Successful Completion Research Articles

BLUE SABINO: Development of a BiLateral Upper-Limb Exoskeleton for Simultaneous Assessment of Biomechanical and Neuromuscular Output

Arm and hand function play a critical role in the successful completion of everyday tasks. Lost function due to neurological impairment impacts millions of lives worldwide. Despite improvements in the ability to assess and rehabilitate arm deficits, knowledge about underlying sources of impairment and related sequela remains limited. The comprehensive assessment of function requires the measurement of both biomechanics and neuromuscular contributors to performance during the completion of tasks that often use multiple joints and span three-dimensional workspaces. To our knowledge, the complexity of movement and diversity of measures required are beyond the capabilities of existing assessment systems. To bridge current gaps in assessment capability, a new exoskeleton instrument is developed with comprehensive bilateral assessment in mind. The development of the BiLateral Upper-limb Exoskeleton for Simultaneous Assessment of Biomechanical and Neuromuscular Output (BLUE SABINO) expands on prior iterations toward full-arm assessment during reach-and-grasp tasks through the development of a dual-arm and dual-hand system, with 9 active degrees of freedom per arm and 12 degrees of freedom (six active, six passive) per hand. Joints are powered by electric motors driven by a real-time control system with input from force and force/torque sensors located at all attachment points between the user and exoskeleton. Biosignals from electromyography and electroencephalography can be simultaneously measured to provide insight into neurological performance during unimanual or bimanual tasks involving arm reach and grasp. Design trade-offs achieve near-human performance in exoskeleton speed and strength, with positional measurement at the wrist having an error of less than 2 mm and supporting a range of motion approximately equivalent to the 50th-percentile human. The system adjustability in seat height, shoulder width, arm length, and orthosis width accommodate subjects from approximately the 5th-percentile female to the 95th-percentile male. Integration between precision actuation, human–robot-interaction force-torque sensing, and biosignal acquisition systems successfully provide the simultaneous measurement of human movement and neurological function. The bilateral design enables use with left- or right-side impairments as well as intra-subject performance comparisons. With the resulting instrument, the authors plan to investigate underlying neural and physiological correlates of arm function, impairment, learning, and recovery.

Fostering scholarly writing development using a scaffolding approach

Satisfactory scholarly writing is identified as a barrier to successful completion for students enrolled in graduate nursing programs. In this semester-long activity, students work collaboratively to develop and apply strategies including PICO(T) question development, appraisal of primary and secondary literature, and literature matrix development to enhance their professional writing. Students' demonstration of inquiry and scholarly writing improved throughout the semester. This innovative teaching approach to fostering scholarly writing development is an effective way to prepare students for dissemination.

Primary care physicians and laypersons' perceptions of multicancer detection clinical trial designs.

The National Cancer Institute Cancer Screening Research Network is launching a pilot study (Vanguard) to determine feasibility of successful completion of a clinical trial of multicancer detection tests. This focus group study reports perceptions of primary care physicians and laypersons of different clinical trial designs and willingness to participate in a multicancer detection clinical trial. We undertook 14 focus groups with 88 laypersons and 6 focus groups with 45 primary care physicians. Participants were shown graphics of clinical trial designs and asked for their reactions. Focus group recordings were transcribed verbatim, and thematic analysis of the transcripts were conducted to identify emergent themes. Primary care physician and layperson participants recognized the importance of conducting clinical trials to determine the clinical utility of multicancer detection tests. Primary care physicians expressed reluctance to participate in trials because of workload burden, and laypersons expressed hesitancy about enrolling in the control group. Primary care physicians and laypersons expressed concern about a study design in which multicancer detection test results would not be returned to the control group (intended effect), but they respectively indicated a willingness to refer patients to, or participate in, a multicancer detection test clinical trial given transparent and clear communication on collection and use of biospecimens and data, particularly if a multicancer detection test would eventually be run and results eventually returned. This study yielded important insights to guide trial design in planning prospective evaluation of multicancer detection testing. Maintaining transparency and trust while possibly withholding multicancer detection test results to maximize trial feasibility and efficiency is of particular concern.

