The Plight of the Minority Resident Physician— Similar Challenges in a Different World

In the article “Minority Resident Physicians’ Views on the Role of Race/Ethnicity in Their Training Experiences in the Workplace,� Osseo-Asare et al1 report a qualitative approach to teasing out the plight of underrepresented in medicine minority (URMM) resident physicians in their training programs. Underrepresented minorities in medicine include black, Latino, and Native American individuals. Their study involved mostly black residents who were surveyed by semistructured interview at the 2017 Annual Medical Education Conference, sponsored by the Student National Medical Association. Comments from participants in the study transcend the academic health center environment, ranging from concerns like being thought to “play the race card,� their minority culture being viewed as unprofessional, and, as black resident physicians, being asked to fix diversity and culture problems that were thought to be minority problems. Themes included having to deal with racism and discrimination on a daily basis, managing the influence of diversity pressures on their professional and personal lives, and the effect of discrimination on self-identify

The Diversity Efforts Disparity in Academic Medicine

The diversity efforts disparity in academic medicine can be defined as part of the minority tax that negatively impacts faculty who are underrepresented in medicine. This disparity can be defined as differences between minority and non-minority faculty in their recruitment or assignment by the institution to address diversity issues, climate concerns and conflict around inclusion in academic medicine. It can manifest as disproportionate committee service, being asked to be the face of diversity for the school on websites or brochures or being asked to serve on diversity task forces or initiatives. In this article, the author further characterizes the diversity efforts disparity and provides recommendations for how to identify and address it in academic medicine

Design studies of large aperture, high-resolution Earth science microwave radiometers compatible with small launch vehicles

High-spatial-resolution microwave radiometer sensing from space with reasonable swath widths and revisit times favors large aperture systems. However, with traditional precision antenna design, the size and weight requirements for such systems are in conflict with the need to emphasize small launch vehicles. This paper describes tradeoffs between the science requirements, basic operational parameters, and expected sensor performance for selected satellite radiometer concepts utilizing novel lightweight compactly packaged real apertures. Antenna, feed, and radiometer subsystem design and calibration are presented. Preliminary results show that novel lightweight real aperture coupled with state-of-the-art radiometer designs are compatible with small launch systems, and hold promise for high-resolution earth science measurements of sea ice, precipitation, soil moisture, sea surface temperature, and ocean wind speeds

Divergent Roles for RalA and RalB in Malignant Growth of Human Pancreatic Carcinoma Cells

SummaryBackgroundThe Ral guanine nucleotide-exchange factors (RalGEFs) serve as key effectors for Ras oncogene transformation of immortalized human cells. RalGEFs are activators of the highly related RalA and RalB small GTPases, although only the former has been found to promote Ras-mediated growth transformation of human cells. In the present study, we determined whether RalA and RalB also had divergent roles in promoting the aberrant growth of pancreatic cancers, which are characterized by the highest occurrence of Ras mutations.ResultsWe now show that inhibition of RalA but not RalB expression universally reduced the transformed and tumorigenic growth in a panel of ten genetically diverse human pancreatic cancer cell lines. Despite the apparent unimportant role of RalB in tumorigenic growth, it was nevertheless critical for invasion in seven of nine pancreatic cancer cell lines and for metastasis as assessed by tail-vein injection of three different tumorigenic cell lines tested. Moreover, both RalA and RalB were more commonly activated in pancreatic tumor tissue than other Ras effector pathways.ConclusionsRalA function is critical to tumor initiation, whereas RalB function is more important for tumor metastasis in the tested cell lines and thus argues for critical, but distinct, roles of Ral proteins during the dynamic progression of Ras-driven pancreatic cancers

Ventricular-vascular coupling is predictive of adverse clinical outcome in paediatric pulmonary arterial hypertension

AIMS: Ventricular-vascular coupling, the ratio between the right ventricle's contractile state (Ees) and its afterload (Ea), may be a useful metric in the management of paediatric pulmonary arterial hypertension (PAH). In this study we assess the prognostic capacity of the ventricular-vascular coupling ratio (Ees/Ea) derived using right ventricular (RV) pressure alone in children with PAH. METHODS: One hundred and thirty paediatric patients who were diagnosed with PAH via right heart catheterisation were retrospectively reviewed over a 10-year period. Maximum RV isovolumic pressure and end-systolic pressure were estimated using two single-beat methods from Takeuchi et al (Ees/Ea_(Takeuchi)) and from Kind et al (Ees/Ea_(Kind)) and used with an estimate of end-systolic pressure to compute ventricular-vascular coupling from pressure alone. Patients were identified as either idiopathic/hereditary PAH or associated PAH (IPAH/HPAH and APAH, respectively). Haemodynamic data, clinical functional class and clinical worsening outcomes-separated into soft (mild) and hard (severe) event categories-were assessed. Adverse soft events included functional class worsening, syncopal event, hospitalisation due to a proportional hazard-related event and haemoptysis. Hard events included death, transplantation, initiation of prostanoid therapy and hospitalisation for atrial septostomy and Pott's shunt. Cox proportional hazard modelling was used to assess whether Ees/Ea was predictive of time-to-event. RESULTS: In patients with IPAH/HPAH, Ees/Ea_(Kind) and Ees/Ea_(Takeuchi) were both independently associated with time to hard event (p=0.003 and p=0.001, respectively) and when adjusted for indexed pulmonary vascular resistance (p=0.032 and p=0.013, respectively). Neither Ees/Ea_(Kind) nor Ees/Ea_(Takeuchi) were associated with time to soft event. In patients with APAH, neither Ees/Ea_(Kind) nor Ees/Ea_(Takeuchi) were associated with time to hard event or soft event. CONCLUSIONS: Ees/Ea derived from pressure alone is a strong independent predictor of adverse outcome and could be a potential powerful prognostic tool for paediatric PAH

Mentoring as a Buffer for the Syndemic Impact of Racism and COVID-19 among Diverse Faculty within Academic Medicine

Within this article, we explore the dual impact of two pandemics, racism and COVID-19, on the career and psychological well-being of diverse faculty within academic medicine. First, we present a discussion of the history of racism in academic medicine and the intensification of racial disparities due to the COVID-19 pandemic. As a result of the syndemic of racism and COVID-19, the outlook for the recruitment, retention, and advancement of diverse faculty and leaders within academic medicine is at risk. While mentoring is known to have benefits for career and personal development, we focus on the unique and often unacknowledged role that mentoring can play as a buffer for women and people of color, especially when working in institutions that lack diversity and are now struggling with the syndemic of racism and COVID-19. We also discuss the implications of acknowledging mentoring as a buffer for future leadership development, research, and programs within academic medicine and health professions