International Journal of Environmental Research and Public Health

Research

13 pages, 1227 KiB

Open AccessArticle

Morehouse Choice Accountable Care Organization and Education System (MCACO-ES): Integrated Model Delivering Equitable Quality Care

by Michelle Brown, Elizabeth O. Ofili, Debbie Okirie, Priscilla Pemu, Cheryl Franklin, Yoon Suk, Alexander Quarshie, Mohamed Mubasher, Charles Sow, Valerie Montgomery Rice, David Williams, Michael Brooks, Ernest Alema-Mensah, Dominic Mack and Daniel Dawes

Int. J. Environ. Res. Public Health 2019, 16(17), 3084; https://doi.org/10.3390/ijerph16173084 - 25 Aug 2019

Cited by 9 | Viewed by 4805

Abstract

Accountable Care Organizations (ACOs) seek sustainable innovation through the testing of new care delivery methods that promote shared goals among value-based health care collaborators. The Morehouse Choice Accountable Care Organization and Education System (MCACO-ES), or (M-ACO) is a physician led integrated delivery model [...] Read more.

Accountable Care Organizations (ACOs) seek sustainable innovation through the testing of new care delivery methods that promote shared goals among value-based health care collaborators. The Morehouse Choice Accountable Care Organization and Education System (MCACO-ES), or (M-ACO) is a physician led integrated delivery model participating in the Medicare Shared Savings Program (MSSP) offered through the Centers for Medicare and Medicaid Services (CMS) Innovation Center. The MSSP establishes incentivized, performance-based payment models for qualifying health care organizations serving traditional Medicare beneficiaries that promote collaborative efficiency models designed to mitigate fragmented and insufficient access to health care, reduce unnecessary cost, and improve clinical outcomes. The M-ACO integration model is administered through participant organizations that include a multi-site community based academic practice, independent physician practices, and federally qualified health center systems (FQHCs). This manuscript aims to present a descriptive and exploratory assessment of health care programs and related innovation methods that validate M-ACO as a reliable simulator to implement, evaluate, and refine M-ACO’s integration model to render value-based performance outcomes over time. A part of the research approach also includes early outcomes and lessons learned advancing the framework for ongoing testing of M-ACO’s integration model across independently owned, rural, and urban health care locations that predominantly serve low-income, traditional Medicare beneficiaries, (including those who also qualify for Medicaid benefits (also referred to as “dual eligibles”). M-ACO seeks to determine how integration potentially impacts targeted performance results. As a simulator to test value-based innovation and related clinical and business practices, M-ACO uses enterprise-level data and advanced analytics to measure certain areas, including: 1) health program insight and effectiveness; 2) optimal implementation process and workflows that align primary care with specialists to expand access to care; 3) chronic care management/coordination deployment as an effective extender service to physicians and patients risk stratified based on defined clinical and social determinant criteria; 4) adoption of technology tools for patient outreach and engagement, including a mobile application for remote biometric monitoring and telemedicine; and 5) use of structured communication platforms that enable practitioner engagement and ongoing training regarding the shift from volume to value-based care delivery. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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16 pages, 1265 KiB

Open AccessArticle

The Association of Black Cardiologists (ABC) Cardiovascular Implementation Study (CVIS): A Research Registry Integrating Social Determinants to Support Care for Underserved Patients

by Elizabeth O. Ofili, Laura E. Schanberg, Barbara Hutchinson, Felix Sogade, Icilma Fergus, Phillip Duncan, Joe Hargrove, Andre Artis, Osita Onyekwere, Wayne Batchelor, Marcus Williams, Adefisayo Oduwole, Anekwe Onwuanyi, Folake Ojutalayo, Jo Ann Cross, Todd B. Seto, Henry Okafor, Priscilla Pemu, Lilly Immergluck, Marilyn Foreman, Ernest Alema Mensah, Alexander Quarshie, Mohamed Mubasher, Almelida Baker, Alnida Ngare, Andrew Dent, Mohamad Malouhi, Paul Tchounwou, Jae Lee, Traci Hayes, Muna Abdelrahim, Daniel Sarpong, Emma Fernandez-Repollet, Stephen O. Sodeke, Adrian Hernandez, Kevin Thomas, Anne Dennos, David Smith, David Gbadebo, Janet AJULUCHUKWU, B. Waine Kong, Cassandra McCollough, Sarah R. Weiler, Marc D. Natter, Kenneth D. Mandl and Shawn Murphy Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2019, 16(9), 1631; https://doi.org/10.3390/ijerph16091631 - 10 May 2019

Cited by 8 | Viewed by 4746

Abstract

African Americans, other minorities and underserved populations are consistently under- represented in clinical trials. Such underrepresentation results in a gap in the evidence base, and health disparities. The ABC Cardiovascular Implementation Study (CVIS) is a comprehensive prospective cohort registry that integrates social determinants [...] Read more.

African Americans, other minorities and underserved populations are consistently under- represented in clinical trials. Such underrepresentation results in a gap in the evidence base, and health disparities. The ABC Cardiovascular Implementation Study (CVIS) is a comprehensive prospective cohort registry that integrates social determinants of health. ABC CVIS uses real world clinical practice data to address critical gaps in care by facilitating robust participation of African Americans and other minorities in clinical trials. ABC CVIS will include diverse patients from collaborating ABC member private practices, as well as patients from academic health centers and Federally Qualified Health Centers (FQHCs). This paper describes the rationale and design of the ABC CVIS Registry. The registry will: (1) prospectively collect socio-demographic, clinical and biospecimen data from enrolled adults, adolescents and children with prioritized cardiovascular diseases; (2) Evaluate the safety and clinical outcomes of new therapeutic agents, including post marketing surveillance and pharmacovigilance; (3) Support National Institutes of Health (NIH) and industry sponsored research; (4) Support Quality Measures standards from the Center for Medicare and Medicaid Services (CMS) and Commercial Health Plans. The registry will utilize novel data and technology tools to facilitate mobile health technology application programming interface (API) to health system or practice electronic health records (EHR). Long term, CVIS will become the most comprehensive patient registry for underserved diverse patients with cardiovascular disease (CVD) and co morbid conditions, providing real world data to address health disparities. At least 10,000 patients will be enrolled from 50 sites across the United States. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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12 pages, 269 KiB

Open AccessArticle

Supporting New Community-Based Participatory Research Partnerships

by Nicolette I. Teufel-Shone, Anna L. Schwartz, Lisa J. Hardy, Hendrik D. De Heer, Heather J. Williamson, Dorothy J. Dunn, Kellen Polingyumptewa and Carmenlita Chief

Int. J. Environ. Res. Public Health 2019, 16(1), 44; https://doi.org/10.3390/ijerph16010044 - 25 Dec 2018

Cited by 23 | Viewed by 5555

Abstract

Marginalized communities have a documented distrust of research grounded in negative portrayals in the academic literature. Yet, trusted partnerships, the foundation for Community-Based Participatory Research (CBPR), require time to build the capacity for joint decision-making, equitable involvement of academically trained and community investigators, [...] Read more.

