United States

Background
TikTok, a popular social media platform for short-form mobile videos, provides a source for individuals to share and receive information regarding permanent sterilization methods. TikTok has become the primary source for young adults to receive a majority of their daily information, including contraceptive health information among young women. While TikTok has become beneficial in connecting individuals with shared concerns, users can also be exposed to significant misinformation.
Methods
101 TikTok videos under #tubal, #tuballigation, and #tubestied were collected using Apify web-scraping software for analysis. Each video was evaluated for creator demographics, tonality, and medical content by two separate reviewers, a third reviewer mediating discrepancies in assessment. DISCERN and PEMAT (Patient Education Materials Assessment Tool) criteria were used to evaluate the quality and accuracy of medical information presented through the TikTok videos regarding tubal ligation. DISCERN scores range from a low of 1 and a high of 5 regarding medical information quality. PEMAT scores range from 10%-100% and evaluate the understandability of patient education audiovisual materials.
Results
Results indicated that video tonality was split between positive (32.7%), negative (31.7%), and neutral (27.7%). While 25.7% of the videos explicitly referenced a negative experience with female permanent contraception a majority did not, with 5.9% mentioning both a positive and negative experience. 16 videos (15.8%) explicitly focused on failure of the tubal ligation procedure resulting in unexpected pregnancy. Of the 28.7% of videos showcasing a personal experience, changes in menstruation, hormones, and increased pain and cramping were highlighted as notable and debilitating side effects, with the colloquial term “post-tubal syndrome” emerging among women. Only a minority of videos were created by healthcare professions (24.8%), and among those, most (80%) were board certified Obstetric Gynecologists who often shared content regarding the logistics of procedures, risks, complications, and outcomes. Of the 15 videos containing medical content created by healthcare professionals the average DISCERN score was 3.8 compared to a score of 3 by laypeople (n=22). The average PEMAT score for videos with medical content was 84.2%, higher among healthcare professionals (93.3%) than lay people (81.8%). 
Conclusion
#tuballigation, #tubal, and #tubestied videos on TikTok commonly showcase negative experiences and failed procedures resulting in pregnancy through the sharing of individual’s personal experiences as well as content regarding procedural logistics and sterilization education from healthcare professionals. Qualified health professionals may consider utilizing TikTok as a platform to effectively share credible medical knowledge regarding female permanent contraception, as many individuals seek and obtain health information from the platform. Awareness of the content patients consume can help healthcare professionals address misinformation and guide informed medical decision-making. 



AMA Research Challenge 2025 

Use of TikTok as a Source of Medical Information Regarding Tubal Ligation

### Welcome to The 63rd Annual Meeting of the Association for Computational Linguistics (ACL 2025)

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Background: Vagus nerve stimulation (VNS) has been demonstrated to reduce stress-induced cortisol release. Several non-invasive techniques for VNS are currently available, including transcutaneous auricular and cervical VNS. Cervical VNS potentially activates efferent and afferent vagal nerve fibers, while auricular VNS activates the auricular branch of the vagus nerve, which is a purely afferent nerve. We hypothesized that VNS causes a state of mental tranquility, thereby reducing arterial blood pressure.
Methods: The study was approved by the Burrell College Institutional Review Board and included 16 healthy young participants (5 ♂) who provided written informed consent. Exclusion criteria included pregnancy, acute or chronic illnesses, and use of prescription medications, except contraceptives. Participants were randomly assigned to: time control (CTR, no intervention), transcutaneous cervical VNS (cVNS), transcutaneous auricular VNS applied to either the tragus (atVNS) or the cymba conchae (acVNS). A 30-minute baseline recording was followed by VNS or no intervention. VNS was applied three times for 5 min. Each 5-minute VNS was followed by 1 minute without stimulation. cVNS was delivered bilaterally using the Pulsetto device (25 Hz, 100 μs, < 40 mA). atVNS and acVNS (10 Hz, 300 μs, 2-3 mA). Heart rate (ECG), blood pressure (finger plethysmography), and a single-channel EEG (FP1 location) were recorded continuously. Statistics included one-way ANOVA for repeated measures with post-hoc t-tests for each experimental group. P < 0.05 was considered significant, 0.05 < P < 0.10 was considered a trend. 
Results: Systolic blood pressure only decreased during cVNS (133.6±5.0 mmHg at baseline vs. 124.2±4.8 mmHg, n=7, P<0.05) but not in the time control or both auricular VNS groups. No significant changes in heart rate were observed in any group. The amplitude of alpha waves in the EEG increased only in the cVNS group (0.654±0.070 arb. units at baseline vs. 0.827±0.076 arb. units, n=7, P=0.06) but not in the time control or both auricular VNS groups. No significant changes were observed for any other EEG waves.
Conclusion: Non-invasive transcutaneous VNS reduced systolic blood pressure and increased alpha waves in the EEG of the frontal lobe when the cervical vagus nerve was targeted bilaterally, but not when the auricular branch of the vagus nerve was stimulated unilaterally. Increased alpha waves are consistent with a more relaxed mental state, which may have caused the reduction in systolic blood pressure with cVNS, potentially through decreased stress hormone release.