Differential Difference Equations in Trajectory Planning and Control for Differential Drive Robots: A Comprehensive Exploration

This paper provides a thorough investigation into the utilisation of differential difference equations (DDEs) for the purposes of trajectory planning and control in the context of differential drive four-wheeled robots. The inclusion of sensor and control delays is crucial when developing navigation strategies that are both resilient and efficient for robots functioning in dynamic environments. Differential delay equations (DDEs) provide a robust mathematical framework for representing the dynamics of such systems, facilitating precise and reliable path tracking. In order to demonstrate the versatility and practicality of Delay Differential Equations (DDEs), we investigate three distinct scenarios: straight-line path tracking, circular path tracking, and path planning with obstacle avoidance. These scenarios serve as demonstrations of how Delay Differential Equations (DDEs) facilitate the robot's ability to adjust its motion by utilising previous information, thereby ensuring a trajectory tracking process that is both smooth and stable. The trajectory plots provide a visual representation of the robot's path and effectively illustrate the successful completion of various navigation objectives. This study highlights the importance of dynamic differential equations (DDEs) in the advancement of intelligent and adaptable robotic systems, thereby paving the way for future progress in the realm of robotics and autonomous systems.

Initial Clinical Experience With a Novel Robotically Assisted Platform for Combined Mini-Percutaneous Nephrolithotomy and Flexible Ureteroscopic Lithotripsy.

We sought to evaluate the technical feasibility of performing a combined robotically assisted mini-percutaneous nephrolithotomy (PCNL) and flexible ureteroscopy (URS) procedure by a single urologist using the MONARCH Platform, Urology (Johnson & Johnson MedTech, Redwood City, California). In this prospective, first-in-human clinical trial, 13 patients underwent robotically-assisted PCNL for renal calculi at the University of California-Irvine, Department of Urology. Successful completion of the procedure was assessed as the primary endpoint. Postoperative adverse events were monitored for 30 days following the completion of the procedure. Stone ablation efficiency was evaluated on postoperative day 30 with low-dose 2-3 mm slice CT scans. Patients were classified according to the maximum length of their residual stone fragments as either absolute stone-free (Grade A), < 2 mm remnants (Grade B), or 2.1-4.0 mm remnants (Grade C). The combined robotic mini-PCNL and URS procedure was successfully completed in 12 of 13 procedures. No robotic device-related adverse events occurred. Preoperative stone burden was quantified by both maximum linear measurement (median 32.8 mm) as well as by CT-based volume (median 1645.9 mm3). Using the unique robotically assisted targeting system, percutaneous access was gained directly through the center of the renal papilla in a single pass in all cases. Median operative time was 187 minutes (range: 83-383 minutes). On postoperative day 30, a 98.7% (range: 72.9%-100.0%) volume reduction was achieved, with 5 Grade A (38.5%), 1 Grade B (7.7%), and 2 Grade C (15.4%). Three patients experienced complications (2 grade 1 and one grade 2 Clavien-Dindo). Our preliminary investigation demonstrates the safety, efficacy, and feasibility of a unique robotic-assisted combined mini-PCNL and URS platform.

Outcomes after Endovascular Arch Repair in Patients with a Mechanical Aortic Valve: Results from a Multicentre Study

The aim of this study was to investigate outcomes after endovascular aortic arch repair in patients with a mechanical aortic valve where the valve needs to be crossed. An international, multicentre, retrospective observational study was undertaken including all consecutive patients who underwent endovascular arch repair with mechanical aortic valve crossing. From March 2020 to August 2023, 12 patients were included in the study (median age 55 years, interquartile range 45, 67 years; 58% male). Five patients (42%) had a genetically confirmed connective tissue disorder (CTD) and three more had a high clinical suspicion of CTD. Most patients had a bileaflet valve (11/12; 92%) and one patient had a monoleaflet one. All patients had previously undergone surgical ascending aortic repair. Technical success was 100% with successful completion of the procedure with no valve damage. Two deaths (17%) were observed in the first 30 days post-operatively with no signs of valve malfunction: one patient died of major stroke due to excessive wire and sheath manipulation in the arch; and another due to cardiac arrest of unknown cause, with no valve damage being detected in the autopsy. No intra-operative technical difficulties regarding valve cannulation were observed. During a median follow up of eight months, one patient died fifteen months after the procedure owing to non-aortic related causes, and four endoleaks were present on the latest computed tomography angiography, none type I or III. Endovascular aortic arch repair in a selected group of patients with a mechanical aortic valve treated in experienced, high volume aortic centres seems technically feasible and reasonably safe. These preliminary results underline the complexity of the procedure and should be validated by larger cohort studies. With careful patient selection and adequate physician experience, the presence of a mechanical aortic valve could potentially no longer pose a major contraindication for endovascular arch repair in the future.