Marginalized communities have a documented distrust of research grounded in negative portrayals in the academic literature. Yet, trusted partnerships, the foundation for Community-Based Participatory Research (CBPR), require time to build the capacity for joint decision-making, equitable involvement of academically trained and community investigators, and co-learning. Trust can be difficult to develop within the short time between a funding opportunity announcement and application submission. Resources to support community- and academic-based investigators’ time to discuss contexts, concerns, integration of expertise and locally acceptable research designs and data collection are limited. The National Institutes of Health (NIH) funded Center for American Indian Resilience and the Southwest Health Equity Research Collaborative have implemented an internal funding mechanism to support community and academic-based investigators’ travel cost and time to discuss complementary areas of interest and skills and to decide if moving forward with a partnership and a collaborative grant proposal would be beneficial to the community. The rationale and administration of this Community-Campus Partnership Support (CCPS) Program are described and four examples of supported efforts are provided. Centers and training programs frequently fund pilot grants to support junior investigators and/or exploratory research. This CCPS mechanism should be considered as precursor to pilot work, to stimulate partnership building without the pressure of an approaching grant application deadline. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

7 pages, 645 KiB

Open AccessCommunication

The Role of Vitamin D and Oxidative Stress in Chronic Kidney Disease

by Keith C. Norris, Opeyemi Olabisi, M. Edwina Barnett, Yuan-Xiang Meng, David Martins, Chamberlain Obialo, Jae Eun Lee and Susanne B. Nicholas

Int. J. Environ. Res. Public Health 2018, 15(12), 2701; https://doi.org/10.3390/ijerph15122701 - 30 Nov 2018

Cited by 15 | Viewed by 3776

Abstract

Chronic kidney disease (CKD) is a major non-communicable disease associated with high rates of premature morbidity and mortality. The prevalence of hypovitaminosis D (deficiency of 25(OH)D or 25D) is greater in racial/ethnic minorities and in patients with CKD than the general population. Low [...] Read more.

Chronic kidney disease (CKD) is a major non-communicable disease associated with high rates of premature morbidity and mortality. The prevalence of hypovitaminosis D (deficiency of 25(OH)D or 25D) is greater in racial/ethnic minorities and in patients with CKD than the general population. Low 25D is associated with bone and mineral disorders as well as immune, cardiometabolic and cardiovascular (CV) diseases. Thus, it has been suggested that low 25D contributes to the poor outcomes in patients with CKD. The prevalence of hypovitaminosis D rises progressively with advancing severity of kidney disease with over 30% of patients with CKD stage 3 and 70% patients with CKD stage 5 estimated to have low levels of 25D. This report describes several of the abnormal physiologic and counter-regulatory actions related to low 25D in CKD such as those in oxidative stress and inflammatory systems, and some of the preclinical and clinical evidence, or lack thereof, of normalizing serum 25D levels to improve outcomes in patients with CKD, and especially for the high risk subset of racial/ethnic minorities who suffer from higher rates of advanced CKD and hypovitaminosis D. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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13 pages, 452 KiB

Open AccessArticle

Knowledge Management for Fostering Biostatistical Collaboration within a Research Network: The RTRN Case Study

by Jae Eun Lee, Jung Hye Sung, Daniel Sarpong, Jimmy T. Efird, Paul B. Tchounwou, Elizabeth Ofili and Keith Norris

Int. J. Environ. Res. Public Health 2018, 15(11), 2533; https://doi.org/10.3390/ijerph15112533 - 12 Nov 2018

Cited by 2 | Viewed by 3067

Abstract

Purpose: While the intellectual and scientific rationale for research collaboration has been articulated, a paucity of information is available on a strategic approach to facilitate the collaboration within a research network designed to reduce health disparities. This study aimed to (1) develop [...] Read more.

Purpose: While the intellectual and scientific rationale for research collaboration has been articulated, a paucity of information is available on a strategic approach to facilitate the collaboration within a research network designed to reduce health disparities. This study aimed to (1) develop a conceptual model to facilitate collaboration among biostatisticians in a research network; (2) describe collaborative engagement performed by the Network’s Data Coordinating Center (DCC); and (3) discuss potential challenges and opportunities in engaging the collaboration. Methods: Key components of the strategic approach will be developed through a systematic literature review. The Network’s initiatives for the biostatistical collaboration will be described in the areas of infrastructure, expertise and knowledge management and experiential lessons will be discussed. Results: Components of the strategic approach model included three Ps (people, processes and programs) which were integrated into expert management, infrastructure management and knowledge management, respectively. Ongoing initiatives for collaboration with non-DCC biostatisticians included both web-based and face-to-face interaction approaches: Network’s biostatistical capacities and needs assessment, webinar statistical seminars, mobile statistical workshop and clinics, adjunct appointment program, one-on-one consulting, and on-site workshop. The outreach program, as a face-to-face interaction approach, especially resulted in a useful tool for expertise management and needs assessment as well as knowledge exchange. Conclusions: Although fostering a partnered research culture, sustaining senior management commitment and ongoing monitoring are a challenge for this collaborative engagement, the proposed strategies centrally performed by the DCC may be useful in accelerating the pace and enhancing the quality of the scientific outcomes within a multidisciplinary clinical and translational research network. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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11 pages, 306 KiB

Open AccessArticle

Using Risk Communication Strategies for Zika Virus Prevention and Control Driven by Community-Based Participatory Research

by Deborah Juarbe-Rey, Adriana Obén Pérez, Roberto Papo Christian P. Santoni, Melissa Ramírez Ramírez and Mildred Vera

Int. J. Environ. Res. Public Health 2018, 15(11), 2505; https://doi.org/10.3390/ijerph15112505 - 9 Nov 2018

Cited by 10 | Viewed by 4443

Abstract

Background: In this study, we use community-based participatory processes to engage community and academic partners in a meaningful exchange to identify and pilot test risk communication strategies for Zika virus prevention and control. Methods: Community members were actively involved in planning, developing, and [...] Read more.

Background: In this study, we use community-based participatory processes to engage community and academic partners in a meaningful exchange to identify and pilot test risk communication strategies for Zika virus prevention and control. Methods: Community members were actively involved in planning, developing, and implementing a risk communication initiative. Qualitative and quantitative data gathered through individual interviews, focus groups, and community advisory board input provided information for the identification of relevant risk communication strategies to increase the understanding about Zika virus and to promote behavior change. To examine its impact we obtained baseline and follow-up data from a random sample of 75 community residents. A face-to-face interview was conducted to assess community members’ knowledge, attitudes, and behaviors regarding Zika virus infection. Results: Study activities focused on three risk communication strategies: Zika awareness health fair, health education through theater, and community forums and workshops. The risk communication initiative was implemented over a two-month period. Findings from baseline and follow-up data demonstrated significant positive changes in respondents’ recognition of personal and community responsibility for the prevention of Zika infection, increased knowledge of prevention strategies, and enhanced engagement in preventive behaviors for mosquito control. Conclusion: Our findings sustain the benefits of community based participatory research for the design and implementation of risk communication strategies that are relevant to enable residents in low-income communities to take informed decisions for the protection against Zika virus and other mosquito-borne diseases. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

16 pages, 1006 KiB

Open AccessArticle

A Survey of Health Disparities, Social Determinants of Health, and Converging Morbidities in a County Jail: A Cultural-Ecological Assessment of Health Conditions in Jail Populations

by Robert T Trotter II, Monica R Lininger, Ricky Camplain, Viacheslav Y Fofanov, Carolyn Camplain and Julie A Baldwin

Int. J. Environ. Res. Public Health 2018, 15(11), 2500; https://doi.org/10.3390/ijerph15112500 - 8 Nov 2018

Cited by 34 | Viewed by 7108

Abstract

The environmental health status of jail populations in the United States constitutes a significant public health threat for prisoners and the general population. The ecology of jails creates a dynamic condition in relation to general population health due to the concentrated potential exposure [...] Read more.

The environmental health status of jail populations in the United States constitutes a significant public health threat for prisoners and the general population. The ecology of jails creates a dynamic condition in relation to general population health due to the concentrated potential exposure to infectious diseases, difficult access to treatment for chronic health conditions, interruption in continuity of care for serious behavioral health conditions, as well as on-going issues for the prevention and treatment of substance abuse disorders. This paper reports on elements of a cross-sectional survey embedded in a parent project, “Health Disparities in Jail Populations.” The overall project includes a comprehensive secondary data analysis of the health status of county jail populations, along with primary data collection that includes a cross-sectional health and health care services survey of incarcerated individuals, coupled with collection of biological samples to investigate infectious disease characteristics of a county jail population. This paper reports on the primary results of the survey data collection that indicate that this is a population with complex and interacting co-morbidities, as well as significant health disparities compared to the general population. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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16 pages, 2368 KiB

Open AccessArticle

Cigarette Smoking Modulation of Saliva Microbial Composition and Cytokine Levels

by Mary Rodríguez-Rabassa, Pablo López, Ronald E. Rodríguez-Santiago, Antonio Cases, Marcos Felici, Raphael Sánchez, Yasuhiro Yamamura and Vanessa Rivera-Amill

Int. J. Environ. Res. Public Health 2018, 15(11), 2479; https://doi.org/10.3390/ijerph15112479 - 7 Nov 2018

Cited by 36 | Viewed by 6715

Abstract

Tobacco use has been implicated as an immunomodulator in the oral cavity and contributes to the development of oral cancer. In the present study, we investigated the effects of cigarette smoking on bacterial diversity and host responses compared to healthy nonsmoking controls. Saliva [...] Read more.