NOTE: All listed authors contributed equally. 


Non-Invasive Cervical Vagus Nerve Stimulation Increases Brain Alpha Waves and Reduces Arterial Blood Pressure

Background 

The right atrioventricular (tricuspid) valve (RAV) separates the right atrium and ventricle to inhibit retrograde blood flow during ventricular systole. Although traditionally described as having three leaflets — anterior, posterior, and septal — it is not uncommon for the RAV leaflet number to vary with previous studies finding three leaflets in 28% to 71.1%, four leaflets in 28.9% to 52%, and as few as 2 and as many as 6 have been documented. An understanding of RAV functional morphology is essential for successful transcatheter tricuspid valve repair (TTVR) procedures for the treatment of tricuspid regurgitation. Although less common than mitral valvular disorders, tricuspid regurgitation has been shown to correlate with poor cardiac sequela and increased cardiac mortality, leading to increasing incidence of TTVR procedures. This ongoing study explores the prevalence of variation in RAV leaflet numbers using cadaveric donors at Midwestern University to contribute to the understanding of its morphology and implications for TTVR. 

Methods 

Thirty-seven cadaveric donor hearts consisting of 19 males and 18 females were examined and classified according to the schema—Type 1 (three leaflets), Type 2 (two leaflets), and Type 3 (four leaflets). The presence of a fourth leaflet was further subdivided based on additional leaflet location—type 3A (anterior), 3B (posterior), and 3C (septal). Individual leaflets were defined during dissection as existing within a distinct gross margin of the valve and having unique papillary muscle attachments. This procedure allowed us to distinguish discrete additional leaflets from commissural leaflets that exist between two leaflet margins but function in tandem with a single leaflet. 

Results 

This study found that of the 37 hearts, 29 (78.4%) were Type 1, three (8.1%) were Type 2, and five (13.5%) were Type 3. Of the Type 3, one was Type 3A (2.7%), two were Type 3B (5.4%), and two were Type 3C (5.4%). 

Conclusion 

This study found lower frequencies of a fourth leaflet than previous studies. However, the findings of these studies vary widely, primarily due to procedural differences in defining and distinguishing leaflets from commissural leaflets arising from a lack of universal naming protocols. Regarding TTVR, the presence of a fourth RAV leaflet is clinically significant as it is associated with increased residual regurgitation following procedure in those treated for isolated tricuspid regurgitation. These preliminary data contribute to the growing understanding of RAV morphology, which has the potential to contribute to current and future advancements in the treatment of tricuspid regurgitation.

Anatomical Variation in Cadaveric Tricuspid Valves and Implications for Transcatheter Tricuspid Repair

Background
Adefovir dipivoxil (ADV) is an antiviral nucleotide analog used clinically to treat hepatitis B that was found to have nephrotoxic effects when used at higher doses to treat human immunodeficiency virus. This effect is hypothesized to result from inhibition of mitochondrial DNA replication in the nephron. ADV also promotes the expression of CCAAT-enhancer-binding protein-β (C/EBPβ) target genes involved in fatty acid oxidation in mitochondria and prevents diet-induced obesity in mice, though the mechanisms are currently unclear. Free fatty acids are toxic to pancreatic β cells and thus important in the development of type 2 diabetes mellitus. We hypothesize that ADV can protect against fatty acid toxicity in pancreatic β cell lines and increase insulin secretion through mitohormesis.

