bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upholding Our PROMISE: Underrepresented in Medicine Pediatric Residents' Perspectives on Interventions to Promote Belonging
Authors: Yemane Lahia , Kas-Osoka Oriaku , Burns Audrea , Blankenburg Rebecca , Prakash Laura Kester , Poitevien Patricia , Schwartz Alan , Lucas Candice Taylor , Marbin Jyothi 
Published: September 2023

Abstract

Purpose
Underrepresented in medicine (UIM) residents experience challenges during training that threaten their sense of belonging in medicine; therefore, residency programs should intentionally implement interventions to promote belonging. This study explored UIM pediatric residents' perspectives on current residency program measures designed to achieve this goal.

Method
The authors conducted a secondary qualitative analysis as part of a national cross-sectional study, PROmoting Med-ed Insight into Supportive Environments (PROMISE), which explored pediatric residents' experiences and perspectives during training in relation to their self-identities. A 23-item web-based survey was distributed through the Association of Pediatric Program Directors Longitudinal Educational Research Assessment Network from October 2020 to January 2021. Participants provided free-text responses to the question “What are current measures that promote a sense of belonging for the UIM community in your training program?” The authors used conventional content analysis to code and identify themes in responses from UIM participants.

Results
Of the 1,748 residents invited to participate, 931 (53%) residents from 29 programs completed the survey, with 167 (18%) identifying as UIM. Of the 167 UIM residents, 74 (44%) residents from 22 programs responded to the free-text question. The authors coded more than 140 unique free-text responses and identified 7 major themes: (1) critical mass of UIM residents; (2) focused recruitment of UIM residents; (3) social support, including opportunities to build community among UIM residents; (4) mentorship; (5) caring and responsive leadership; (6) education on health disparities, diversity, equity, inclusion, and antiracism; and (7) opportunities to serve, including giving back to the local community and near-peer mentorship of UIM premedical and medical students.

Conclusions
This is the first national study to describe UIM pediatric residents' perspectives on interventions that promote a sense of belonging. Programs should consider implementing these interventions to foster inclusion and belonging among UIM trainees.
Patient-Led Approaches to a Vaginal Birth After Cesarean Delivery Calculator
Authors: Rubashkin Nicholas , Asiodu Ifeyinwa , Vedam Saraswathi , Sufrin Carolyn , Adams Vincanne 
Published: September 2023

OBJECTIVE:
To describe patient approaches to navigating their probability of a vaginal birth after cesarean (VBAC) within the context of prediction scores generated from the original Maternal-Fetal Medicine Units’ VBAC calculator, which incorporated race and ethnicity as one of six risk factors.

METHODS:
We invited a diverse group of participants with a history of prior cesarean delivery to participate in interviews and have their prenatal visits recorded. Using an open-ended iterative interview guide, we queried and observed these individuals' mode-of-birth decisions in the context of their VBAC calculator scores. We used a critical and feminist approach to analyze thematic data gleaned from interview and visit transcripts.

RESULTS:
Among the 31 participants who enrolled, their self-identified racial and ethnic categories included: Asian or South Asian (2); Black (4); Hispanic (12); Indigenous (1); White (8); and mixed-Black, -Hispanic, or -Asian background (4). Predicted VBAC success probabilities ranged from 12% to 95%. Participants completed 64 interviews, and 14 prenatal visits were recorded. We identified four themes that demonstrated a range of patient-led approaches to interpreting the probability generated by the VBAC calculator: 1) rejecting the role of race and ethnicity; 2) reframing failure, finding success; 3) factoring the physical experience of labor; and 4) modifying the probability for VBAC.