Tobacco use has been implicated as an immunomodulator in the oral cavity and contributes to the development of oral cancer. In the present study, we investigated the effects of cigarette smoking on bacterial diversity and host responses compared to healthy nonsmoking controls. Saliva samples were collected from eighteen smokers and sixteen nonsmoking individuals by passive drool. The 16S rRNA gene was used to characterize the salivary microbiome by using the Illumina MiSeq platform. Cytokine and chemokine expression analyses were performed to evaluate the host response. Significant differences in cytokine and chemokine expression levels of MDC, IL-10, IL-5, IL-2, IL-4, IL-7, adrenocorticotropic hormone (ACTH), insulin, and leptin were observed between smokers and nonsmokers. Taxonomic analyses revealed differences between the two groups, and some bacterial genera associated with the smokers group had correlations with hormones and cytokines identified as statistically different between smokers and nonsmokers. These factors have been associated with inflammation and carcinogenesis in the oral cavity. The data obtained may aid in the identification of the interactions between the salivary microbiome, host inflammatory responses, and metabolism in smokers. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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12 pages, 592 KiB

Open AccessFeature PaperArticle

Using a Virtual Community (the Health Equity Learning Collaboratory) to Support Early-Stage Investigators Pursuing Grant Funding

by Meldra Hall, Jeffrey Engler, Japera Hemming, Ernest Alema-Mensah, Adriana Baez, Kimberly Lawson, Alexander Quarshie, Jonathan Stiles, Priscilla Pemu, Winston Thompson, Douglas Paulsen, Ann Smith and Elizabeth Ofili

Int. J. Environ. Res. Public Health 2018, 15(11), 2408; https://doi.org/10.3390/ijerph15112408 - 30 Oct 2018

Cited by 17 | Viewed by 6148

Abstract

Junior investigators often have limited access to networks of scientific experts and resources that facilitate competitive grant submissions. Since environments in which scientists are trained are critically important for long-term success, we built and tested a virtual environment for early-stage investigators (ESIs) working [...] Read more.

Junior investigators often have limited access to networks of scientific experts and resources that facilitate competitive grant submissions. Since environments in which scientists are trained are critically important for long-term success, we built and tested a virtual environment for early-stage investigators (ESIs) working on grant proposals. The aim of this study was to evaluate the virtual community’s influence on grant submission patterns among participants from underrepresented groups. As part of a grant writing coaching model, junior investigators were recruited into a professional development program designed to develop competitive grantsmanship skills. Designed by the Research Resources and Outreach Core (RROC) of the National Research Mentoring Network (NRMN), the Health Equity Learning Collaboratory (EQ-Collaboratory) provided a virtual community for social support, accountability, constructive feedback, and access to peer networks to help investigators overcome barriers to grant submission. This study assessed differences in outcomes for participants who completed the training within the EQ-Collaboratory compared to those who did not. The analyzed data revealed a statistically significant difference in the average time to submission for participants enrolled in the EQ-Collaboratory. EQ-Collaboratory ESIs submitted proposals 148.6 days earlier, (p < 0.0001). The results suggest that a supportive virtual environment can help investigators more quickly overcome barriers to grant submission. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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16 pages, 2662 KiB

Open AccessArticle

Poor Sleep Quality Is Associated with Higher Hemoglobin A1c in Pregnant Women: A Pilot Observational Study

by Sanika Chirwa, Chioma R. Nwabuisi, Gwinnett M. Ladson, Linda Korley, Janice E. Whitty, Robin Atkinson and John T. Clark

Int. J. Environ. Res. Public Health 2018, 15(10), 2287; https://doi.org/10.3390/ijerph15102287 - 18 Oct 2018

Cited by 13 | Viewed by 4448

Abstract

We hypothesized that poor sleep quality exacerbates glucose intolerance manifested as elevated glycosylated hemoglobin (HbA1c), which increases the risk for gestational diabetes. To test this, 38 pregnant and 22 non-pregnant (age, 18–35 years; body-mass index, 20–35 kg/m²) otherwise healthy women were [...] Read more.

We hypothesized that poor sleep quality exacerbates glucose intolerance manifested as elevated glycosylated hemoglobin (HbA1c), which increases the risk for gestational diabetes. To test this, 38 pregnant and 22 non-pregnant (age, 18–35 years; body-mass index, 20–35 kg/m²) otherwise healthy women were enrolled in the study. Sleep quality was assessed during gestational week 24 (pregnant), or outside of the menstrual period (non-pregnant), using qualitative (Pittsburgh Sleep Quality Index) and objective (actigraphic wrist-watch) measures. Blood glucose, total cortisol, and depression status were evaluated. Eight pregnant and one non-pregnant women were lost to follow-up, or withdrew from the study. There was a higher incidence of poor sleep quality in pregnant (73%) relative to non-pregnant women (43%). Although actigraphic data revealed no differences in actual sleep hours between pregnant and non-pregnant women, the number of wake episodes and sleep fragmentation were higher in pregnant women. Poor sleep quality was positively correlated with higher HbA1c in both pregnant (r = 0.46, n = 26, p = 0.0151) and non-pregnant women (r = 0.50, n = 19, p = 0.0217), reflecting higher average blood glucose concentrations. In contrast, poor sleep was negatively correlated with cortisol responses in pregnant women (r = −0.46, n = 25, p = 0.0167). Three pregnant women had elevated one-hour oral glucose tolerance test results (>153 mg/dL glucose). These same pregnant women exhibited poor sleep quality. These results support the suggestion that poor sleep quality is an important risk factor that is associated with glucose intolerance and attendant health complications in pregnancy. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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9 pages, 1205 KiB

Open AccessArticle

Contemplative Practices: A Strategy to Improve Health and Reduce Disparities

by Marino A. Bruce, Kia Skrine Jeffers, Jan King Robinson and Keith C. Norris

Int. J. Environ. Res. Public Health 2018, 15(10), 2253; https://doi.org/10.3390/ijerph15102253 - 15 Oct 2018

Cited by 9 | Viewed by 4927

Abstract

Health has many dimensions, and intolerance and lack of compassion may contribute to the poor health and disparities in our nation. Tolerance can convey an inherent paradox or dissonance that can be associated with stress. However, tolerance has a dimension of acceptance, an [...] Read more.

Health has many dimensions, and intolerance and lack of compassion may contribute to the poor health and disparities in our nation. Tolerance can convey an inherent paradox or dissonance that can be associated with stress. However, tolerance has a dimension of acceptance, an acknowledgement and acceptance of what “is” at the present moment, that can relieve tension associated with differing beliefs and practices. Compassionate consideration of others can be combined with acceptance to create harmony within and across individuals. In this article, we explore how contemplative practices can cultivate tolerance and compassion and contribute to improvements in individual and population health. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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7 pages, 262 KiB

Open AccessCommunication

A Multi-Pronged Approach to Diversifying the Workforce

by Doris M. Rubio, Colleen A. Mayowski and Marie K. Norman

Int. J. Environ. Res. Public Health 2018, 15(10), 2219; https://doi.org/10.3390/ijerph15102219 - 11 Oct 2018

Cited by 9 | Viewed by 4462

Abstract

The biomedical workforce continues to lack diversity, despite growing evidence demonstrating the advantages of diverse teams in workplaces for creativity and innovation. At the University of Pittsburgh Institute for Clinical Research Education, we have taken a multi-pronged, collaborative approach to enhance the diversity [...] Read more.

