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For diversity to exist in the medical graduate workforce, students from all backgrounds should have equitable opportunities of employment. Specialties have utilized a minimal threshold for USMLE Step 1 score when screening applicants for residency interviews. The OHSU SOM class of 2021 completed a 14-question voluntary survey on their Step 1 score and the following non-modifiable risk factors: Adverse Childhood Experience score (ACEs), sex, gender, Underrepresented in Medicine status (URiM), family income during adolescence, highest degree held by a guardian, discrimination experience during medical school, federal/state assistance use, and rural versus urban primary home. Descriptive statistics and unadjusted risk ratios were applied to study the relation between Step 1 score and non-modifiable risk factors as well as certain non-modifiable risk factors and ACEs ≥ 3. The mean Step 1 score was 230 (213, 247). Of the students, 28.2% identified ACEs ≥ 3, 13.6% were considered URiM, and 65.4% were female. URiM were 2.34 (1.30, 4.23),females were 2.77 (1.06-7.29), and those who experienced discrimination in medical school were 4.25 (1.85, 9.77) times more likely to have ACEs ≥ 3. Students who had ACEs ≥ 3 were 3.58 (1.75, 7.29) times less likely to meet a minimal threshold for residency interviews of 220. These are the first results to demonstrate a relationship between Step 1 score and ACEs. Those who identified as URiM, females, and those who experienced discrimination in medical school were at a higher risk of ACEs of ≥ 3. Step 1 transitioned to pass/fail in January 2022. However, the first application cycle that residencies will see pass/fail scoring is 2023-2024, and fellowships will continue to see scored Step 1 until, at the earliest, the 2026-2027 application cycle. These data contribute to a foundation of research that could apply to Step 2CK testing scores, and help to inform decisions about the diversity and equity of the residency interview process.

We aimed to determine absolute and relative risks of either symptomatic or asymptomatic SARS-CoV-2 infection for late cardiovascular (CV) events and all-cause mortality. We conducted a retrospective double cohort study of patients with either symptomatic or asymptomatic SARS-CoV-2 infection (COVID-19+ cohort) and its documented absence (COVID-19− cohort). The study investigators drew a simple random sample of records from all patients under the Oregon Health & Science University Healthcare (n = 65,585), with available COVID-19 test results, performed March 1, 2020 to September 13, 2020. Exclusion criteria were age <18 years and no established Oregon Health & Science University care. The primary outcome was a composite of CV morbidity and mortality. All-cause mortality was the secondary outcome. The study population included 1,355 patients (mean age 48.7 ± 20.5 years; 770 women [57%], 977 White non-Hispanic [72%]; 1,072 ensured [79%]; 563 with CV disease history [42%]). During a median 6 months at risk, the primary composite outcome was observed in 38 of 319 patients who were COVID-19+ (12%) and 65 of 1,036 patients who were COVID-19− (6%). In the Cox regression, adjusted for demographics, health insurance, and reason for COVID-19 testing, SARS-CoV-2 infection was associated with the risk for primary composite outcome (hazard ratio 1.71, 95% confidence interval 1.06 to 2.78, p = 0.029). Inverse probability-weighted estimation, conditioned for 31 covariates, showed that for every patient who was COVID-19+, the average time to all-cause death was 65.5 days less than when all these patients were COVID-19−: average treatment effect on the treated −65.5 (95% confidence interval −125.4 to −5.61) days, p = 0.032. In conclusion, either symptomatic or asymptomatic SARS-CoV-2 infection is associated with an increased risk for late CV outcomes and has a causal effect on all-cause mortality in a late post-COVID-19 period.