Methods
Immortalized β cells were treated with increasing levels of ADV and palmitic acid and evaluated for toxicity and mitochondrial function via flow cytometry, insulin secretion via ELISA, and mitochondrial morphology via microscopy (no palmitate was given with this method).

Results
We found that insulin secretion was increased in cells treated with ADV compared to those without ADV treatment at no palmitate levels. Our research also revealed that ADV protects against fatty acid toxicity, with the least cell death seen in cells treated with ADV at maximum palmitate concentrations. Finally, we found that mitochondrial function, as quantified by TMRE fluorescence to MitoTracker Deep Red fluorescence ratio, was highest in cells treated with ADV at all concentrations, regardless of palmitate concentrations. For mitochondrial morphology, qualitatively, cells treated with ADV appeared to have more punctate mitochondria than those without ADV treatment; this phenomenon is consistent with prior observations in other cell types. 

Conclusion
These data show that ADV can protect against fatty acid toxicity and increase insulin secretion in pancreatic β cells, potentially through mitohormesis. We hypothesize that ADV treatment may have this effect by promoting mitophagy, given the findings of punctate mitochondria, though this requires further investigation. This drug can elucidate the role of mitochondria in the pathogenesis of type 2 diabetes mellitus, which may lead to new understandings and therapeutic approaches for one of the most widespread chronic diseases in the United States.

Protective effects of adefovir dipivoxil in pancreatic β cell lines

Background: GBM, WHO grade IV, is classified transcriptionally into three subtypes: proneural, mesenchymal, or classical. High grade gliomas have been shown to demonstrate high intratumoral heterogeneity, which promotes an environment conducive for plasticity and selection. PDGFRA is amplified in 14% of newly diagnosed GBM studied by The Cancer Genome Atlas. Assaying different subpopulations from the same tumor, our objective was to characterize the genetic programs associated with the presence and absence of PDGFRA ecDNA.

Methods: To identify gene signatures associated with negative and positive selection of PDGFRA, we performed droplet-based single-cell RNA sequencing (Chromium Next GEM Single Cell 3’ v3 library (10X Genomics, Pleasanton, CA)) on 4 distinct populations from a patient-derived model, HF3253. Data preprocessing was conducted in Cell Ranger and Seurat. After filtering cells with greater than 10% mitochondrial content, 27,842 cells were subjected to canonical correlation analysis and assessed by Loupe, AUCell, and CellChat.

Results: Gene signatures for all three subtype signatures were present in distinct clusters in the mosaic projection derived from the 4 unique subpopulations. Unexpectedly, a 24-gene mesenchymal signature was enriched in 70% of the assayed cells (AUC = 0.056). This enriched signature was present in almost 47% PDGFRA-expressing cells (log > 1) and was also well- represented in a literature-based dataset. In addition to this signature, PDGFRA+ cells were identified as endothelial and vascular leptomeningeal cells (VLMC, brain fibroblast). PDGFRA transcript was virtually absent in microglial-like cells. Cell-cell communication inference classified the VLMC population as the dominant signaling node, modulating both incoming and outgoing signals. We next mapped the top 50 most significant differentially expressed genes associated with PDGFRA ecDNA loss from bulk RNA sequencing to our single-cell data. These unique clusters were highly enriched in neurodevelopmental cell types (oligodendrocyte precursor cells, oligodendrocytes, astrocytes). Specifically, 37% of the total cell population highly expressed a 103-gene signature for mature astrocytes (AUC = 0.17).

Conclusion: PDGFRA amplifications have traditionally been classified as a driver of an OPC- like gene program in GBM. Our identification of a fibroblast-like gene program in PDGFRA ecDNA+ cells challenges the notion that tumor drivers have a definitive cellular program and hypothesizes that GBM tumor evolution can be attributed to oncogene-driven plasticity. As mesenchymal transition is a predominant evolutionary mechanism in recurrent GBM specimens, our work validates PDGFRA as a therapeutic target following early tumor progression. Loss of PDGFRA in our model appears to promote cell differentiation associated with normal neurodevelopmental trajectories.

Characterization of glioblastoma (GBM) transcriptional heterogeneity in a patient derived platelet derived growth factor receptor alpha (PDGFRA) extrachromosomal DNA (ecDNA) amplified model

Background
The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) was created with the goal of quality improvement in bariatric surgery. Centers with MBSAQIP accreditation report outcomes to a national database. Staple line bleeds are a primary cause of postoperative hemorrhage in vertical sleeve gastrectomy (VSG). Review of our institution’s MBSAQIP semiannual report noted higher instances of reoperations following laparoscopic. This study sought to standardize practice across surgeons and reduce reoperation for bleeding following VSG.

