RESUMO
This manuscript conveys the story of the health and economic challenges faced by a coalition of barbershops and salons in West Philadelphia. It is grounded in city and national data that illustrate the widening racial and class disparities during coronavirus disease 2019. Ultimately, it is a story of resilience that outlines a budding partnership between barbershop and salon owners, their community, and medical providers.
RESUMO
PURPOSE: Many academic medical centers fund educational opportunities (pipeline programs) for students who are underrepresented in medicine (URM). However, there is a sparsity of published literature on pipeline programs and an even smaller body of published literature that investigates program effectiveness. METHODS: In a retrospective cohort study (n=12) of the Provost's Summer Mentorship Program-Medicine (SMPM), we evaluated students' rating of program effectiveness, students' rating of the program's impact on their mindsets, and SAT scores. Several program mindsets, including sense of belonging (inclusiveness) in the health professions and connection to mentors in the medical field, reflect common barriers that prevent URM students from pursuing careers in medicine as outlined in pipeline literature. We describe program effectiveness using mean and median ratings of SMPM effectiveness, ratings of mindsets, and SAT scores. We used Wilcoxon Rank Sum to assess pre and post program differences in ratings of mindsets and SAT scores. RESULTS: SMPM was effective for learners. The overall mean rating for SMPM effectiveness was 4.27. Mindsets for confidence, interest, sense of belonging, college mentorship, and physician mentorship were statistically different from the start to the end of SMPM (p<0.05), with mean improvement of about 34%, 41%, 44%, 180%, and 140% respectively. The mean pre and post SMPM SAT scores as well as 4-month follow-up SAT mean scores were 713 (SD:155), 813 (SD:83), and 1058 (SD:147), respectively. There was a statistically significant difference between all three SAT scores (p<0.05). CONCLUSION: In addition to providing educational support, our pipeline program effectively increased students' sense of belonging in the medical field and their connections to physician mentors, which are two common barriers for URM students who are interested in medicine.
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BACKGROUND: The development of a novel tuberculosis vaccine is a leading global health priority. SRL172, an inactivated, whole-cell mycobacterial vaccine, was safe, immunogenic and reduced the incidence of culture-confirmed tuberculosis in a phase III trial in HIV-infected and BCG immunized adults in Tanzania. Here we describe the immunogenicity and protective efficacy of DAR-901, a booster vaccine against tuberculosis manufactured from the same seed strain using a new scalable method. METHODS: We evaluated IFN-γ responses by ELISpot and antibody responses by enzyme linked immunosorbent assay in C57BL/6 and BALB/c mice after three doses of DAR-901. In an aerosol challenge model, we evaluated the protective efficacy of the DAR-901 booster in C57BL/6 mice primed with BCG and boosted with two doses of DAR-901 at 4 dosage levels in comparison with homologous BCG boost. RESULTS: DAR-901 vaccination elicited IFN-γ responses to mycobacterial antigen preparations derived from both DAR-901 and Mycobacterium tuberculosis. DAR-901 immunization enhanced antibody responses to DAR-901 but not Mycobacterium tuberculosis lysate or purified protein derivative. Among animals primed with BCG, boosting with DAR-901 at 1 mg provided greater protection against aerosol challenge than a homologous BCG boost (lungs P = 0.036, spleen P = 0.028). CONCLUSIONS: DAR-901 induces cellular and humoral immunity and boosts protection from M. tuberculosis compared to a homologous BCG boost.
Assuntos
Vacina BCG/imunologia , Imunização Secundária , Imunogenicidade da Vacina , Mycobacterium tuberculosis/imunologia , Tuberculose/imunologia , Tuberculose/prevenção & controle , Animais , Antígenos de Bactérias , Vacina BCG/farmacologia , Modelos Animais de Doenças , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB CRESUMO
Bacille Calmette-Guérin (BCG), the only licensed vaccine for the prevention of tuberculosis (TB), provides only limited protection against certain forms of Mycobacterium tuberculosis (Mtb) infection. While infection with Mtb can be treated with antibiotics, the therapy is expensive, toxic, and requires several months for treatment. In addition, the emergence of drug resistant strains limits the impact of antibiotics and underlines the importance of developing a more effective vaccine to control this disease. Given that pulmonary TB is the most common form of the disease, a vaccine capable of inducing lung-resident immunity may be advantageous for combating this infection. New advances in pulmonary delivery make this route of vaccination feasible and affordable. Here, we evaluate the safety and immunogenicity of an aerosolized Ad35-based vaccine, AERAS-402, delivered to the lungs in nonhuman primates as part of a GLP acute and chronic toxicology and safety study. In this study, animals received three high doses (1 x 10(11) vp) of AERAS-402 by inhalation via a nebulizer at 1-week intervals. Aerosol delivery of AERAS-402 resulted in an increase in relative lung weights as well as microscopic findings in the lungs, mediastinal lymph nodes, bronchus-associated lymphatic tissue, and the naso-oropharynx that were consistent with the induction of an immune response during the acute phase. These findings resolved by the chronic phase and were considered to be non-adverse. Furthermore, we observed transient vaccine-specific immune responses in the peripheral blood as well as sustained high-level polyfunctional CD4(+) and CD8(+) T cell responses in the bronchoalveolar lavage fluid of vaccinated nonhuman primates. The data suggest that pulmonary delivery of Ad35-based vaccines can be safe and can induce potent lung-resident immunity.