence …

Manajemen Koinfeksi Malaria Berat Dengan Hiv Belum Mendapat Terapi Antiretrovirus Di Era Pandemi Covid-19: Sebuah Laporan Kasus, Paul Harijanto, Rosye Mawuntu, Novia Rusli, Randy Adiwinata, Agung Nugroho

Jurnal Penyakit Dalam Indonesia

Severe malaria is a serious infectious disease that required immediate diagnosis and prompt treatment. Severe malaria may result several organ failures which is similar with other infectious diseases like SARS-CoV-2, sepsis, dengue, and HIV infection. Most of those infection have similar symptoms such as fever, myalgia, and headache, therefore physician should have high suspicion regarding co-infection with other infectious agents. The overlapping symptoms of co-infections may become a challenge for physician in diagnosing and delivering prompt therapy. Failure to deliver prompt treatment may lead to fatal outcome such as in severe malaria case. Stigmatization of all patients with fever and …

Kesintasan Satu Tahun Pasien Yang Menjalani Intervensi Koroner Perkutan Primer Di Rumah Sakit Dr. Cipto Mangukusumo, Muhammad Afriadi Hamdan, Ika Prasetya Wijaya, Alvina Widhani, Muhammad Yamin

Jurnal Penyakit Dalam Indonesia

Introduction. Primary percutaneous coronary intervention (PPCI) is an angioplasty (with or without a stent) performed immediately on the infarct-related artery without prior administration of fibrinolytics. Although PPCI is the reperfusion therapy of choice in ST-segment Elevation Myocardial Infarction (STEMI) patients, survival in post-PPCI patients still varied and research on its determinant factors still showed inconsistent results. This study aimed to determine the predictors of oneyear survival in patients undergoing PPCI at Dr Cipto Mangunkusumo General Hospital.

Methods. This retrospective cohort study evaluated the medical records of patients who underwent PPCI at Dr. Cipto Mangunkusumo General Hospital from January …

Profil Pasien Ketoasidosis Diabetikum Di Rumah Sakit Rujukan Tersier Di Bali, Indonesia, Noviana Joenputri Nj, Ketut Suastika Ks, Wira Gotera Wg, Made Ratna Saraswati Mrs, I Made Pande Dwipayana Impd, I Made Siswadi Semadi Imss, Ida Bagus Aditya Nugraha Iban

Jurnal Penyakit Dalam Indonesia

Introduction. Diabetic ketoacidosis (DKA) is one of life-threatening acute complication of diabetes mellitus (DM) characterized by hyperglycemia, ketosis, and acidosis. The prevalence of DM is increasing, therefore the incidence of DKA is predicted to continue to increase. The aim of this study was to obtain the profile of DKA patients in RSUP Prof. Dr. IGNG. Ngoerah (RSPN), Denpasar, Bali as a tertiary refferal hospital of Bali and Nusa Tenggara region.

Methods. This study was a cohort retrospective study. All patients aged 18 years or older with a diagnosis of DKA during Januari 2022 to February 2023 at RSPN, …

Assessment Of The Offline Setup Correction Protocol And Thermoplastic Mask Use For Head And Neck Cancer Radiotherapy: A Single Institution Experience, Furahini Yoram, Nazima Dharsee, Khamza Maunda, Jumaa D. Kisukari, Geofrey F. Soko

Tanzania Journal of Science

This study assessed the efficiency of offline setup correction protocol and the use of a thermoplastic mask for head and neck cancer (HNC) patients treated with three-dimensional conformal radiotherapy at Ocean Road Cancer Institute. A prospective study was conducted from April to August 2021 to verify 62 patients’ treatment setup using an offline setup correction protocol while immobilized with a thermoplastic mask. Megavoltage images were matched with digitally reconstructed radiographs obtained during CT simulation to determine the gross set-up deviations. Box plots were used to show the deviations on three consecutive days of the first week and a successive weekly …

The Effects Of Postpartum Hemorrhage Simulation, Kera Olson

Doctor of Nursing Practice Projects

Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide. Evidence supports the importance and impact simulation has had on preparation for postpartum hemorrhage. Preparation with hands-on education is imperative for a safe outcome during a real-life hemorrhage situation. Lack of frequent education and simulation can equate to negative outcomes for all involved. The purpose of this project was to increase exposure to a safe environment to explore knowledge and skills during a postpartum hemorrhage event. This quality improvement project surveyed postpartum nurses pre and post-mock postpartum hemorrhage simulation. The setting allowed for mistakes, discussion, and open …

The Role Of Non-Coding Rnas In Myelodysplastic Neoplasms, Vasileios Georgoulis, Epameinondas Koumpis, Eleftheria Hatzimichael

Computational Medicine Center Faculty Papers

Myelodysplastic syndromes or neoplasms (MDS) are a heterogeneous group of myeloid clonal disorders characterized by peripheral blood cytopenias, blood and marrow cell dysplasia, and increased risk of evolution to acute myeloid leukemia (AML). Non-coding RNAs, especially microRNAs and long non-coding RNAs, serve as regulators of normal and malignant hematopoiesis and have been implicated in carcinogenesis. This review presents a comprehensive summary of the biology and role of non-coding RNAs, including the less studied circRNA, siRNA, piRNA, and snoRNA as potential prognostic and/or predictive biomarkers or therapeutic targets in MDS.