The manager-IPA pair in mental health: experimenting with a new form of collaboration

In2021, the first advanced practice nurses (APNs) specializing in psychiatry and mental health will have entered the vast field of practice of this discipline. Two years on, the missions entrusted to them within the establishments that have supported the development of their new skills are as varied as ever. While their scope of action remains to be defined in some places, the fact remains that collaboration between the APN and the local health executive is already proving to be a powerful lever for the successful completion of large-scale projects aimed at the continuous improvement of care in their shared field of practice. A look back at the deployment of a quality tool to improve care safety.

Sustained Long-Term Decline in Anti-HCV Neutralizing Antibodies in HIV/HCV-Coinfected Patients Five Years after HCV Therapy: A Retrospective Study.

Background: This study evaluated titers and amplitudes of anti-E2 antibodies (anti-E2-Abs) and neutralizing antibodies against hepatitis C virus (HCV; anti-HCV-nAbs) in HIV/HCV-coinfected individuals over five years after successful HCV treatment completion. Methods: We retrospectively analyzed 76 HIV/HCV-coinfected patients achieving sustained virologic response post-HCV treatment. Plasma levels of anti-E2-Abs and anti-HCV-nAbs against five HCV genotypes (Gt1a, Gt1b, Gt2a, Gt3a, and Gt4a) were determined using ELISA and microneutralization assays, respectively. Statistical analyses comparing the three follow-up time points (baseline, one year, and five years post-HCV treatment) were performed using generalized linear mixed models, adjusting p-values with the false discovery rate (q-value). Results: Compared to baseline, anti-E2-Abs titers decreased at one year (1.9- to 2.3-fold, q-value < 0.001) and five years (3.4- to 9.1-fold, q-value < 0.001) post-HCV treatment. Anti-HCV-nAbs decreased 2.9- to 8.4-fold (q-value < 0.002) at one year and 17.8- to 90.4-fold (q-value < 0.001) at five years post-HCV treatment. Anti-HCV-nAbs titers against Gt3a were consistently the lowest. Nonresponse rates for anti-E2-Abs remained low throughout the follow-up, while anti-HCV-nAbs nonresponse rates increased 1.8- to 13.5-fold (q-value < 0.05) at five years post-HCV treatment, with Gt3a showing the highest nonresponse rate. Conclusions: Humoral immune responses against HCV decreased consistently one and five years post-HCV treatment, regardless of HCV genotype and previous HCV therapy or type of treatment (IFN- or DAA-based therapy). This decline was more pronounced for anti-HCV-nAbs, particularly against Gt3.

Stimulation Therapy to Induce Mothers: Protocol for a Multicenter Randomized Controlled Trial.

