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Introduction: Despite significant efforts to address gender equality in medical education, the issue persists. The narrative review aimed to address the research question: What are the strategies implemented to address issues of gender inequality in medical education and what were their outcomes? Methods: Seven major electronic databases of CINAHL, Embase, ERIC, PsyInfo, PubMed, SCOPUS and Web of Science were reviewed. Search phrases used were (Medical education) AND (Gender equality) OR (Gender bias) OR (Gender diversity) OR (Gender discrimination). Original research articles were included, together with systematic reviews with outcomes reporting on strategies to address gender equality. Results: Articles unrelated to medical education (e.g. allied health and nursing education) and non-English articles were excluded from the study. A total of 1248 articles were identified, and 23 articles met the inclusion criteria. Training programs (n=14; 60.8%) for medical students and faculty have successfully increased awareness on the issues of gender equality and boost confidence in handling cases on gender inequality, yet implicit bias remains with leadership continuing to be associated more strongly with males. Conclusion: Leadership bodies in Institutions of Higher Education and policymakers would be in an ideal position to address these issues through shaping policies and provision of training for hiring bodies and faculty.

BackgroundGlobal populations are aging, and the numbers of stroke survivors is increasing. Consequently, the need for caregiver support has increased. Because of this and demographic and socioeconomic changes, foreign caregivers are increasingly in demand in many developed countries. Therefore, the perspectives of older adult care recipients regarding foreign caregivers warrants attention. This study explored the experiences of older stroke survivors receiving care from foreign caregivers in Taiwan, examining their expectations, needs, and challenges.MethodsThis study employed a descriptive qualitative approach, conducting in-depth interviews with 23 older stroke survivors (mean age, 73.4 years; women, 47.8%). Thematic analysis was applied to transcribed data, with reflective memos aiding in meaning derivation. Methodological rigor was ensured through member checking, triangulation, and auditing.ResultsThree major themes emerged: the motivations for hiring a foreign caregiver, expectations of stroke survivors toward foreign caregivers, and challenges related to employing foreign caregivers. Stroke survivors expected foreign caregivers to be obedient, embrace the local language and culture, and be proficient in caregiving and homemaking. Various challenges, including communication difficulties, cultural differences, skill gaps, and unfavorable attitudes and behaviors among caregivers, were noted.ConclusionsForeign caregivers are a major part of the long-term care workforce and play a crucial role in stroke rehabilitation in aging Asian societies. Older stroke survivors often hire foreign caregivers to alleviate caregiving burdens, and they typically expect foreign caregivers to conform to their needs. However, employing foreign caregivers can be frustrating and stressful. Government intervention and open dialogue is necessary to improve care quality and prevent recurring caregiving problems and conflicts.

In this study, cupric oxide nanowires (CuO NWs) on patterned interdigitated electrodes (PIEs) used as ozone (O3) gas sensors, were successfully fabricated using thermal oxidation and the microelectromechanical systems (MEMS) technique. After the thermal oxidation process, CuO NWs with different heights and densities were fabricated using a pure copper seed layer with a thickness ranging from 0.5 μm to 2 μm. In this experiment, a low temperature, low concentration, and repeatable CuO NWs gas sensor was fabricated, which can detect O3 gas at a low concentration of 50 ppb and low temperature of 100°C with a high sensor response (40%). The concentration response of this gas sensor shows an increasing linear trend, with an increase of O3 concentration in the range of 50 ppb - 300 ppb. Additionally, the results indicated that this CuO NWs gas sensor is more selective for O3 than CO, CO2, C2H5OH, C3H6O, NO2, or NH3. While CuO has been less studied in O3 detection compared with other semiconducting metal oxide materials, CuO NWs show potential applications in gas sensing devices for low-temperature and low-concentration O3 environmental monitoring.