Existing Evidence For Influenza B Virus Adaptations To Drive Replication In Humans As The Primary Host, Matthew J. Pekarek, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

Influenza B virus (IBV) is one of the two major types of influenza viruses that circulate each year. Unlike influenza A viruses, IBV does not harbor pandemic potential due to its lack of historical circulation in non-human hosts. Many studies and reviews have highlighted important factors for host determination of influenza A viruses. However, much less is known about the factors driving IBV replication in humans. We hypothesize that similar factors influence the host restriction of IBV. Here, we compile and review the current understanding of host factors crucial for the various stages of the IBV viral replication cycle. While …

Deleterious Heteroplasmic Mitochondrial Mutations Are Associated With An Increased Risk Of Overall And Cancer-Specific Mortality, Yun Soo Hong, Stephanie L Battle, Wen Shi, Daniela Puiu, Vamsee Pillalamarri, Jiaqi Xie, Nathan Pankratz, Nicole J Lake, Monkol Lek, Jerome I Rotter, Stephen S Rich, Charles Kooperberg, Alex P Reiner, Paul L Auer, Nancy Heard-Costa, Chunyu Liu, Meng Lai, Joanne M Murabito, Daniel Levy, Megan L Grove, Alvaro Alonso, Richard Gibbs, Shannon Dugan-Perez, Lukasz P Gondek, Eliseo Guallar, Dan E Arking

Faculty, Staff and Student Publications

Mitochondria carry their own circular genome and disruption of the mitochondrial genome is associated with various aging-related diseases. Unlike the nuclear genome, mitochondrial DNA (mtDNA) can be present at 1000 s to 10,000 s copies in somatic cells and variants may exist in a state of heteroplasmy, where only a fraction of the DNA molecules harbors a particular variant. We quantify mtDNA heteroplasmy in 194,871 participants in the UK Biobank and find that heteroplasmy is associated with a 1.5-fold increased risk of all-cause mortality. Additionally, we functionally characterize mtDNA single nucleotide variants (SNVs) using a constraint-based score, mitochondrial local constraint …

Policy Implementation Analysis Of Spm Health Sector For Hypertension Sufferers In South Kalimantan Province, Indonesia In 2022, Anggi Asri Rusliana Dewi, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

Hypertension is a major cardiovascular risk factor that causes disability throughout the world and among those who are not aware of their health condition, it is often referred to as the silent killer . The prevalence rate of hypertension in Indonesia is quite high. Based on Riskesdas (2018), South Kalimantan Province shows the highest prevalence of hypertension, but the percentage of hypertension sufferers who receive health services is still low. Banjarbaru City has the lowest percentage, namely 11.3% of the target of 100%. Health services for hypertension sufferers are included in the Minimum Service Standards (SPM) for the Health Sector …

Persistent Polyclonal B-Cell Lymphocytosis With Buttock-Like Cells Mimicking Follicular Lymphoma, Fnu Aakash, Sa A Wang, Karan Saluja, Beenu Thakral

Faculty, Staff and Student Publications

No abstract provided.

A Ck2 And Sumo-Dependent, Pml Nb-Involved Regulatory Mechanism Controlling Blm Ubiquitination And G-Quadruplex Resolution, Shichang Liu, Erin Atkinson, Adriana Paulucci-Holthauzen, Bin Wang

Faculty, Staff and Student Publications

The Boom syndrome helicase (BLM) unwinds a variety of DNA structures such as Guanine (G)-quadruplex. Here we reveal a role of RNF111/Arkadia and its paralog ARKL1, as well as Promyelocytic Leukemia Nuclear Bodies (PML NBs), in the regulation of ubiquitination and control of BLM protein levels. RNF111 exhibits a non-canonical SUMO targeted E3 ligase (STUBL) activity targeting BLM ubiquitination in PML NBs. ARKL1 promotes RNF111 localization to PML NBs through SUMO-interacting motif (SIM) interaction with SUMOylated RNF111, which is regulated by casein kinase 2 (CK2) phosphorylation of ARKL1 at a serine residue near the ARKL1 SIM domain. Upregulated BLM in …

Updates On The Immune Cell Basis Of Hepatic Ischemia-Reperfusion Injury, Mi Jeong Heo, Ji Ho Suh, Kyle L Poulsen, Cynthia Ju, Kang Ho Kim

Faculty, Staff and Student Publications

Liver ischemia-reperfusion injury (IRI) is the main cause of organ dysfunction and failure after liver surgeries including organ transplantation. The mechanism of liver IRI is complex and numerous signals are involved but cellular metabolic disturbances, oxidative stress, and inflammation are considered the major contributors to liver IRI. In addition, the activation of inflammatory signals exacerbates liver IRI by recruiting macrophages, dendritic cells, and neutrophils, and activating NK cells, NKT cells, and cytotoxic T cells. Technological advances enable us to understand the role of specific immune cells during liver IRI. Accordingly, therapeutic strategies to prevent or treat liver IRI have been …

Severe Covid-19 Outcomes And Hematological Cancers: The Clot Thickens-Are Platelets The Culprit?, Lenard M Lichtenberger, K Vinod Vijayan

Faculty, Staff and Student Publications

No abstract provided.

