Supplemental Digital Content is available in the text.

Purpose of review Racial, ethnic, and gender disparities in cardiovascular care are well-documented. This review aims to highlight the disparities and impact on a group particularly vulnerable to disparities, women from racial/ethnic minority backgrounds. Recent findings Women from racial/ethnic minority backgrounds remain underrepresented in major cardiovascular trials, limiting the generalizability of cardiovascular research to this population. Certain cardiovascular risk factors are more prevalent in women from racial/ethnic minority backgrounds, including traditional risk factors such as hypertension, obesity, and diabetes. Female-specific risk factors including gestational diabetes and preeclampsia as well as non-traditional psychosocial risk factors like depressive and anxiety disorders, increased child care, and familial and home care responsibility have been shown to increase risk for cardiovascular disease events in women more so than in men, and disproportionately affect women from racial/ethnic minority backgrounds. Despite this, minimal interventions to address differential risk have been proposed. Furthermore, disparities in treatment and outcomes that disadvantage minority women persist. The limited improvement in outcomes over time, especially among non-Hispanic Black women, is an area that requires further research and active interventions. Summary Understanding the lack of representation in cardiovascular trials, differential cardiovascular risk, and disparities in treatment and outcomes among women from racial/ethnic minority backgrounds highlights opportunities for improving cardiovascular care among this particularly vulnerable population.

Despite the importance of spirituality to health and patient care, there remains a lack of educational opportunities for medical students to learn about and engage the spiritual needs of patients. Shadowing of hospital chaplains has been employed as a means of providing instruction in spirituality, but published experiences of this pedagogy are limited. This study therefore analyzed an elective, firstyear medical student, eight-hour, trauma chaplain shadowing experience, the objectives of which are to increase students' knowledge and understanding of (i) the role of chaplains/pastoral care in patient care; (ii) strategies for engaging patients and/or families in difficult situations; and (iii) approaches for discussing issues of spirituality with patients and families. A questionnaire was sent to participants after the experience assessing the value of the experience. Two focus groups provided additional qualitative data. Of the 148 participants over 6 years, 100 completed the questionnaire (68%). Participants on average engaged 1.78 trauma patients or their families and experienced 3.63 overall patient/family interactions during their shadowing. Over 90% of respondents agreed or strongly agreed that the experience provided agreater understanding of the role of the chaplain, and was educationally, professionally, and personally useful. Over 60% of respondents agreed or strongly agreed that the experience improved their understanding of discussing difficult or spiritual topics with patients and families. Nearly all respondents (98%) would recommend asimilar shadowing experience to fellow medical students. Qualitative remarks echoed these findings, revealing themes surrounding the educational benefits, surprise, and awe experienced by participants, and indicating appreciation for the interprofessional aspect of the experience. These data demonstrate that trauma chaplain shadowing may be effective for introducing first-year medical students to healthcare chaplaincy, educating them about the challenges of navigating difficult spiritual conversations with patients and families, and exposing them to interprofessional collaboration.

Electric cell-substrate impedance sensing (ECIS) is an emerging technique for sensitively monitoring morphological changes of adherent cells in tissue culture. In this study, human mesenchymal stem cells (hMSCs) were exposed to different concentrations of carbonyl cyanide 4-(trifluoromethoxy)phenylhydrazone (FCCP) for 20 h and their subsequent concentration-dependent responses in micromotion and wound healing migration were measured by ECIS. FCCP disrupts ATP synthesis and results in a decrease in cell migration rates. To detect the change of cell micromotion in response to FCCP challenge, time-series resistances of cell-covered electrodes were monitored and the values of variance were calculated to verify the difference. While Seahorse XF-24 extracellular flux analyzer can detect the effect of FCCP at 3 μM concentration, the variance calculation of the time-series resistances measured at 4 kHz can detect the effect of FCCP at concentrations as low as 1 μM. For wound healing migration, the recovery resistance curves were fitted by sigmoid curve and the hill slope showed a concentration-dependent decline from 0.3 μM to 3 μM, indicating a decrease in cell migration rate. Moreover, dose dependent incline of the inflection points from 0.3 μM to 3 μM FCCP implied the increase of the half time for wound recovery migration. Together, our results demonstrate that partial uncoupling of mitochondrial oxidative phosphorylation reduces micromotion and wound healing migration of hMSCs. The ECIS method used in this study offers a simple and sensitive approach to investigate stem cell migration and its regulation by mitochondrial dynamics.

No abstract