CONCLUSION:
Our findings demonstrate that a numeric probability for VBAC may not be highly valued or important to all patients, especially those who have strong intentions for VBAC. Black and Hispanic participants challenged the VBAC calculator's incorporation of race and ethnicity as a risk factor and resisted the implication it produced, especially that their bodies were less capable of achieving a vaginal birth. Our findings suggest that patient-led approaches to assessing and interpreting VBAC probability may be an untapped resource for achieving a more person-centered, equitable approach to counseling.
Multilevel Community Engagement to Inform a Randomized Clinical Trial
Authors: Wycoff Kirby L. , Coleman Jabina G. , Santoro Christine M. , Zullig Leah L. , Darden Niesha , Holland Porsche M. , Cruice Jane F. , Mitchell Shukriyyah , Smith Michelle , McNeil Saleemah J. , Herring Sharon J. 
Published: September 2023

OBJECTIVE:
To explore how patients, community-based perinatal support professionals, and health system clinicians and staff perceived facilitators and barriers to implementation of a randomized clinical trial (RCT) designed to optimize Black maternal heart health.

METHODS:
This article describes the formative work that we believed needed to occur before the start of the Change of H.E.A.R.T (Here for Equity, Advocacy, Reflection and Transformation) RCT. We used a qualitative, descriptive design and community-based, participatory approach, the latter of which allowed our team to intentionally focus on avoiding harm and equalizing power dynamics throughout the research process. Data were collected between November 2021 and January 2022 through six semistructured focus groups that included attending physicians and midwives (n=7), residents (n=4), nurses (n=6), support staff (n=7), community-based perinatal support professionals (n=6), and patients (n=8).

RESULTS:
Four primary themes emerged. The first three themes were present across all groups and included: 1) Trauma in the Community and Health System, 2) Lack of Trust, and 3) Desire to Be Heard and Valued. The fourth theme, Hope and Enthusiasm, was expressed predominantly by patients, community-based perinatal support professionals, residents, and support staff, and less so by the attending physician group.

CONCLUSION:
Participants articulated a number of key sentiments regarding facilitators and barriers to implementing Change of H.E.A.R.T. We noted variability in perceptions from different groups. This has important implications for health equity efforts in similarly underresourced health systems where Black birthing people experience the greatest morbidity and mortality.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT05499507.
Prospective Assessment of Loteprednol Etabonate 0.25% for Prevention of Immunologic Rejection After Descemet Membrane Endothelial Keratoplasty in Eyes With Fuchs Dystrophy
Authors: Price Marianne O. , Feng Matthew T. , Gang Anjulie , Price Francis W. 
Published: September 2023

Purpose:
The purpose of this study was to assess off-label use of loteprednol etabonate 0.25% ophthalmic suspension for prevention of immunologic rejection after Descemet membrane endothelial keratoplasty (DMEK).

Methods:
This prospective, open-label study enrolled 70 eyes of 70 participants without preexisting glaucoma 1 month after DMEK. Participants used topical loteprednol 0.25% 4 times daily for 2 months, tapered by 1 drop/month to once daily use, and continued use through 1 year after DMEK. Main outcomes were rate of intraocular pressure (IOP) elevation (defined as a relative increase of ≥10 mm Hg over the pretransplant IOP) and rate of initial allograft rejection episodes. The results were compared with historical data using the log-rank test.

Results:
All participants had Fuchs dystrophy, and 40 of 70 (57%) were female. None (0%) experienced an immunologic graft rejection episode, matching the previously reported efficacy of prednisolone acetate 1% suspension and loteprednol 0.5% gel (both 0% incidence). One study eye developed IOP elevation 3 months after DMEK (cumulative risk 1.5%). Compared with historical data, this was similar to the risk with loteprednol 0.5% gel (4%, P = 0.36) and significantly lower than the risk with prednisolone 1% suspension (18%, P = 0.0025). Two participants (3%) complained of instillation site discomfort, consistent with the 5% rate reported on package labeling.