The biomedical workforce continues to lack diversity, despite growing evidence demonstrating the advantages of diverse teams in workplaces for creativity and innovation. At the University of Pittsburgh Institute for Clinical Research Education, we have taken a multi-pronged, collaborative approach to enhance the diversity of our trainees and scholars. We started by implementing a program for postdoctoral fellows and junior faculty, the Career Education and Enhancement for Health Care Research Diversity (CEED) program. We then built on this program and created a sister program for medical students (CEED II). These two programs were intended to build a local community of diverse researchers. Following the success of these programs, we extended our efforts and pursued federal funding to establish other programs. Our first funded program was designed to teach leadership and career coaching skills to mentors who are committed to mentoring people from diverse backgrounds, the Professional Mentoring Skills Enhancing Diversity (PROMISED) program. We then partnered with minority serving institutions to create a fellowship in translational research skills training, Leading Emerging and Diverse Scientists to Success (LEADS), training in patient-centered outcomes research, Expanding National Capacity in PCOR through Training (ENACT), and a year-long fellowship to work with a specific mentor at Pitt, the Clinical and Translational Science (CTS) Fellowship (TL1). With recognition that much work remains to be done, we believe these programs represent a small but positive step toward diversifying the biomedical workforce. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

18 pages, 8580 KiB

Open AccessArticle

Characterization of Histone Genes from the Bivalve Lucina Pectinata

by Ingrid M. Montes-Rodríguez, Yesenia Rodríguez-Pou, Ricardo R. González-Méndez, Juan Lopez-Garriga, Alexander J. Ropelewski and Carmen L. Cadilla

Int. J. Environ. Res. Public Health 2018, 15(10), 2170; https://doi.org/10.3390/ijerph15102170 - 2 Oct 2018

Cited by 3 | Viewed by 3206

Abstract

Lucina pectinata is a clam that lives in sulfide-rich environments and houses intracellular sulfide-oxidizing endosymbionts. To identify new Lucina pectinata proteins, we produced libraries for genome and transcriptome sequencing and assembled them de novo. We searched for histone-like sequences using the Lucina pectinata [...] Read more.

Lucina pectinata is a clam that lives in sulfide-rich environments and houses intracellular sulfide-oxidizing endosymbionts. To identify new Lucina pectinata proteins, we produced libraries for genome and transcriptome sequencing and assembled them de novo. We searched for histone-like sequences using the Lucina pectinata histone H3 partial nucleotide sequence against our previously described genome assembly to obtain the complete coding region and identify H3 coding sequences from mollusk sequences in Genbank. Solen marginatus histone nucleotide sequences were used as query sequences using the genome and transcriptome assemblies to identify the Lucina pectinata H1, H2A, H2B and H4 genes and mRNAs and obtained the complete coding regions of the five histone genes by RT-PCR combined with automated Sanger DNA sequencing. The amino acid sequence conservation between the Lucina pectinata and Solen marginatus histones was: 77%, 93%, 83%, 96% and 97% for H1, H2A, H2B, H3 and H4, respectively. As expected, the H3 and H4 proteins were the most conserved and the H1 proteins were most similar to H1′s from aquatic organisms like Crassostrea gigas, Aplysia californica, Mytilus trossulus and Biomphalaria glabrata. The Lucina pectinata draft genome and transcriptome assemblies, obtained by semiconductor sequencing, were adequate for identification of conserved proteins as evidenced by our results for the histone genes. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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10 pages, 284 KiB

Open AccessCommunication

The Economic Impact of Herpes Zoster Vaccine Disparities in Elderly United States Blacks

by La’Marcus T. Wingate, Keisha Stubbs, Iman Ahmed, Rachel K. Mayaka, Mary K. Maneno, Earl Ettienne, Oluchi Elekwachi and Veronica Clarke-Tasker

Int. J. Environ. Res. Public Health 2018, 15(10), 2128; https://doi.org/10.3390/ijerph15102128 - 27 Sep 2018

Cited by 2 | Viewed by 3840

Abstract

There are persistent disparities with regard to receipt of herpes zoster vaccine among elderly blacks, but no data is available regarding the public health or economic impact of these disparities. A decision tree was constructed with multiple Markov nodes in order to estimate [...] Read more.

There are persistent disparities with regard to receipt of herpes zoster vaccine among elderly blacks, but no data is available regarding the public health or economic impact of these disparities. A decision tree was constructed with multiple Markov nodes in order to estimate the preventable cases of herpes zoster occurring among elderly blacks due to disparities in receipt of herpes zoster vaccine and to quantify the economic costs associated with these disparities. The model was constructed to examine the number of herpes zoster cases occurring among elderly blacks from the age of 60 to 84 over a 20 year period and also calculated costs due to herpes zoster complications and lost productivity. Achievement of health equity would prevent over 34,500 cases of herpes zoster from occurring in the future and avert over $180 million in lost productivity and treatment costs as a result of these cases of herpes zoster. These results help to show that thousands of cases of herpes zoster could be prevented if blacks were vaccinated at the same frequency as whites and help to show the benefit of implementing viable strategies to achieving this goal. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

18 pages, 4277 KiB

Open AccessArticle

Cancer Health Literacy and Willingness to Participate in Cancer Research and Donate Bio-Specimens

by Margarita Echeverri, David Anderson, Anna María Nápoles, Jacqueline M. Haas, Marc E. Johnson and Friar Sergio A. Serrano

Int. J. Environ. Res. Public Health 2018, 15(10), 2091; https://doi.org/10.3390/ijerph15102091 - 24 Sep 2018

Cited by 26 | Viewed by 5652

Abstract

Although it has been well documented that poor health literacy is associated with limited participation in cancer clinical trials, studies assessing the relationships between cancer health literacy (CHL) and participation in research among diverse populations are lacking. In this study, we examined the [...] Read more.

Although it has been well documented that poor health literacy is associated with limited participation in cancer clinical trials, studies assessing the relationships between cancer health literacy (CHL) and participation in research among diverse populations are lacking. In this study, we examined the relationship between CHL and willingness to participate in cancer research and/or donate bio-specimens (WPRDB) among African Americans, Latinos, and Whites. Participants completed the Cancer Health Literacy Test and the Multidimensional Cancer Literacy Questionnaire. Total-scale and subscale scores, frequencies, means, and distributions were computed. Analyses of variance, the Bonferroni procedure, and the Holm method were used to examine significant differences among groups. Cronbach’s alphas estimated scales’ internal consistency reliability. Significant interactions were found between race/ethnicity, gender, and CHL on WPRDB scales and subscale scores, even after education and age were taken into account. Our study confirms that CHL plays an important role that should be considered and researched further. The majority of participants were more willing to participate in non-invasive research studies (surveys, interviews, and training) or collection of bio-specimens (saliva, check cells, urine, and blood) and in studies led by their own healthcare providers, and local hospitals and universities. However, participants were less willing to participate in more-invasive studies requiring them to take medications, undergo medical procedures or donate skin/tissues. We conclude that addressing low levels of CHL and using community-based participatory approaches to address the lack of knowledge and trust about cancer research among diverse populations may increase not only their willingness to participate in research and donate bio-specimens, but may also have a positive effect on actual participation rates. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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11 pages, 739 KiB

Open AccessArticle

Do Progestin-Only Contraceptives Contribute to the Risk of Developing Depression as Implied by Beta-Arrestin 1 Levels in Leukocytes? A Pilot Study

by Keisha Smith, Sanket Nayyar, Tanu Rana, Anthony E. Archibong, Kimberly R. Looney and Tultul Nayyar

Int. J. Environ. Res. Public Health 2018, 15(9), 1966; https://doi.org/10.3390/ijerph15091966 - 9 Sep 2018

Cited by 9 | Viewed by 5879

Abstract

We reported previously that reduction in beta-arrestin 1 (β-AR 1) protein levels in peripheral blood mononuclear leukocytes (PBMC) significantly correlated with the severity of depressive symptoms in reproductive women. In this pilot study, we used β-AR 1 protein levels in PBMC as a [...] Read more.