BackgroundThis retrospective study aimed to evaluate the short-term recovery and cost-effectiveness of bilateral unicompartmental knee arthroplasty (UKA) compared to staged unilateral UKA. The study analyzed postoperative pain scores, medical costs, and complications in patients with knee osteoarthritis who underwent these procedures.MethodsA total of 226 patients who received either unilateral UKA (Group A, n = 170) or bilateral UKA (Group B, n = 56) using the mobile-bearing UKA were included in the study. Patient demographics, surgical details, postoperative pain scores, knee range of motion, length of hospital stay, self-controlled analgesic use, total medical costs, and complications were retrospectively collected from medical records.ResultsThe demographic characteristics were comparable between the groups. Group B had a longer surgical time and higher medical costs than Group A. However, there were no significant differences in hospital stay, pain scores, or knee range of motion between the two groups. Complications were infrequent and not significantly different. Insert dislocation and loosening were the most common complications. Patient-controlled analgesia effectively reduced pain scores in Group A but not in Group B.ConclusionBilateral UKA does not significantly affect hospital stay, postoperative pain, or complications compared to unilateral UKA. Although bilateral UKA requires longer surgical time and incurs higher costs, it offers the potential benefit of reducing anesthesia-related complications and overall health insurance expenditures. This study recommends bilateral UKA as a suitable option for patients with bilateral knee osteoarthritis, given its comparable short-term outcomes and potential cost-saving advantages.Level of EvidenceIII

Importance: Hospital admission for a critical illness episode creates communication breakpoints and can lead to medication discrepancies during hospital stays. Due to the patient’s underlying condition and the care setting, chronic medications such as cardiovascular medication are often held, discontinued, or changed to alternative administration routes. Unfortunately, data on the optimal timing of cardiovascular drug reinitiation among intensive care unit (ICU) survivors are lacking. Objective: The primary objective of this study was to describe the prevalence of chronic cardiovascular medication taken before hospital admission and discontinued at ICU discharge and hospital discharge for critically ill patients. A secondary objective was to assess factors associated with medication discontinuation. Design setting and participants: We conducted a multicentered retrospective cohort study at 2 tertiary academic hospitals in Canada. All adult patients taking cardiovascular medication before ICU admission and surviving to hospital discharge between April 1, 2016, and April 1, 2017, were eligible. Main outcomes and measures: The main outcome of the study was the discontinuation of cardiovascular medication prescribed before ICU admission. The outcome was assessed through participants’ chart review. Results: We included 352 patients with a median age of 71.0 years. A total of 155 patients (44.03%) had at least 1 cardiovascular medication discontinued during their stay. Our adjusted model uncovered 3 factors associated with cardiovascular medication discontinuation: male sex (odds ratio [OR] = 0.564, 95% confidence interval [CI] = 0.346-0.919), number of cardiovascular medications taken preadmission (OR = 1.669, 95% CI = 1.003-2.777 for 2 medications and OR = 3.170, 95% CI = 1.325-7.583), and the use of vasopressors (OR = 1.770, 95% CI = 1.045-2.997). Conclusion: Our study uncovered that cardiovascular medication discontinuation for ICU patients is frequent, especially for renin-angiotensin system (RAS) blockers. Data from our study could be used to reinforce site-specific protocols of medication reconciliation and optimization, as well as inform future protocols aimed at RAS blocker reinitiation follow-up.

Reducing carbon emissions from agricultural soils contributes to global greenhouse mitigation. Although the integration of no-tillage practices into maize/pea intercropping systems can achieve this reduction, the specific microbial mechanisms involved remain unclear. This study aimed to explore the effects of integrating maize/pea intercropping and no-tillage technologies on soil carbon emissions and microbial communities. The results indicated that intercropping no-till maize with peas reduced the average soil respiration rates by 19%. In 2021 and 2022, intercropping no-till maize with peas decreased soil carbon emissions by 25.1 and 30.4%, respectively. This practice resulted in a reduction of soil microbiota carbon and nitrogen by 26.9 and 19.7%, respectively, while simultaneously increasing the soil microbial gene beta diversity. Proteobacteria, Actinobacteria, Planctomycetes, Firmicutes, Bacteroidetes, and Acidobacteria collectively represented over 95% of the population and were predominant across all treatments. Intercropping no-till maize with peas decreased the abundance of carbohydrate-active enzymes in the soil. The structural equation modeling indicated that combined no-tillage and intercropping practices effectively decreased soil carbon emissions by modulating the community structure of soil microorganisms. This affected the abundance of carbohydrate-active enzymes and carbon-metabolizing genes in the soil. This study indicated that no-tillage and intercropping methods contributed to carbon reduction by influencing soil microbes. This study can provide microbial-level insights for refining agronomic practices to mitigate soil carbon emissions.