Conclusions:
Loteprednol 0.25% suspension, approved for short-term treatment of dry eyes, effectively prevented immunologic rejection episodes with minimal risk of IOP elevation when used from 1 month until 12 months after DMEK in patients without preexisting glaucoma.
The Complexity of Being a Parent in the Hospital and a Patient at Home
Authors: Romare Strandh Maria , Hovén Emma , Sörensdotter Renita , Stålberg Karin , Enebrink Pia , Ljungman Lisa , Wikman Anna 
Published: September 2023

Background
Parents given a diagnosis of cancer must balance the demands of their illness and caregiving responsibilities. This can result in parental stress and have a negative impact on the well-being of the whole family. A greater understanding of the experiences of parents with cancer is necessary to provide adequate support.

Objective
The aim of this study was to explore parenting concerns and challenges among parents with cancer who were caring for dependent children younger than 18 years.

Methods
Semistructured interviews were carried out with 22 parents with cancer. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis.

Results
Parental concerns and challenges affected parents in their parental role and their everyday family life. Three overarching themes described the struggles in balancing life as a parent and as a patient: navigating dual roles as a parent with cancer, impact of cancer on parenting, and impact on family life. Parents’ primary focus was on their children’s well-being, and they struggled to manage their own expectations of parenting and the demands on their role in the family.

Conclusion
The results highlight the complexity of being a parent with cancer while caring for dependent children. To support parents during the cancer journey, it is important to understand the consequences of their illness on their parental role and the family.

Implications for Practice
Supporting parents to feel secure in their parental role and providing support to them during their cancer journey should be integrated into routine cancer care, where parenting concerns and challenges are addressed.
Three-Phase Video-Assisted Multidisciplinary Team Debriefing in High-Fidelity Blast Simulation through the Advocacy and Inquiry Method
Authors: Gasteratos Konstantinos , Daniels Bethany , Gebhart Sarah-Jane , Patterson Nautyca , Tarrant Madilyn J. , Goverman Jeremy , Rakhorst Hinne , van der Hulst René Remmelt Willie Johan 
Published: September 2023

Background:
Video-assisted debriefing (VAD) combined with the advocacy and inquiry (A&I) technique is a tool that allows video playback of selected segments of a simulation, thereby helping the debriefers structure the session. However, no consensus exists on how to optimally perform a team debriefing. The authors demonstrate and describe the methodology of A&I debriefing in an instructional simulated blast scenario and assess the impact of VAD on residents’ technical and nontechnical skills.

Methods:
After institutional review board approval, the authors performed a study with 50 residents who were randomly assigned to 2 groups. Group 1 (control, or no VAD; n = 25) consisted of residents who received oral debriefing by 1 independent faculty member without the recorded video of the simulation. Group 2 (intervention, or VAD; n = 25) consisted of residents who received VAD from the second independent faculty member. These residents repeated the same simulation scenario 1 week after their debrief. Every resident was assessed on the primary and secondary survey, as well as the nontechnical skills, based on the integrated skills score.

Results:
The VAD group presented significantly higher values for the integrated skills score (P < 0.001) compared with the no-VAD group.

Conclusions:
This demonstration of 3-phase VAD emphasizes important aspects of coherent simulation-based training: psychologic safety, A&I, reflection, cognitive frames, prebrief, main debrief, summary, and translation of new discoveries to real-life patient care. The unique audiovisual aspect of the VAD enhanced residents’ performance in simulation.
ACE2-Coated Virus-Like Particles Effectively Block SARS-CoV-2 Infection
Authors: Bayraktar Canan , Kayabolen Alisan , Odabas Arda , Durgun Ayşegul , Kok İpek , Sevinç Kenan , Supramaniam Aroon , Idris Adi , Bagci-Onder Tugba 
Published: September 2023