More than 1 million women have their labor induced in the United States each year, and synthetic oxytocin infusion is the most common method used. However, compared to spontaneous labor, medical induction is resource intensive, has increased obstetric risks, and is associated with less successful breastfeeding. In contrast to the endogenous oxytocin hormone, which is released in a pulsatile fashion in the brain, synthetic oxytocin is continuously infused intravenously, resulting in important limitations related to efficacy, safety, and cost. Akin to spontaneous labor contractions, infant suckling of the breast nipple is known to stimulate the pulsatile release of endogenous oxytocin from the posterior pituitary gland. Nipple stimulation therapy via an electric breast pump similarly stimulates endogenous oxytocin release and may be a favorable inpatient method for patients undergoing labor induction. This study aims to examine whether inpatient nipple stimulation therapy is an efficacious labor induction method that increases the likelihood of spontaneous vaginal delivery and sustained breastfeeding and determine whether it is a cost-effective approach. This is a multicenter, pragmatic, open-label, parallel-group randomized controlled trial of nulliparous patients with singleton gestations ≥36 weeks undergoing labor induction. This trial compares inpatient nipple stimulation therapy via an electric breast pump versus immediate synthetic oxytocin infusion without nipple stimulation. This trial including 988 nulliparas will provide adequate statistical power to detect clinically meaningful differences in delivery mode and breast milk as the sole source of nutrition for newborns at hospital discharge or 72 hours after birth. The project received pilot funding in 2021 and full funding in 2023. Enrollment for this study began in November 2021 at a single site, and as of May 2024, recruitment is underway at 3 study sites. It is anticipated that enrollment will be completed by late 2026. Successful completion of this trial will provide rigorous data to determine whether inpatient nipple stimulation therapy with an electric breast pump can improve the way we induce labor and positively impact breastfeeding success and early infant nutrition through lactation. ClinicalTrials.gov NCT05079841; https://clinicaltrials.gov/study/NCT05079841. DERR1-10.2196/63463.

Temperature affects recombination rate plasticity and meiotic success between thermotolerant and cold tolerant yeast species.

Meiosis is required for the formation of gametes in all sexually reproducing species and the process is well conserved across the tree of life. However, meiosis is sensitive to a variety of external factors, which can impact chromosome pairing, recombination, and fertility. For example, the optimal temperature for successful meiosis varies between species of plants and animals. This suggests that meiosis is temperature sensitive, and that natural selection may act on variation in meiotic success as organisms adapt to different environmental conditions. To understand how temperature alters the successful completion of meiosis, we utilized two species of the budding yeast Saccharomyces with different temperature preferences: thermotolerant Saccharomyces cerevisiae and cold tolerant Saccharomyces uvarum. We surveyed three metrics of meiosis: sporulation efficiency, spore viability, and recombination rate in multiple strains of each species. As per our predictions, the proportion of cells that complete meiosis and form spores is temperature sensitive, with thermotolerant S. cerevisiae having a higher temperature threshold for successful meiosis than cold tolerant S. uvarum. We confirmed previous observations that S. cerevisiae recombination rate varies between strains and across genomic regions, and add new results that S. uvarum has higher recombination rates than S. cerevisiae. We find that temperature significantly influences recombination rate plasticity in S. cerevisiae and S. uvarum, in agreement with studies in animals and plants. Overall, these results suggest that meiotic thermal sensitivity is associated with organismal thermal tolerance, and may even result in temporal reproductive isolation as populations diverge in thermal profiles.

Non-operating Room Anesthesia (NORA): A Comprehensive Review of Monitored Anesthesia Care.

Monitored anesthesia care (MAC) is being increasingly employed in non-operative environments, particularly in the realms of endoscopy and magnetic resonance imaging (MRI) procedures. This in-depth analysis delves into the essential components of MAC within these specific contexts, with a primary focus on ensuring patient safety, evaluating efficacy, and assessing procedural outcomes. It is a common practice in endoscopic procedures to necessitate sedation for the purpose of alleviating discomfort and anxiety, ultimately ensuring patient cooperation and the successful completion of the procedure. MAC, which entails the administration of sedatives and analgesics under the close supervision of an anesthesia professional, offers a personalized approach that carefully balances the depth of sedation with maintaining optimal patient safety standards. Within the domain of MRI procedures, where challenges such as claustrophobia and motion artifacts can significantly impact the process, MAC plays a crucial role in providing a controlled setting that not only enhances image quality but also improves patient compliance throughout the procedure. The review extensively investigates the various pharmacological agents commonly utilized in these scenarios, including but not limited tomidazolamand fentanyl, shedding light on their pharmacokinetic and pharmacodynamic properties specific to these contexts. Furthermore, the critical role of the anesthesia provider in effectively managing potential complications, such as respiratory depression, hemodynamic instability, and allergic reactions, is thoroughly examined and discussed. The analysis extends to the implementation of MAC protocols, encompassing pre-procedural assessments, continuous intra-procedural monitoring, and comprehensive post-procedural care, all aimed at ensuring the best possible outcomes for patients. Additionally, the review delves into the economic considerations associated with MAC, taking into account its impact on procedural efficiency, healthcare costs, and patient throughput within these settings. By exploring current guidelines and recommendations established by professional societies such as the American Society of Anesthesiologists (ASA), this review aims to provide a holistic understanding of the best practices in MAC for both endoscopy and MRI procedures. Through the synthesis of available evidence, the primary objective of this review is to contribute to informing clinical practices, enhancing patient safety measures, improving procedural success rates, and ultimately advocating for the broader adoption of monitored anesthesia care in diverse non-operative medical settings.