Methods
Using the Plan, Do, Study, Act framework, two review periods were determined. Pre-intervention, surgeons used a hybrid robotic-laparoscopic approach to VSG in which the dissection was performed with the robot and a laparoscopic stapler was used to complete the sleeve. The intervention included standardizing an entirely robotic approach. A peer review and manufacturer recommendation from Covidien were used to develop our technique using 1-2 blue loads based on tissue thickness and feedback from the robot followed by white loads to complete the sleeve.

Results
Pre-intervention, 5/107 cases (4.67%) required reoperation with 80% due to staple line bleeds (3 hybrid technique and 1 robotic sleeve). Post-intervention, 1/56 VSG required reoperation for bleeding on a laparoscopic VSG. There were zero postoperative bleeding episodes for fully robotic sleeves. Sixty-nine percent of robotic cases used additional interventions (clips or oversewing staple lines at the index operation), and 31% did not require additional intervention. 

Conclusion
Standardizing robotic VSG decreased re-operations for bleeding. Reinforcement of robotic staple lines was performed in most cases and likely contributed to the reduction. Future work should consider standardizing reinforcement techniques or using reinforced stapler loads.

Vertical Sleeve Gastrectomy Stapler Length – Quality Improvement Project

Background
Cervical disc degeneration is a condition that significantly diminishes a patient’s quality of life. It is commonly treated with surgical interventions such as anterior cervical discectomy and fusion (ACDF) or cervical disc arthroplasty (CDA). Obesity, an ever-growing global public health concern, introduces unique challenges to spinal surgery due to its detrimental effects on biomechanical stress, wound healing, and recovery. Even with recent advancements in surgical techniques, the literature regarding how obesity affects the outcomes in ACDF vs CDA is limited. Therefore, the objective of this study is to compare clinical outcomes, functional recovery, and complication rates of CDA and ACDF in obese adults to provide evidence-based insights that can guide clinical decision-making for this high-risk population.

Methods
A retrospective database analysis was conducted using the multi-institutional database TriNetX, on the research network, wherein we looked at adult (>18 y/o) obese (>30 BMI) versus non-obese patients (18-29 BMI) undergoing ACDF vs CDA. Propensity score matching was done to ensure balanced demographic and clinical characteristics, which generated 26,272 patients for the 90-day analysis and 2,269 patients for the 2-year analysis in the obese ACDF group, and 2,270 patients for the 90-day analysis and 2,269 patients for the 2-year analysis in the obese CDA group. Our primary outcomes included functional improvement measured by the neck disability index (NDI), composite success, as well as readmission rates. Secondary outcomes included infections, deep vein thrombosis (DVT), cerebrospinal fluid (CSF) leak repairs, mechanical complications, adjacent segment disease, and cervical herniation. Risk ratios (RRs) and statistical significance (p < 0.05) were calculated to compare the two cohorts.

Results
Obese patients that underwent CDA were associated with significantly lower 90-day readmission rates (RR: 0.79; p < 0.001), fewer 2-year readmissions (RR: 0.58; p < 0.001), and improved functional outcomes, including composite success and Neck Disability Index scores (p < 0.001). CDA also demonstrated trends toward fewer infections, adjacent segment disease, and deep vein thrombosis, though these differences were not statistically significant. Mechanical complications and cervical herniation rates were comparable between the two groups. 

Conclusion
In obese patients, CDA demonstrated better functional recovery and lower readmission rates compared to ACDF, with comparable complication rates. Our findings support that CDA may be a more viable option for managing cervical disc degeneration in this vulnerable population.

Cervical Disc Arthroplasty vs. Anterior Cervical Discectomy and Fusion in Obese Patients: 90-Day and 2-Year Outcomes

Effect of miR-29a-3p on PDGFA in Pulmonary Artery Smooth Muscle Cells

Background
In the United States, approximately 1 out of 10 infants are born prematurely. Bronchopulmonary dysplasia (BPD) affects many premature infants often due to being placed on mechanical ventilation at birth. The mechanisms of BPD are not well known and can also have a pulmonary hypertension effect (BPD-PH). In a preliminary study, we conducted a multi-omics analysis in tracheal aspirate of infants with BPD-PH and identified a panel of genes and miRNAs that were specifically highly expressed in BPD-PH. Of them, miR-29a-3p was the most highly expressed markers. The in-silico model of this biomarker panel identified angiogenic and inflammatory molecules as target pathways affected. In this study we investigated the effect of miR-29a-3p on the pulmonary artery smooth muscle cells (PASMC) which are dysregulated and hypertrophied in BPD-PH. 