We reported previously that reduction in beta-arrestin 1 (β-AR 1) protein levels in peripheral blood mononuclear leukocytes (PBMC) significantly correlated with the severity of depressive symptoms in reproductive women. In this pilot study, we used β-AR 1 protein levels in PBMC as a marker for developing depressive symptoms and the Hamilton Depression Rating Scale (HAM-D) scores to assess potential mood-related side effects of oral contraceptive use for routine birth control among women. We evaluated 29 women in this study. We enrolled the participants in three groups: Estrogen-progestin combination-oral contraceptives (COC, n = 10), progestin-only contraceptives (POC, n = 12), and non-hormonal or no contraceptives (NC, n = 7). We determined the β-AR 1 protein levels in PBMCs by enzyme-linked immunosorbent assay (ELISA). We found that women in the POC group had significantly higher HAM-D scores compared to those in the COC (p < 0.0004) and NC (p < 0.004). The levels of β-AR 1 protein were significantly attenuated in women in the POC group compared to women in the NC group (p = 0.03). Our findings suggest that the use of POC is a potential risk factor for developing depressive symptoms. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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13 pages, 305 KiB

Open AccessArticle

Impact of Antidepressant Use on Healthcare Utilization among Individuals with Type 2 Diabetes and Depression Symptoms in the United States: Sociodemographic, Clinical, and Behavioral Factors Matter

by Ammena Y. Binsaleh, Alexandra Perez, Ioana Popovici and Silvia E. Rabionet

Int. J. Environ. Res. Public Health 2018, 15(9), 1904; https://doi.org/10.3390/ijerph15091904 - 1 Sep 2018

Cited by 2 | Viewed by 3954

Abstract

Individuals with diabetes are twice as likely to struggle from depressive symptoms than individuals without diabetes. However, this joint condition is undertreated in nearly two-thirds of patients. Failure to monitor the comorbidity may lead to suboptimal therapy. This study evaluated the association of [...] Read more.

Individuals with diabetes are twice as likely to struggle from depressive symptoms than individuals without diabetes. However, this joint condition is undertreated in nearly two-thirds of patients. Failure to monitor the comorbidity may lead to suboptimal therapy. This study evaluated the association of antidepressant use with healthcare utilization in a national sample of patients with type 2 diabetes and depression symptoms in the United States. It further assessed the differences in sociodemographic, clinical, and behavioral factors between those who use antidepressants and those who do not. This study was a secondary data analysis using the National Health and Nutrition Examination Survey (NHANES) for the period 2005–2014. To assess if there were significant differences in sociodemographic, clinical, and behavioral factors between those who were taking antidepressants or not, Chi Square and independent t-tests were used. To assess if there was a significant association between antidepressant use and healthcare utilization, univariate and multivariate regression analyses were conducted. Of the 955 participants, only 33% were on antidepressants. There were significant differences in sociodemographic, clinical, and behavioral factors among those who used antidepressants and those who did not. Regardless of antidepressant use, the study population had access to health care. Those on antidepressants had fewer diabetes specialists’ visits and more mental health care. There might be underlying health care disparities related to the use of, and access to, antidepressants. Further studies are needed to comprehensively explore the management of these comorbidities. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

14 pages, 463 KiB

Open AccessArticle

Learning and Action in Community Health: Using the Health Belief Model to Assess and Educate African American Community Residents about Participation in Clinical Research

by Latrice Rollins, Angela Sy, Nicole Crowell, Desiree Rivers, Assia Miller, Pamela Cooper, Debra Teague, Cassandra Jackson, Tabia Henry Akintobi and Elizabeth Ofili

Int. J. Environ. Res. Public Health 2018, 15(9), 1862; https://doi.org/10.3390/ijerph15091862 - 28 Aug 2018

Cited by 18 | Viewed by 6541

Abstract

The Learning and Action in Community Health project was implemented to gather preliminary data needed to inform community-engaged educational approaches to increase clinical research participation among racial minorities. The Health Belief Model was the theoretical framework utilized to develop the intervention and assessment [...] Read more.

The Learning and Action in Community Health project was implemented to gather preliminary data needed to inform community-engaged educational approaches to increase clinical research participation among racial minorities. The Health Belief Model was the theoretical framework utilized to develop the intervention and assessment tools. An educational session about clinical research and biorepository participation was designed using clinicaltrials.gov information and administered to adult, African American community residents (n = 60) in Atlanta, Georgia. Pre- and post-tests were collected and analyzed to assess changes in participants’ knowledge, perceptions, and willingness to participate in clinical studies and biorepositories. There were statistically significant changes in knowledge about joining a clinical study (p < 0.001) and registry or biorepository (p < 0.001). There was no statistically significant change in willingness to participate in clinical research or biorepositories after the educational session. Focus groups were conducted to gather feedback on the educational session and perceived barriers and benefits to participating in clinical research. Perceived benefits were improving health, receiving incentives, early detection of health issues, and access to care. Perceived barriers included fear, lack of knowledge, historical mistrust of research, and time constraints. Results have implications for subsequent community-engaged approaches to increasing minority participation in clinical research. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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14 pages, 959 KiB

Open AccessArticle

A Portfolio Analysis of Culturally Tailored Trials to Address Health and Healthcare Disparities

by Marisa Torres-Ruiz, Kaitlynn Robinson-Ector, Dionna Attinson, Jamie Trotter, Ayodola Anise and Steven Clauser

Int. J. Environ. Res. Public Health 2018, 15(9), 1859; https://doi.org/10.3390/ijerph15091859 - 28 Aug 2018

Cited by 45 | Viewed by 7717

Abstract

In 2010, Patient-Centered Outcomes Research Institute (PCORI) was authorized by Congress to improve the quality and relevance of evidence available to help patients, caregivers, employers, insurers, and policy makers make better-informed health decisions. We conducted a qualitative analysis of behavioral health trials in [...] Read more.

In 2010, Patient-Centered Outcomes Research Institute (PCORI) was authorized by Congress to improve the quality and relevance of evidence available to help patients, caregivers, employers, insurers, and policy makers make better-informed health decisions. We conducted a qualitative analysis of behavioral health trials in the PCORI Addressing Disparities portfolio to examine cultural tailoring strategies across the following priority populations: racial and ethnic minorities, rural populations, people with low-income or low socioeconomic status, individuals with disabilities, people with low health literacy, and lesbian, gay, bisexual, and transgender (LGBT) communities. The Common Strategies for Enhancing Cultural Appropriateness model was used to examine cultural tailoring strategies within trials. We hypothesized increased intersectionality within a patient population at risk for disparities would correlate with the dosage and type of cultural tailoring strategies applied. Thirty-three behavioral health trials applied cultural tailoring strategies and a majority of trials (n = 30) used three or more strategies. Trends in cultural tailoring were associated with certain racial and ethnic groups; however, increased use of tailoring was not associated with the number of priority populations included in a trial. The PCORI Addressing Disparities portfolio demonstrates how a range of cultural tailoring strategies are used, within comparative clinical effectiveness research trials, to address the needs and intersectionality of patients to reduce health and healthcare disparities. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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14 pages, 10361 KiB

Open AccessArticle

Reversing the Trends toward Shorter Lives and Poorer Health for U.S. Women: A Call for Innovative Interdisciplinary Research

by April Schweinhart and Janine Austin Clayton

Int. J. Environ. Res. Public Health 2018, 15(9), 1796; https://doi.org/10.3390/ijerph15091796 - 21 Aug 2018

Cited by 4 | Viewed by 4600

Abstract

The United States (U.S.) is a leader and innovator in biomedicine, yet trails behind for many key health indicators, especially for women. This paper highlights key evidence indicating that not only is the state of women’s health in the U.S. lagging, but it [...] Read more.