AbstractA large body of research accumulated over the past three years dedicated to our understanding and fighting COVID-19. Blocking the interaction between SARS-CoV-2 Spike and ACE2 receptor has been considered an effective strategy as anti-SARS-CoV-2 therapeutics. In this study, we developed ACE2-coated virus-like particles (ACE2-VLPs), which can be utilized to prevent viral entry into host cells and efficiently neutralize the virus. These ACE2-VLPs exhibited high neutralization capacity even when applied at low doses, and displayed superior efficacy compared to extracellular vesicles carrying ACE2, in the in vitro pseudoviral assays. ACE2-VLPs were stable under different environmental temperatures, and they were effective in blocking all tested variants of concern in vitro. Finally, ACE2-VLPs displayed marked neutralization capacity against Omicron BA.1 in the Vero E6 cells. Based on their superior efficacy compared to extracellular vesicles, and their demonstrated success against live virus, ACE2-VLPs can be considered as vital candidates for treating SARS-CoV-2. This novel therapeutic approach of VLP coating with receptor particles can serve as proof-of-concept for designing effective neutralization strategies for other viral diseases in the future.Graphical AbstractIn our study, we demonstrate the prevention of SARS-CoV-2 infection through the use of Ace2-coated VLPs.
G4-Ligand Conjugated Oligonucleotides Mediate Selective Binding and Stabilization of Individual G4 DNA Structures
Authors: Berner Andreas , Das Rabindra Nath , Bhuma Naresh , Golebiewska Justyna , Abrahamsson Alva , Andréasson Måns , Chaudhari Namrata , Doimo Mara , Bose Partha Pratim , Chand Karam , Strömberg Roger , Wanrooij Sjoerd , Chorell Erik 
Published: September 2023

ABSTRACTG-quadruplex (G4) DNA structures are prevalent secondary DNA structures implicated in fundamental cellular functions such as replication and transcription. Furthermore, G4 structures are directly correlated to human diseases such as cancer and have been highlighted as promising therapeutic targets for their ability to regulate disease-causing genes, e.g., oncogenes. Small molecules that bind and stabilize these structures are thus valuable from a therapeutic perspective and helpful in studying the biological functions of G4 structures. However, there are hundreds of thousands of G4 DNA motifs in the human genome, and a longstanding problem in the field is how to achieve specificity amongst these different G4 structures. Here, we have developed a strategy to selectively target an individual G4 DNA structure. The strategy is based on a ligand that binds and stabilizes G4s without selectivity, conjugated to a guide oligonucleotide, that specifically directs the G4 Ligand conjugated Oligo (GL-O) to the single target G4 structure. By employing various biophysical and biochemical techniques, we show that the developed method enables the targeting of a unique, specific G4 structure without impacting other off-target G4 formations. Considering the vast amounts of G4s in the human genome, this represents a promising strategy to study the presence and functions of individual G4s but may also hold potential as a future therapeutic modality.
Simultaneous arm morphing quadcopter and autonomous flight system design
Authors: Kose Oguz , Oktay Tugrul , Özen Enes 
Published: September 2023

Purpose
The purpose of this paper is to obtain values that stabilize the lateral and longitudinal flight of the quadrotor for which the morphing amount and the best Proportional-Integral-Derivative (PID) coefficients are determined by using the simultaneous perturbation stochastic approximation (SPSA) optimization algorithm.

Design/methodology/approach
Quadrotor consists of body and arms; there are propellers at the ends of the arms to take off and rotors that rotate them. By reducing the angle between mechanism 1 and the rotors with the horizontal plane, the angle between mechanism 2 and the arms, the rotors rise and different configurations are obtained. Conventional multi-rotor aircraft has a fixed fuselage and does not need a tail rotor to change course as helicopters do. The translational and rotational movements are provided by the rotation of the rotors of the aircraft at different speeds by creating moments about the geometric center in 6-degree-of-freedom (DOF) space. These commands sent from the ground are provided by the flight control board in the aircraft. The longitudinal and lateral flight stability and properties of different configurations evaluated by dynamic analysis and simulations in 6 DOF spaces are investigated. An algorithm and PID controller are being developed using SPSA to achieve in-flight position and attitude control of an active deformable aircraft. The results are compared with the results of the literature review and the results of the previous article.

