Women with a history of gestational diabetes mellitus (GDM) are at a higher risk of developing type 2 diabetes. Several postpartum lifestyle intervention studies have been conducted for this high-risk group; however, the randomized clinical trials have not been evaluated systematically. Thus, the aim of this article is to evaluate the outcomes of clinical trials that focus on diabetes prevention among women with DGM. This systematic review utilized Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Chinese and US databases were searched. Randomized controlled trials of postpartum lifestyle interventions to prevent type 2 diabetes in women with prior GDM were reviewed. Outcomes included in this review are type 2 diabetes incidences, insulin insistence, and weight-related measures. The effect size of these outcomes in each study was computed. Data on intervention components were extracted, including type (in-person vs. technology-based), content (diet or physical activity or both), form (individual session vs. group session), duration, intensity, evaluation time point, and program delivery. A total of 12 studies met the inclusion criteria. The mean annual type 2 diabetes mellitus (T2DM) incidence of the intervention group was lower than that of the comparison group (6.0% vs. 9.3%), although there was no statistical difference between the two groups. About 50% of these studies and two-thirds of studies, respectively, reported a significant decrease in insulin resistance-related measures and weight-related measures in the intervention group compared with the comparison group. The median intervention duration and study length were 6 months. Postpartum lifestyle interventions can be effective in reducing T2DM development and insulin resistance, and decrease weight in women with GDM history, regardless of the intervention types (technology-based or in-person). Effective interventions typically include dietary changes while some physical activity changes can also improve outcomes. However, more interventions with long-term efficacy evaluation are warranted.

Problem: Most medical students use Wikipedia as an information source, yet medical schools do not train students to improve Wikipedia or use it critically. Approach: Between November 2013 and November 2015, the authors offered fourth-year medical students a credit-bearing course to edit Wikipedia. The course was designed, delivered, and evaluated by faculty, medical librarians, and personnel from WikiProject Medicine, Wikipedia Education Foundation, and Translators Without Borders. The authors assessed the effect of the students’ edits on Wikipedia’s content, the effect of the course on student participants, and readership of students’ chosen articles. Outcomes: Forty-three enrolled students made 1,528 edits (average 36/student), contributing 493,994 content bytes (average 11,488/student). They added higher-quality and removed lower-quality sources for a net addition of 274 references (average 6/student). As of July 2016, none of the contributions of the first 28 students (2013, 2014) have been reversed or vandalized. Students discovered a tension between comprehensiveness and readability/translatability, yet readability of most articles increased. Students felt they improved their articles, enjoyed giving back “specifically to Wikipedia,” and broadened their sense of physician responsibilities in the socially networked information era. During only the “active editing months,” Wikipedia traffic statistics indicate that the 43 articles were collectively viewed 1,116,065 times. Subsequent to students’ efforts, these articles have been viewed nearly 22 million times. Next Steps: If other schools replicate and improve on this initiative, future multi-institution studies could more accurately measure the effect of medical students on Wikipedia, and vice versa.

Introduction: The COVID-19 pandemic ushered in a rapid, transformative adoption of telemedicine to maintain patient access to care. As clinicians made the shift from in-person to virtual practice, they faced a paucity of established and reliable clinical examination standards for virtual care settings. In this systematic review, we summarize the accuracy and reliability of virtual assessments compared with traditional in-person examination tools. Methods: We searched PubMed, Embase, Web of Science, and CINAHL from inception through September 2019 and included additional studies from handsearching of reference lists. We included studies that compared synchronous video (except allowing for audio-only modality for cardiopulmonary exams) with in-person clinical assessments of patients in various settings. We excluded behavioral health and dermatological assessments. Two investigators abstracted data using a predefined protocol. Results: A total of 64 studies were included and categorized into 5 clinical domains: neurological ( N = 41), HEENT (head, eyes, ears, nose, and throat; N = 5), cardiopulmonary ( N = 5), musculoskeletal ( N = 8), and assessment of critically ill patients ( N = 5). The cognitive assessment within the neurological exam was by far the most studied ( N = 19) with the Mini-Mental Status Exam found to be highly reliable in multiple settings. Most studies showed relatively good reliability of the virtual assessment, although sample sizes were often small (<50 participants). Conclusions: Overall, virtual assessments performed similarly to in-person exam components for diagnostic accuracy but had a wide range of interrater reliability. The high heterogeneity in population, setting, and outcomes reported across studies render it difficult to draw broad conclusions on the most effective exam components to adopt into clinical practice. Further work is needed to identify virtual exam components that improve diagnostic accuracy.

Background: Cancer‐related pain is common and debilitating. Patients frequently use integrative medicine therapies to manage this, though safety and efficacy evidence is incomplete. This scoping review aims to characterize the state of integrative cancer pain therapy (ICPT) and identify priorities for future research. Methods: Following PRISMA guidelines, we searched PubMed, Embase, Web of Science, PsycINFO, CINAHL, and Cochrane for ICPT studies published between January 1, 1975 and May 26, 2022. Study findings were extracted and analyzed using descriptive statistics and thematic analysis. Interventions were categorized as follows: Whole Systems of Medicine (WSM); Mind–body Medicine (MBM); Botanicals and Supplements (BAS); and Manual Therapies (MT). Quality appraisal was performed using the Downs and Black checklist. Efficacy was “positive” if there were statistically significant differences between study arms ( p < 0.05) favoring ICPT. Results: Among 1246 studies reviewed, 151 met inclusion criteria; 63.5% were excellent or good quality, and 68.9% were RCTs; 122 studies (80.7%) were published since 2010. Studies occurred in 24 countries, in variable settings, among participants with a wide range of cancers, disease status, and age ranges. Studies investigating WSM and MBM interventions were most frequent (35.7% for each), MT (20.59%), and BAS (7.9%). Overall, of the included studies, 127 (84.1%) found that the ICPT intervention reduced pain. Conclusions: Studies on ICPT are increasingly common, and the majority of ICPT interventions demonstrated a positive impact on cancer pain. Future rigorous research should compare efficacy across integrative and biomedical interventions and explore how to incorporate evidence‐based ICPT into standard cancer treatment.