The United States (U.S.) is a leader and innovator in biomedicine, yet trails behind for many key health indicators, especially for women. This paper highlights key evidence indicating that not only is the state of women’s health in the U.S. lagging, but it is at risk for falling off the curve. Women’s health care remains fragmented; research in the field can be disconnected and difficult to integrate across disciplines—silos prevail. Structural obstacles contribute to this lack of cohesion, and innovative, interdisciplinary research approaches which integrate the multidimensional aspects of sex and gender, and race and ethnicity, with a life course perspective are sorely needed. Such synergistic, scientific strategies have the potential to reverse the trend towards shorter life expectancy and poorer health for women in the U.S. The National Institute for Health (NIH) seeks to raise the bar for the health of all women by tackling these issues through enhancing the relevance of biomedical research to the health of women and driving the sustained advancement of women in biomedical careers. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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13 pages, 2458 KiB

Open AccessArticle

6 Hz Active Anticonvulsant Fluorinated N-Benzamide Enaminones and Their Inhibitory Neuronal Activity

by Isis J. Amaye, Thomas Heinbockel, Julia Woods, Zejun Wang, Miguel Martin-Caraballo and Patrice Jackson-Ayotunde

Int. J. Environ. Res. Public Health 2018, 15(8), 1784; https://doi.org/10.3390/ijerph15081784 - 20 Aug 2018

Cited by 12 | Viewed by 4403

Abstract

A small library of novel fluorinated N-benzamide enaminones were synthesized and evaluated in a battery of acute preclinical seizure models. Three compounds (GSA 62, TTA 35, and WWB 67) were found to have good anticonvulsant activity in the 6-Hz ‘psychomotor’ 44-mA rodent model. [...] Read more.

A small library of novel fluorinated N-benzamide enaminones were synthesized and evaluated in a battery of acute preclinical seizure models. Three compounds (GSA 62, TTA 35, and WWB 67) were found to have good anticonvulsant activity in the 6-Hz ‘psychomotor’ 44-mA rodent model. The focus of this study was to elucidate the active analogs’ mode of action on seizure-related molecular targets. Electrophysiology studies were employed to evaluate the compounds’ ability to inhibit neuronal activity in central olfactory neurons, mitral cells, and sensory-like ND7/23 cells, which express an assortment of voltage and ligand-gated ion channels. We did not find any significant effects of the three compounds on action potential generation in mitral cells. The treatment of ND7/23 cells with 50 µM of GSA 62, TTA 35, and WWB 67 generated a significant reduction in the amplitude of whole-cell sodium currents. Similar treatment of ND7/23 cells with these compounds had no effect on T-type calcium currents, indicating that fluorinated N-benzamide enaminone analogs may have a selective effect on voltage-gated sodium channels, but not calcium channels. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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6 pages, 1513 KiB

Open AccessArticle

Translating Research as an Approach to Enhance Science Engagement

by Michelle T. Juarez and Chloe M. Kenet

Int. J. Environ. Res. Public Health 2018, 15(8), 1749; https://doi.org/10.3390/ijerph15081749 - 15 Aug 2018

Cited by 2 | Viewed by 4162

Abstract

The impact of research depends on the effective communication of discoveries. Scientific writing is the primary tool for the dissemination of research, and is an important skill that biomedical trainees have to develop. Despite its importance, scientific writing is not part of the [...] Read more.

The impact of research depends on the effective communication of discoveries. Scientific writing is the primary tool for the dissemination of research, and is an important skill that biomedical trainees have to develop. Despite its importance, scientific writing is not part of the mainstream curriculum. One strategy used to teach scientific writing is holding a journal club style discussion of primary research literature that the students are asked to read. However, this activity can result in a passive learning experience and limit the development of trainees’ scientific writing skills. In order to improve trainees’ written communication skills, we tested an exercise that involved generating a revised article describing prior research, in essence “translating” the science into basic language. Following the guidelines set out by “Frontiers for Young Minds” and feedback received from “Young Reviewers”, we wrote a revised article with a simpler description of the research. In this article, we describe this scientific writing exercise, which may ultimately serve as a model for scientists to share their research more efficiently in order to promote better public health outcomes. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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8 pages, 1697 KiB

Open AccessArticle

Human Papillomavirus-16 DNA Quantitation Differentiates High-Grade Anal Neoplasia

by Melissa Agsalda-Garcia, Tiffany Shieh, Eleanore Chuang, Nicholas Loi, Cris Milne, Rui Fang, Eunjung Lim, Jeffrey Killeen and Bruce Shiramizu

Int. J. Environ. Res. Public Health 2018, 15(8), 1690; https://doi.org/10.3390/ijerph15081690 - 8 Aug 2018

Cited by 3 | Viewed by 3538

Abstract

Background: Due to their higher rates of anal dysplasia/cancer, human immunodeficiency virus (HIV)-positive individuals are recommended to undergo anal dysplasia screening, which consists of anal cytology (AC) and high resolution anoscopy (HRA) with anal biopsy (AB) after abnormal AC result. However, AC variability [...] Read more.

Background: Due to their higher rates of anal dysplasia/cancer, human immunodeficiency virus (HIV)-positive individuals are recommended to undergo anal dysplasia screening, which consists of anal cytology (AC) and high resolution anoscopy (HRA) with anal biopsy (AB) after abnormal AC result. However, AC variability limits its usefulness. Our objective was to evaluate human papillomavirus (HPV)-16 DNA quantitation as part of the screening algorithm. Methods: HPV-16 was detected in AC specimens from 75 HIV-positive participants using quantitative real-time polymerase chain reaction. AB results were available from 18/44 patients who had abnormal AC. Statistical tests included Mann-Whitney U, Kruskal-Wallis, receiver operating characteristic (ROC) analysis and Kappa coefficient tests. Results: HPV-16 copy numbers differed significantly across AC (p = 0.001) and AB grades (p = 0.009). HPV-16 ≥ 65 copies/cell predicted high-grade AB (p = 0.04). Using this cut-off in comparison to AB, it had better specificity (1.00) than AC (0.75) and specificity (0.77) than qualitative HPV-16 detection (0.38). Also, the Kappa coefficient of the cut-off (κ = 0.649) was higher than AC (κ = 0.557) and qualitative HPV-16 detection (κ = 0.258) to AB. Conclusion: Higher HPV-16 copy numbers corresponded to higher AC and AB grades, suggesting the importance of HPV burden on disease stage. Furthermore, HPV-16 ≥ 65 copies/cell distinguished high-grade disease and demonstrated better sensitivity, specificity, and agreement with AB than AC or qualitative HPV-16 detection. These results support the potential use of HPV quantitation in conjunction with AC in anal dysplasia screening. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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10 pages, 1822 KiB

Open AccessArticle

Epidemiological Investigation of Type 2 Diabetes and Alzheimer’s Disease in a Pakistani Population

by Zarish Noreen, Jessica DeJesus, Attya Bhatti, Christopher A. Loffredo, Peter John, Jahangir S. Khan, Gail Nunlee-Bland and Somiranjan Ghosh

Int. J. Environ. Res. Public Health 2018, 15(8), 1582; https://doi.org/10.3390/ijerph15081582 - 26 Jul 2018

Cited by 5 | Viewed by 5309

Abstract

The epidemic of type 2 diabetes mellitus (T2DM) and the possibility of it contributing to the risk of Alzheimer’s disease (AD) have become important health concerns worldwide and in Pakistan, where the co-occurrence of T2DM and AD is becoming more frequent. To gain [...] Read more.