School-Issued Devices For Home Use In Kindergarten Through 5th Grade And Parent Perceptions Of Child Learning, Behavior, And Conflict, Brandon T. Mcdaniel Phd, Nathalie Gullo, Zachary Kaiser, Lauren Reining, I. Joyce Chang, Michelle Drouin Phd

Health Services and Informatics Research

With many U.S. schools adopting 1-to-1 school device programs, research on the potential impacts of this device usage at home is critical. In this study, we examined elementary school parents’ perceptions of their child’s use of their school-issued device for academic skill-building and entertainment at home. We then examined the associations between these different types of use and children’s learning, behavior, and parent-child conflict over the device use. Overall, we found that children’s use of school devices at home for building academic skills was predictive of positive impacts on learning and child behaviors and less frequent parent-child conflict over …

Health Policy Reform Through Strengthening Indonesia's Health Resilience System, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

The National Health System in Indonesia is developing and being discussed more seriously after entering the COVID-19 pandemic. With a national health system and several existing tools, Indonesia needed more time to be ready to face the challenges of that time. Upstream health policies should be optimized to mobilize resources and increase the nation's efforts to build a national resilience system. This paper was built using selected policy documents up-to-date and reliable literature. By reviewing empirical evidence, the author believes and shows the role of strengthening health policies in building a robust national health resilience system. Indonesia has several policies …

The Effects Of Vaccination Against Covid-19 Incidence: Is The Current Age-Priorities Appropriate?, Dian Ip Nugrahari, Nurhanifah Hamdah

Journal of Indonesian Health Policy and Administration

Age is an independent risk factor for COVID-19. Thus, the government of Indonesia prioritizes the elderly and adults with significant comorbidities for COVID-19 vaccination. To discover whether this policy is still appropriate, we evaluated the effects of vaccination against the COVID-19 incidence and infection risk.It was a retrospective cohort study of the NAR COVID-19 and Dashboard KPCPEN COVID-19 of the Depok City Health Department. The tests used to analyze the data were the chi-square and logistic regression tests. We discovered that there was a 92.7% total reduction in the COVID-19 infection rate with vaccination. The infection risk for COVID-19 in …

Purification And Characterization Of Mitochondrial Mg2+-Independent Sphingomyelinase From Rat Brain, Jong Min Choi, Yongwei Piao, Kyong Hoon Ahn, Seok Kyun Kim, Jong Hoon Won, Jae Hong Lee, Ji Min Jang, In Chul Shin, Zhicheng Fu, Sung Yun Jung, Eui Man Jeong, Dae Kyong Kim

Faculty, Staff and Students Publications

Sphingomyelinase (SMase) catalyzes ceramide production from sphingomyelin. Ceramides are critical in cellular responses such as apoptosis. They enhance mitochondrial outer membrane permeabilization (MOMP) through self-assembly in the mitochondrial outer membrane to form channels that release cytochrome c from intermembrane space (IMS) into the cytosol, triggering caspase-9 activation. However, the SMase involved in MOMP is yet to be identified. Here, we identified a mitochondrial Mg

Nurses’ Perceptions Of Using Volunteer Support In Health Care Settings: A Systematic Scoping Review, Kate Crookes, Rosemary Saunders, Vivien Kemp, Olivia Gallagher, Manonita Ghosh, Caroline Bulsara, Karen Gullick, Bev O'Connell

Research outputs 2022 to 2026

Aims: To understand nurses’ perceptions of volunteer support in health care settings. Background: Increasingly, volunteers provide specialised support to health care service users, requiring volunteers and nurses to work closely together. However, little is known about nurses’ perceptions of volunteer support. Methods: A scoping review was conducted following the PRISMA-ScR checklist. A mixed-methods convergent integrative approach was taken guided by the JBI framework. Quantitative data were transformed into qualitative data for synthesis and descriptive thematic analysis. Six databases were searched (CINHAL+, EMBASE, PubMed, Scopus, PsycInfo, ProQuest Health and Medical Collection) on 24 January 2022 using terms related to nurses, perceptions, …

Feminization Of Sri Lankan Doctors And Key Specialties: 2000 To 2020, Dileep De Silva, Pamila Adikari, Mihiri S. Rubasinghe, Udeni L. Seneviratne

Journal of Indonesian Health Policy and Administration

The study focused on the feminization of Sri Lankan generalist doctors in all major and selected minor specialties between 2000 and 2020. The study analyzed all relevant documents by exploring Sri Lanka's male-to-female doctor and specialist ratio over 20 years. This was determined by analyzing state medical faculty records from 1990 to 2020. For better clarity, the researchers analyzed the gender ratio changes in every five-year block from 1990 to 2020. Focus groups filled PGIM's gender data fields. Five-year medical students surged from 43% to 63% between 1990 and 2020. Linear trend analysis predicts 68% of female medical students by …