An integrated multi-criteria decision making approach for selecting the starting location of railroad projects

PurposeThe successful completion of linear infrastructure construction projects such as railroads, roads, tunnels, and pipelines relies heavily on decision-making processes during planning phase. Professionals in the construction industry emphasize that determining the starting point of a linear infrastructure construction project is one of the most important decisions to be made in the planning phase. However, the existing literature does not specifically focus on selection of the starting point of the segments to be constructed. Therefore, it is of utmost importance to develop a multi-criteria decision-making (MCDM) model to support selection of the starting point of the segments to be constructed in linear infrastructure construction projects.Design/methodology/approachBased on the characteristics of the railroad projects and insights gathered from expert interviews, the appropriate criteria for the model were determined. Once the criteria were determined, a decision hierarchy was developed and the weights of the criteria (w_i) were calculated using DEcision MAking Trial and Evaluation Laboratory (DEMATEL) method. Then, Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), COmplex PRoportional Assessment (COPRAS), and evaluation based on distance from average solution (EDAS) methods were used. The alternatives were ranked in terms of their priority with TOPSIS method based on relative closeness (Ci) of each alternative to the ideal solution, COPRAS method based on quantitative utility (Ui) for each alternative and EDAS method based on evaluation score (ASi) for all alternatives. The results were compared with each other.FindingsThe study reveals the effects of all criteria on the proposed model. The results of DEMATEL method indicated that quantity of aggregate (w_i = 0.075), ballast (w_i = 0.071), and sub-ballast (w_i = 0.069) are the most important criteria in starting location selection for railroads, where earthquake (w_i = 0.046), excavation cost (w_i = 0.054), and longest distance from borrow pit (w_i = 0.055) were found to be less important criteria. The starting location alternatives were ranked based on TOPSIS, COPRAS and EDAS methods. The A-1 alternative was selected as the most appropriate alternative (Ci = 0.64; Ui = 100%; ASi = 0.81), followed by A-6 alternative (Ci = 0.61; Ui = 97%; ASi = 0.73) and A-7 alternative (Ci = 0.59; Ui = 94%; ASi = 0.60). Even tough different methods were used, they provided compatible results where the same ranking was achieved except three alternatives.Originality/valueThis study identifies novel criteria for the starting location selection of railroad construction based on the data of a railroad project. This study uses different methods for selecting the starting location. Considering the project type and its scope, the model can be used by decision-makers in linear infrastructure projects for which efficient planning and effective location selection are critical for successful operations.

An emotion-sensitive dialogue policy for task-oriented dialogue system

Reinforcement learning (RL) is an effective method in training dialogue policies to steer the conversation towards successful task completion. However, most RL-based methods only rely on semantic inputs that lack empathy as they ignore the user emotional information. Moreover, these methods suffer from delayed rewards caused by the user simulator returning valuable results only at dialogue end. Recently, some methods have been proposed to learn the reward function together with user emotions, but they omit considering user emotion in each dialogue turn. In this paper, we proposed an emotion-sensitive dialogue policy model (ESDP), it incorporates user emotions information into dialogue policy and selects the optimal action by the combination of top-k actions with the user emotions. The user emotion information in each turn is used as an immediate reward for the current dialogue state to solve sparse rewards and the dependency on termination. Extensive experiments validate that our method outperforms the baseline approaches when combined with different Q-Learning algorithms, and also surpasses other popular existing dialog policies’ performance.