The epidemic of type 2 diabetes mellitus (T2DM) and the possibility of it contributing to the risk of Alzheimer’s disease (AD) have become important health concerns worldwide and in Pakistan, where the co-occurrence of T2DM and AD is becoming more frequent. To gain insights on this phenomenon, a cross-sectional study was initiated. We recruited and interviewed 820 research participants from four cities in Pakistan: 250 controls, 450 T2DM, 100 AD, and 20 with both diseases. Significant differences between groups were observed for age (p < 0.0001), urban vs. rural locality (p = 0.0472) and residing near industrial areas. The average HbA1c (%) level was 10.68 ± 2.34 in the T2DM group, and females had a lower level than males (p = 0.003). In the AD group, significant relationships existed between education and family history. Overall, the results suggest that T2DM and AD were associated with both socio-demographic and environmental factors in Pakistani participants. Detailed molecular investigations are underway in our laboratory to decipher the differential genetic pathways of the two diseases to address their increasing prevalence in this developing nation. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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8 pages, 315 KiB

Open AccessCommunication

Suicide Stigma among Medical Students in Puerto Rico

by Eliut Rivera-Segarra, Ernesto Rosario-Hernández, Paola Carminelli-Corretjer, Nelmit Tollinchi-Natali and Norka Polanco-Frontera

Int. J. Environ. Res. Public Health 2018, 15(7), 1366; https://doi.org/10.3390/ijerph15071366 - 29 Jun 2018

Cited by 7 | Viewed by 5511

Abstract

Suicide is a global public health issue and the 10th leading cause of death, regardless of age, in the U.S. Puerto Ricans are U.S. citizens with one of the highest rates of suicide ideation and attempts (SIA) among all Latino sub-groups. Research has [...] Read more.

Suicide is a global public health issue and the 10th leading cause of death, regardless of age, in the U.S. Puerto Ricans are U.S. citizens with one of the highest rates of suicide ideation and attempts (SIA) among all Latino sub-groups. Research has found that stigma is a risk factor for SIA. Medical students are an important group to target as they engage in routine clinical interactions with potential suicide victims, playing an important role in suicide prevention efforts. However, these efforts may be hampered by suicide stigma. The purpose of this study is to examine the correlates of suicide stigma in a sample of medical students in Puerto Rico. We implement an exploratory cross-sectional design using quantitative techniques. A total of 123 medical students participate in the study. Bivariate analyses suggest that gender is significantly correlated to suicide stigma (p < 0.05). Hierarchical regression analysis suggests that suicide literacy (β = −0.196, p < 0.05) and emotional reaction to suicide (β = 0.212, p < 0.05) predict suicide stigma. Although preliminary, these findings echo previous research regarding the importance of literacy and emotional reaction in the stigmatization process. Future research may develop intervention strategies aimed at reducing suicide stigma among medical students. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

13 pages, 617 KiB

Open AccessArticle

Clinical Relevant Polymorphisms Affecting Clopidogrel Pharmacokinetics and Pharmacodynamics: Insights from the Puerto Rico Newborn Screening Program

by Dagmar F. Hernandez-Suarez, Jonnalie C. Tomassini-Fernandini, Angelica Cuevas, Anyelis N. Rosario-Berrios, Héctor J. Nuñez-Medina, Dariana Padilla-Arroyo, Nannette Rivera, Jennifer Liriano, Rocio K. Vega-Roman, Jessicca Y. Renta, Kyle Melin and Jorge Duconge

Int. J. Environ. Res. Public Health 2018, 15(6), 1115; https://doi.org/10.3390/ijerph15061115 - 30 May 2018

Cited by 6 | Viewed by 5170

Abstract

Background: Variations in several clopidogrel-pharmacogenes have been linked to clopidogrel response variability and clinical outcomes. We aimed to determine the frequency distribution of major polymorphisms on CYP2C19, PON1, ABCB1 and P2RY12 pharmacogenes in Puerto Ricans. Methods: This was a cross-sectional, [...] Read more.

Background: Variations in several clopidogrel-pharmacogenes have been linked to clopidogrel response variability and clinical outcomes. We aimed to determine the frequency distribution of major polymorphisms on CYP2C19, PON1, ABCB1 and P2RY12 pharmacogenes in Puerto Ricans. Methods: This was a cross-sectional, population-based study of 200 unrelated “Guthrie” cards specimens from newborns registered in the Puerto Rican newborn screening program (PRNSP) between 2004 and 2014. Taqman^® SNP assay techniques were used for genotyping. Results: Minor allele frequencies (MAF) were 46% for PON1 (rs662), 41% for ABCB1 (rs1045642), 14% for CYP2C19*17, 13% for CYP2C19*2, 12% for P2RY12-H2 and 0.3% for CYP2C19*4. No carriers of the CYP2C19*3 variants were detected. All alleles and genotype proportions were found to be in Hardy–Weinberg equilibrium (HWE). Overall, there were no significant differences between MAFs of these variants in Puerto Ricans and the general population (n = 453) of the 1000 Genome project, except when comparisons to each individual parental group were performed (i.e., Africans, Europeans and East-Asians; p < 0.05). As expected, the prevalence of these markers in Puerto Ricans most resembled those in the 181 subjects from reference populations of the Americas. Conclusions: These prevalence data provide a necessary groundwork for future clinical studies of clopidogrel pharmacogenetics in Caribbean Hispanics. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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Review

Jump to: Research, Other

7 pages, 267 KiB

Open AccessReview

Statins and Cardiovascular Disease Outcomes in Chronic Kidney Disease: Reaffirmation vs. Repudiation

by Chamberlain I. Obialo, Elizabeth O. Ofili and Keith C. Norris

Int. J. Environ. Res. Public Health 2018, 15(12), 2733; https://doi.org/10.3390/ijerph15122733 - 4 Dec 2018

Cited by 15 | Viewed by 3628

Abstract

Cardiovascular disease (CVD) burden is several-fold higher in patients with chronic kidney disease (CKD). Although statins have been shown to provide significant CVD benefits in both the general population and patients with CKD, this has not translated into survival advantage in patients with [...] Read more.

Cardiovascular disease (CVD) burden is several-fold higher in patients with chronic kidney disease (CKD). Although statins have been shown to provide significant CVD benefits in both the general population and patients with CKD, this has not translated into survival advantage in patients with advanced CKD or on dialysis. It has been reported that CVD risk continues to escalate as CKD progresses to end-stage kidney disease (ESKD); however, the CVD risk reduction by statins appears to decline as patients’ progress from the early to later stages of CKD. Statins have also been associated with a higher incidence of stroke in ESKD patients. Thus, the CVD benefits of statins in ESKD remain questionable. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

11 pages, 955 KiB

Open AccessReview

Neuromodulation of Synaptic Transmission in the Main Olfactory Bulb

by John D. Harvey and Thomas Heinbockel

Int. J. Environ. Res. Public Health 2018, 15(10), 2194; https://doi.org/10.3390/ijerph15102194 - 8 Oct 2018

Cited by 31 | Viewed by 7301

Abstract

A major step in our understanding of brain function is to determine how neural circuits are altered in their function by signaling molecules or neuromodulators. Neuromodulation is the neurochemical process that modifies the computations performed by a neuron or network based on changing [...] Read more.

A major step in our understanding of brain function is to determine how neural circuits are altered in their function by signaling molecules or neuromodulators. Neuromodulation is the neurochemical process that modifies the computations performed by a neuron or network based on changing the functional needs or behavioral state of the subject. These modulations have the effect of altering the responsivity to synaptic inputs. Early sensory processing areas, such as the main olfactory bulb, provide an accessible window for investigating how neuromodulation regulates the functional states of neural networks and influences how we process sensory information. Olfaction is an attractive model system in this regard because of its relative simplicity and because it links primary olfactory sensory neurons to higher olfactory and associational networks. Likewise, centrifugal fibers from higher order brain centers target neurons in the main olfactory bulb to regulate synaptic processing. The neuromodulatory systems that provide regulatory inputs and play important roles in olfactory sensory processing and behaviors include the endocannabinoid system, the dopaminergic system, the cholinergic system, the noradrenergic system and the serotonergic system. Here, we present a brief survey of neuromodulation of olfactory signals in the main olfactory bulb with an emphasis on the endocannabinoid system. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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7 pages, 290 KiB

Open AccessReview

Epigenetic Effects of Drugs of Abuse

by Thomas Heinbockel and Antonei B. Csoka

Int. J. Environ. Res. Public Health 2018, 15(10), 2098; https://doi.org/10.3390/ijerph15102098 - 25 Sep 2018

Cited by 16 | Viewed by 6213

Abstract

Drug addiction affects a large extent of young people and disadvantaged populations. Drugs of abuse impede brain circuits or affect the functionality of brain circuits and interfere with bodily functions. Cannabinoids (Δ9-tetrahydrocannabinol) form key constituents of marijuana derived from the cannabis plant. Marijuana [...] Read more.