Methods
PASMC were grown using Lonza smooth muscle growth medium and were transfected with 375nM of a FAM tagged miR-29a-3p mimic using the Mirus Transfection System at 300V. The control PASMC condition was transfected with a miRNA scramble. Cells were plated at a density of 3x106 cells/cm2 in a 6 well plate and 72 hours later, cells were imaged using the Cytation5 and harvested using the Lonza ReagentPack. Cells were RNA extracted, and RT-qPCR was performed for multiple mRNA transcripts (PDGFA, VEGF-A, IL-6, TGF-, ANGPTL4, TNF-).

Results
There was a significantly decreased expression of PDGFA in the miR-29a transfected PASMC when compared to control cells. We also noted slight trends in decreased expression of other angiogenic factors including VEGFA, ANGPTL4 and increased expression of inflammatory markers such as TNF- and TGF-. 

Conclusion
In our preliminary study miR-29a-3p has been overexpressed in premature neonates with BPD-PH. An increase in miR-29a-3p expression in PASMC decreased the level of PDGFA expression. Further research is needed to identify the specific mechanism through which the miR-29a modulates the angiogenic factors.

Impact of miR-29a-3p on Pulmonary Artery Smooth Muscle Cells

Abstract Title: Salvage irreversible electroporation (IRE) for radio-recurrent prostate cancer: perioperative and early postoperative outcomes 



Authors: William Connolly, BA, MSF1,2, Jarrett Noakes3, Katherine Wainwright1, Elias Hyams, MD1,2 

1Brown University, Providence, RI; 2Brown University Health; 3Florida Atlantic University 



Introduction: 

Local recurrence after radiation therapy (RT) for prostate cancer (PCa) creates a therapeutic dilemma based on risks of treatment in a previously radiated pelvis. Irreversible electroporation (IRE), a novel non-thermal focal therapy, has emerged as a potentially safe and effective local salvage therapy for these patients, however there are limited published data. 



Methods: 

We retrospectively analyzed 12 patients with radio-recurrent PCa who underwent salvage IRE (sIRE) between 12/23-1/25. These procedures were performed by one surgeon in a standardized transperineal approach. Pre-operative characteristics as well as post-operative outcomes were recorded. 



Results: 

Mean patient age was 75.4+/-5.38. All patients had undergone external beam radiation therapy +/- ADT for localized disease. Pretreatment Grade group was GG1, 2, 4, and 5 in 5(41.7%),4(33.3%),2(16.7%), and 1(8.3%) patient, respectively. Median pretreatment PSA was 5.3 (7.1). At sIRE, mean PSA was 5.15+/-2.30. All patients had local recurrence only by PSMA PET. All patients underwent saturation transperineal biopsy with cognitive targeting with confirmation of local recurrence. At 3 months postoperatively, mean PSA was 0.93+/-0.89. At 6 months, mean PSA was 1.78+/- 1.66. 5 patients had an MRI at 6 months showing treatment effect or artifact. One patient had a persistently elevated PSA and was found to have a new lung lesion on repeat PSMA PET. Urinary morbidity included two patients (16.7%) with bothersome storage LUTS treated medically; one patient had resolution within 3 months; one had persistent symptoms treated with PTNS. Three patients (25%) had post-operative UTI treated with oral antibiotics, and two patients (16.7%) with retention required limited TURP. 



Conclusions: 

Salvage IRE has encouraging early outcomes by PSA and radiographic response, though longer term follow-up is needed. Patient selection is critical to optimize success. While there was short term urinary morbidity, sequelae were rare. 