Findings
With SPSA, the best PID coefficients were obtained in case of morphing.

Research limitations/implications
The effects of quadrotor arm height and hub angle changes affect flight stability. With the SPSA optimization method presented in this study, the attitude is quickly stabilized.

Practical implications
With the optimization method, the most suitable PID coefficients and angle values for the lateral and longitudinal flight stability of the quadrotor are obtained.

Social implications
The transition rate and PID coefficients are determined by using the optimization method, which is advantageous in terms of cost and practicality.

Originality/value
With the proposed method, the aircraft can change shape to adapt to different environments, and the parameters required for more stable flight for each situation will be calculated, and this will be obtained more quickly and safely with the SPSA optimization method.
Case study of detection and monitoring of wildlife by UAVs equipped with RGB camera and TIR camera
Authors: Perz Rafal , Wronowski Kacper , Domanski Roman , Dąbrowski Igor 
Published: September 2023

Purpose
Observation of the animal world is an important component of nature surveys. It provides a number of different information concerning aspects such as population sizes, migration directions, feeding sites and many other data. The paper below presents the results from the flights of an unmanned aerial vehicle (UAV) aimed at detecting animals in their natural environment.

Design/methodology/approach
The drone used in the research was equipped with RGB and thermal infrared (TIR) cameras. Both cameras, which were mounted on the UAV, were used to take pictures showing the concentration of animals (deer). The overview flights were carried out in the villages of Podlaskie Voivodeship: Szerokie Laki, Bialousy and Sloja. Research flights were made in Bialousy and Sloja. A concentration of deer was photographed during research flights in Sloja. A Durango unmanned platform, equipped with a thermal imaging camera and a Canon RGB camera, was used for research flights. The pictures taken during the flights were used to create orthomaps. A multicopter, equipped with a GoPro camera, was used for overview flights to film the flight locations. A flight control station was also used, consisting of a laptop with MissionPlanner software.

Findings
Analysis of the collected images has indicated that environmental, organisational and technical factors influence the quality of the information. Sophisticated observation precision is ensured by the use of high-resolution RGB and TIR cameras. A proper platform for the cameras is an UAV provided with advanced positioning systems, which makes it possible to create high-quality orthomaps of the area. When observing animals, the time of day (temperature contrast), year season (leaf ascent) or flight parameters is important.

Originality/value
The paper introduces the conclusions of the research flights, pointing out useful information for animal observation using UAVs.
Breaking the mold with effective communication: how social initiatives enhance a brand's social perception and catalyze pro-environmental and purchase intentions
Authors: Surira Mukul Dev , Zakkariya K.A. , Sajid Muhammed 
Published: September 2023

PurposeThe purpose of this study is to fill the research gap by investigating the impact of brand social initiatives on both the warmth and competence dimensions of the brand, as well as examining the brand's potential to induce pro-environmental behavioral change among consumers.Design/methodology/approachThe study employed a scenario-based survey design and surveyed 415 consumers in India. The data were analyzed using structural equation modeling (SEM) with SmartPLS 4.0.FindingsThe results show that social initiatives enhance both dimensions of social perception and increase cooperative intentions. Brand competence is more crucial than warmth in predicting behavioral intentions. Brand-cause fit, CSR commitment and initiatives' impact all influence the brand image. A brand's commitment to the cause is more significant than brand-cause fit in determining how consumers evaluate a brand.Practical implicationsThis research provides insights into how social initiatives can enhance brand image and encourage helping intentions through effective communication traits. It can aid brands in building consumer trust, benefiting society and boosting finances. The study offers a framework for effective cause communication strategies, highlighting the importance of commitment to the cause over fitting with the brand's image to elicit desired responses.Originality/valueThis study is a novel attempt that uses the stereotype content model and costly signaling theory to explore how social initiatives influence a brand's warmth and competence and impact consumer behavior. It provides critical insights into the psychological mechanisms behind social initiatives' impact on consumer behavioral intentions.