Assessing the Use of GitHub Copilot on Students of Engineering of Information Systems

This study examines the impact of AI programming assistants like GitHub Copilot and ChatGPT on software engineering efficiency, an area that has seen limited empirical research. We experimentally evaluated the performance of programmers ([Formula: see text]) in Python coding tasks with and without AI assistance, measuring time-to-completion and feature implementation. Results indicate that participants utilizing AI assistance completed tasks significantly faster (p = 0.033) and implemented more required features (p = 0.012) compared to those relying solely on unaided coding. These findings offer empirical insights into the integration of AI tools in software development workflows, highlighting their potential to enhance efficiency without compromising code quality or completeness, with implications for organizational pipelines and practitioner skills. Responses to exit surveys suggest that participants without IA tools assistance encountered frustrations related to code recall, time constraints, and problem-solving, while assisted participants reported no negative experiences, focusing instead on successful completion of tasks within the allotted time.

LSDDEP2: study protocol for a randomised, double-dummy, triple-blind, active placebo-controlled, parallel groups trial of LSD microdosing in patients with major depressive disorder

BackgroundMajor depressive disorder (MDD) poses a significant global health burden with available treatments limited by inconsistent efficacy and notable side effects. Classic psychedelics, including lysergic acid diethylamide (LSD), have garnered attention for their potential in treating psychiatric disorders. Microdosing, the repeated consumption of sub-hallucinogenic doses of psychedelics, has emerged as a self-treatment approach for depression within lay communities. Building upon preliminary evidence and the successful completion of an open-label pilot trial of microdosing LSD for depression (LSDDEP1), this protocol outlines a phase 2b randomised controlled trial (LSDDEP2). The main objective of LSDDEP2 is to assess the modification of depressive symptoms, measured by the Montgomery–Åsberg Depression Rating Scale (MADRS), following a regimen of LSD microdoses versus placebo.MethodsThis is a randomised, double-dummy, triple-blind, active placebo-controlled, parallel groups trial of LSD microdosing in patients meeting DSM-5 criteria for major depressive disorder. Participants will undergo an 8-week LSD microdosing regimen using the titratable MB-22001 formulation taking two doses a week. All doses will be self-administered at home and will be titratable from 4 to 20 μg based on subjective perception and tolerability. In addition to depression symptoms, outcome will include psychiatric and personality inventories, sleep and activity tracking, electroencephalography (EEG), blood biomarkers, semi-structured interviews, and safety (e.g. adverse event, laboratory exam) measures.DiscussionThis study will be the first randomised controlled trial to administer controlled microdoses of LSD for treatment of MDD in participants’ naturalistic environment. The measures included are designed to assess the drug’s safety, mechanism, and treatment efficacy over placebo in this population. The results of this study will be important for assessing the viability of psychedelic microdosing as an additional treatment option and for informing the direction of future clinical trials.Trial registrationANZCTR, ACTRN12624000128594. Prospectively Registered on 13 February 2024.

Building Public Health Workforce Capacity: Longer-Term Effectiveness of a Capacity Building Intervention to Improve Community-Based Public Health Prevention Work

Objective: There is an urgent need to build capacity among existing and incoming public health workers to enhance community-based work focused on prevention and health promotion. Public Health Essentials (PHE), a cohort-based facilitated asynchronous online capacity building intervention, was designed to build public health workers’ strategic skills and professional confidence. Earlier research reported on the short-term learning outcomes of the intervention; here we report on results from a longer-term outcomes evaluation, including skill retention, skill application, and possible indicators of workforce retention and community health improvement.Methods: A sequential mixed-methods research study was used to assess and explore longer-term outcomes among a sample of PHE graduates working in community public health roles.Results: Some 46% of eligible PHE graduates (n=70) completed a skills survey at three timepoints: Pre-PHE, post-PHE, and 3-to-6 months post-PHE completion. Longitudinal analysis of responses showed statistically significant skill gains over baseline (Beginner → Proficient, p<0.005), despite a slight drop in self-perceived ability in the 3-6 months post-PHE completion. Qualitative interviews with respondents and focus groups with their supervisors suggest PHE completion benefits participants’ everyday work by developing strategic skills, and grounding their work in shared public health language, paradigms, and values. Broader reported benefits include the ability to apply new skills to community public health prevention projects and expressed motivation to continue to work in public health.Conclusions: Successful completion of PHE provides learners with durable skills applicable to public health work and may spur interest in continuing to work in the field of public health. The importance of developing and retaining a competent community-focused public health workforce cannot be overstated. Comprehensive facilitated, online asynchronous capacity building programs may be an effective tool.