References: 

Smith CP, Xiang M, Armstrong WR, et al. Patterns of Failure in Men With Radiorecurrent Prostate Cancer: A Post Hoc Analysis of 3 Prospective Gallium 68 Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography Imaging Trials. Int J Radiat Oncol Biol Phys. 2023;116(5):1079-1084. doi:10.1016/j.ijrobp.2023.02.039 

Valle LF, Lehrer EJ, Markovic D, et al. A Systematic Review and Meta-analysis of Local Salvage Therapies After Radiotherapy for Prostate Cancer (MASTER). Eur Urol. 2021;80(3):280-292. doi:10.1016/j.eururo.2020.11.010 

Frame G, Huang X, Haas R, et al. Accelerated growth and local progression of radiorecurrent prostate cancer in an orthotopic bioluminescent mouse model. Sci Rep. 2024;14(1):31205. Published 2024 Dec 28. doi:10.1038/s41598-024-82546-w

Salvage Irreversible Electroporation (IRE) for Radio-Recurrent
Prostate Cancer: Perioperative and Early Postoperative Outcomes

Objectives: 
Opioid use disorder (OUD) is a major public health concern. Integrated obstetric/addiction care models improve outcomes for pregnant and postpartum individuals with OUD. However, racial disparities in OUD treatment suggest potential inequities in service utilization. This study examines service utilization by race among pregnant individuals with OUD in an integrated obstetric/addiction clinic.

Methods: This secondary analysis used data from a retrospective medical record review study of pregnant patients with OUD receiving care at an urban outpatient integrated obstetric/addiction clinic. Participants included individuals who had a live birth between June 2019 and June 2021 and consented to participate in a research study. Demographic, obstetric, and substance use disorder treatment data were collected from electronic health records. Chi-square tests compared service utilization between non-Latine White and non-Latine Black/African American patients.

Results: The study included 41 participants: 68.3% White (68.3%) and 31.7% Black/African American (31.7%). Most participants (68.3%) attended four or more provider visits in the third trimester (White: 75.0%, Black: 53.8%). Third-trimester mental health counseling was utilized by 65.9% of participants (White: 67.0%, Black: 61.5%). No significant racial differences in service utilization were observed. Utilization of pediatric neonatal opioid withdrawal syndrome education (17.1%) and intimate partner violence screening (7.3%) were low.

Conclusions: Service utilization rates were similar across racial groups, suggesting equitable uptake within this sample. However, the study’s generalizability is limited by its sample size. Future research should incorporate diverse racial/ethnic groups and qualitative measures to assess patient experiences and barriers to care. 


Resource Utilization Among Racial Subgroups in an Integrated Obstetric/Addiction Clinic

Intimate Partner Violence (IPV) is a significant public health concern that remains insufficiently addressed in medical education. A national survey indicates that nearly one in two women (47.3%) and more than 40% of men (44.2%) in the United States have experienced IPV in their lifetime. Despite the high prevalence and serious health implications of IPV, comprehensive training on this topic has not been widely incorporated into medical school curricula. Current research shows integrating interactive simulations into medical school curriculum is the best practice for providing lasting knowledge on the training topic at hand. This study aims to bridge the educational gap of IPV in medical students by implementing an interactive, simulation-based curriculum. This will not only enhance future physicians' competency in recognizing IPV but also equip them with the skills to provide appropriate resources to victims. Participants will engage in a structured training session, featuring a role-playing exercise and guided case discussions. A pre- and post-survey model will be used to assess changes in knowledge, confidence, and attitudes toward IPV management. Preliminary data has demonstrated statistically significant improvements in both preparedness and knowledge among participants following the intervention. These preliminary findings suggest the intervention was effective in enhancing medical students’ confidence and understanding related to identifying and managing intimate partner violence in clinical settings. Additionally, initial data suggests students feel more adequately equipped with practical tools for screening and intervention, alongside a heightened sense of empathy, compassion, and understanding of IPV victims - an essential step in providing trauma-informed, supportive care. Notable limitations of this study include the immediate timing of participant responses, which may have been influenced by the emotional impact of the intervention, as well as a small final sample size (n=20). Although 59 participants completed the pre-survey, only 24 completed the post-survey, and just 20 submitted fully completed responses. This low yield of responses raises concerns about feasibility and integration of such a curriculum within an already demanding medical school schedule. Alongside a larger sample size, longitudinal investigation of participants would be needed to assess efficacy of the curriculum in clinical practice. However, by implementing a curriculum that is interactive and attitudinally transformative, we aim to bridge the existing educational gap and, ultimately, provide more comprehensive patient care in clinical practice.

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