Background Warm autoimmune hemolytic anemia is characterized by destruction of red blood cells mediated by autoantibodies, which can be triggered by various underlying factors including tick-borne infections. Babesia spp. are protozoan parasites transmitted by tick bites that cause babesiosis and have been increasingly recognized as a potential precipitating factor for warm autoimmune hemolytic anemia. Case presentation This was a retrospective review of a single case where patient information was extracted from the electronic medical records after written informed consent was obtained. A literature review was also performed. We present a rare case of a 71-year-old White, non-Hispanic/Latino male patient with babesiosis and concurrent warm autoimmune hemolytic anemia. The patient initially presented with fever, chills, and anemia. A tick-borne illness panel was positive for Babesia microti . Despite therapy with doxycycline, azithromycin, and atovaquone, the hemoglobin continued to decline. This prompted investigation for autoimmune hemolytic anemia. A direct antiglobulin test revealed weak positivity for immunoglobulin G. After treatment with high-dose prednisone, the patient’s hemoglobin gradually improved, and his liver enzymes normalized. Conclusions Given the increasing prevalence of tick-borne illnesses, physicians should have a high index of suspicion for concurrent warm autoimmune hemolytic anemia in patients with babesiosis and anemia not improving with typical therapies. In addition, the interplay between babesiosis and warm autoimmune hemolytic anemia underscores the need for clinicians to consider infectious etiologies in the workup of this disease.

Objective To determine whether people of Color experienced disparate levels of employment loss in frontline versus non-frontline occupations during the onset of the COVID-19 pandemic. Methods The Bureau of Labor Statistics Current Population Survey data was analyzed in a cross-sectional study. Percent change in number employed was tabulated quarterly for groups by race and ethnicity (Black or African American, Asian American, or Hispanic or Latinx compared to White or non-Hispanic or Latinx) and frontline occupation status between January 1 and June 30, 2020. Two-tailed two-sample tests of proportions were used to compare groups statistically. Results More dramatic declines in number employed occurred in the Black or African American, Asian American, and Hispanic or Latinx groups. When stratified by sector, greater declines were noted in the Hispanic or Latinx and Asian American frontline, and Black or African American non-frontline groups when compared to the referent groups. Conclusions Structural racism has further affected people of Color through differential employment loss during the onset of the pandemic, both overall and by sector. However, the effect of sector varies dramatically across racial and ethnic groups. Policy Implications Because employment is an important social determinant of health and a potential risk factor for contracting COVID-19, these trends may provide important context for the prioritization of PPE and immunizations, as well as the provision of stable health insurance and income support for vulnerable workers.

This paper reports on the use of estimates of individual animal feed intake (made using time spent feeding measurements) to predict the Feed Conversion Ratio (FCR), a measure of the amount of feed consumed to produce 1 kg of body mass, for an individual animal. Reported research to date has evaluated the ability of statistical methods to predict daily feed intake based on measurements of time spent feeding measured using electronic feeding systems. The study collated data of the time spent eating for 80 beef animals over a 56-day period as the basis for the prediction of feed intake. A Support Vector Regression (SVR) model was trained to predict feed intake and the performance of the approach was quantified. Here, feed intake predictions are used to estimate individual FCR and use this information to categorise animals into three groups based on the estimated Feed Conversion Ratio value. Results provide evidence of the feasibility of utilising the ‘time spent eating’ data to estimate feed intake and in turn Feed Conversion Ratio (FCR), the latter providing insights that guide farmer decisions on the optimisation of production costs.

Human cytomegalovirus (HCMV) extensively modulates host cells, downregulating >900 human proteins during viral replication and degrading ≥133 proteins shortly after infection. The mechanism of degradation of most host proteins remains unresolved, and the functions of many viral proteins are incompletely characterised. We performed a mass spectrometry-based interactome analysis of 169 tagged, stably-expressed canonical strain Merlin HCMV proteins, and two non-canonical HCMV proteins, in infected cells. This identified a network of >3400 virus-host and >150 virus-virus protein interactions, providing insights into functions for multiple viral genes. Domain analysis predicted binding of the viral UL25 protein to SH3 domains of NCK Adaptor Protein-1. Viral interacting proteins were identified for 31/133 degraded host targets. Finally, the uncharacterised, non-canonical ORFL147C protein was found to interact with elements of the mRNA splicing machinery, and a mutational study suggested its importance in viral replication. The interactome data will be important for future studies of herpesvirus infection.