Educational and extracurricular factors influencing the successful completion by graduate students of the state final certification at the university

Educational and extracurricular factors influencing the successful completion by graduate students of the state final certification at the university

Exploring physical therapists’ approach to addressing home exercise program-related low self-efficacy: knowledge, strategies, and barriers

Purpose Self-efficacy is the strongest predictor of completing home exercise programs (HEPs). How physical therapists address low levels of self-efficacy is unknown. Our objectives were to determine (1) knowledge and confidence in addressing patients’ self-efficacy; (2) strategies used to address low self-efficacy; and (3) barriers. Material and Methods Licensed physical therapists who are actively treating patients in the United States participated in our mixed-methods study consisting of: (1) a survey on knowledge, barriers, and confidence; and (2) interviews on strategies used to address low self-efficacy. Descriptive statistics were calculated on all quantitative data. Braun and Clarke’s 6-phase thematic analysis was used for the qualitative data. Results All 37 participants believed that self-efficacy impacts HEP completion. The majority (72.9%) reported addressing low self-efficacy. Barriers that impacted the ability to address low self-efficacy (Theme 1) included lack of knowledge, confidence, tools, guidance, and community resources, patients’ past experiences and complexities, inability to follow-up with patients, and reimbursement. Due to these barriers, participants primarily addressed patients’ low self-efficacy via communication (Theme 2) and ensuring successful exercise completion (Theme 3). Conclusion Instead of using Bandura’s fours sources of self-efficacy (i.e., mastery experiences, verbal persuasion, vicarious experiences, physiological state), participants verbalized addressing low self-efficacy via communication and successful exercise completion. Thus, implementation studies evaluating strategies to overcome the identified barriers are needed.

Mentoring Online Composition Instruction (ALP/Corequisite Writing) for Faculty and Student Success

This paper expands previous research discussing a former faculty-mentoring program for new and adjunct faculty teaching ALP (Accelerated Learning Program) / corequisite writing at the Community College of Rhode Island (CCRI) which was a boon to student success during the pandemic and aims to provide mentoring tools to new and adjunct faculty teaching online. The sudden shift to online learning brought multiple challenges, still relevant today, including student engagement, student attendance, and successful completion of work; thus, we also emphasize best digital practices that enable a successful online learning environment. A continuous support system / mentoring program that helps with all facets of distance learning is important for the success and well-being of both faculty and students.

Pathogenesis of Post-Tuberculosis Lung Disease: Defining Knowledge Gaps and Research Priorities at the Second International Post-Tuberculosis Symposium.

Post-tuberculosis (post-TB) lung disease is increasingly recognized as a major contributor to the global burden of chronic lung disease, with recent estimates indicating that over half of TB survivors have impaired lung function after successful completion of TB treatment. However, the pathologic mechanisms that contribute to post-TB lung disease are not well understood, thus limiting the development of therapeutic interventions to improve long-term outcomes after TB. This report summarizes the work of the Pathogenesis and Risk Factors Committee for the Second International Post-Tuberculosis Symposium, which took place in Stellenbosch, South Africa, in April 2023. The committee first identified six areas with high translational potential: 1) tissue matrix destruction, including the role of matrix metalloproteinase dysregulation and neutrophil activity; 2) fibroblasts and profibrotic activity; 3) granuloma fate and cell death pathways; 4) mycobacterial factors, including pathogen burden; 5) animal models; and 6) the impact of key clinical risk factors, including HIV, diabetes, smoking, malnutrition, and alcohol. We share the key findings from a literature review of those areas, highlighting knowledge gaps and areas where further research is needed.