Drug addiction affects a large extent of young people and disadvantaged populations. Drugs of abuse impede brain circuits or affect the functionality of brain circuits and interfere with bodily functions. Cannabinoids (Δ9-tetrahydrocannabinol) form key constituents of marijuana derived from the cannabis plant. Marijuana is a frequently used illegal drug in the USA. Here, we review the effects of cannabinoids at the epigenetic level and the potential role of these epigenetic effects in health and disease. Epigenetics is the study of alterations in gene expression that are transmitted across generations and take place without an alteration in DNA sequence, but are due to modulation of chromatin associated factors by environmental effects. Epigenetics is now known to offer an extra mechanism of control over transcription and how genes are expressed. Insights from research at the genetic and epigenetic level potentially provide venues that allow the translation of the biology of abused drugs to new means of how to treat marijuana substance use disorder or other addictions using pharmacotherapeutic tools. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

13 pages, 1245 KiB

Open AccessFeature PaperReview

Cross-Talk between Wnt and Hh Signaling Pathways in the Pathology of Basal Cell Carcinoma

by Felicite K. Noubissi, Clement G. Yedjou, Vladimir S. Spiegelman and Paul B. Tchounwou

Int. J. Environ. Res. Public Health 2018, 15(7), 1442; https://doi.org/10.3390/ijerph15071442 - 9 Jul 2018

Cited by 34 | Viewed by 6691

Abstract

Basal cell carcinoma (BCC) is the most frequently occurring form of all cancers. The cost of care for BCC is one of the highest for all cancers in the Medicare population in the United States. Activation of Hedgehog (Hh) signaling pathway appears to [...] Read more.

Basal cell carcinoma (BCC) is the most frequently occurring form of all cancers. The cost of care for BCC is one of the highest for all cancers in the Medicare population in the United States. Activation of Hedgehog (Hh) signaling pathway appears to be a key driver of BCC development. Studies involving mouse models have provided evidence that activation of the glioma-associated oncogene (GLI) family of transcription factors is a key step in the initiation of the tumorigenic program leading to BCC. Activation of the Wnt pathway is also observed in BCCs. In addition, the Wnt signaling pathway has been shown to be required in Hh pathway-driven development of BCC in a mouse model. Cross-talks between Wnt and Hh pathways have been observed at different levels, yet the mechanisms of these cross-talks are not fully understood. In this review, we examine the mechanism of cross-talk between Wnt and Hh signaling in BCC development and its potential relevance for treatment. Recent studies have identified insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1), a direct target of the Wnt/β-catenin signaling, as the factor that binds to GLI1 mRNA and upregulates its levels and activities. This mode of regulation of GLI1 appears important in BCC tumorigenesis and could be explored in the treatment of BCCs. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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14 pages, 858 KiB

Open AccessReview

Racial Disparities and Preventive Measures to Renal Cell Carcinoma

by Jennifer N. Sims, Clement G. Yedjou, Daniel Abugri, Marinelle Payton, Timothy Turner, Lucio Miele and Paul B. Tchounwou

Int. J. Environ. Res. Public Health 2018, 15(6), 1089; https://doi.org/10.3390/ijerph15061089 - 28 May 2018

Cited by 31 | Viewed by 7854

Abstract

Kidney cancer ranks among the top 10 cancers in the United States. Although it affects both male and female populations, it is more common in males. The prevalence rate of renal cell carcinoma (RCC), which represents about 85% of kidney cancers, has been [...] Read more.

Kidney cancer ranks among the top 10 cancers in the United States. Although it affects both male and female populations, it is more common in males. The prevalence rate of renal cell carcinoma (RCC), which represents about 85% of kidney cancers, has been increasing gradually in many developed countries. Family history has been considered as one of the most relevant risk factors for kidney cancer, although most forms of an inherited predisposition for RCC only account for less than four percent. Lifestyle and other factors such as occupational exposure, high blood pressure, poor diet, and heavy cigarette smoking are highly associated with its incidence and mortality rates. In the United States, White populations have the lowest prevalence of RCC compared to other ethnic groups, while Black Americans suffer disproportionally from the adverse effects of RCC. Hence, this review article aims at identifying the major risk factors associated with RCC and highlighting the new therapeutic approaches for its control/prevention. To achieve this specific aim, articles in peer-reviewed journals with a primary focus on risk factors related to kidney cancer and on strategies to reduce RCC were identified. The review was systematically conducted by searching the databases of MEDLINE, PUBMED Central, and Google Scholar libraries for original articles. From the search, we found that the incidence and mortality rates of RCC are strongly associated with four main risk factors, including family history (genetics), lifestyle (poor diet, cigarette smoking, excess alcohol drinking), environment (community where people live), and occupation (place where people work). In addition, unequal access to improvement in RCC cancer treatment, limited access to screening and diagnosis, and limited access to kidney transplant significantly contribute to the difference observed in survival rate between African Americans and Caucasians. There is also scientific evidence suggesting that some physicians contribute to racial disparities when performing kidney transplant among minority populations. New therapeutic measures should be taken to prevent or reduce RCC, especially among African Americans, the most vulnerable population group. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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12 pages, 355 KiB

Open AccessReview

Alcoholism: A Multi-Systemic Cellular Insult to Organs

by Ucee Dguzeh, Natasha C. Haddad, Kathia T. S. Smith, John O. Johnson, Angelia A. Doye, Judith K. Gwathmey and Georges E. Haddad

Int. J. Environ. Res. Public Health 2018, 15(6), 1083; https://doi.org/10.3390/ijerph15061083 - 28 May 2018

Cited by 43 | Viewed by 10544

Abstract

Alcohol abuse can affect more than the heart and the liver. Many observers often do not appreciate the complex and differing aspects of alcohol’s effects in pathophysiologies that have been reported in multiple organs. Chronic alcohol abuse is known to be associated with [...] Read more.

Alcohol abuse can affect more than the heart and the liver. Many observers often do not appreciate the complex and differing aspects of alcohol’s effects in pathophysiologies that have been reported in multiple organs. Chronic alcohol abuse is known to be associated with pathophysiological changes that often result in life-threatening clinical outcomes, e.g., breast and colon cancer, pancreatic disease, cirrhosis of the liver, diabetes, osteoporosis, arthritis, kidney disease, immune system dysfunction, hypertension, coronary artery disease, cardiomyopathy, and can be as far-reaching as to cause central nervous system disorders. In this review article, we will discuss the various organs impacted by alcohol abuse. The lack of clear guidelines on the amount and frequency of alcohol intake, complicated by personal demographics, make extrapolations to real-life practices at best difficult for public health policy-makers. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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8 pages, 313 KiB

Open AccessConference Report

Academic Response to Storm-Related Natural Disasters—Lessons Learned

by Jerris R. Hedges, Karam F. A. Soliman, Gene D’Amour, Dong Liang, Carlos E. Rodríguez-Díaz, Kenira Thompson, Josefina Romaguera, Silvia E. Rabionet Sabater and Richard Yanagihara

Int. J. Environ. Res. Public Health 2018, 15(8), 1768; https://doi.org/10.3390/ijerph15081768 - 17 Aug 2018

Cited by 6 | Viewed by 5782

Abstract

On 30 October 2017, selected faculty and administrators from Research Centers in Minority Institutions (RCMI) grantee institutions gathered to share first-hand accounts of the devastating impact of Hurricanes Harvey, Irma, and Maria, which had interrupted academic activities, including research, education, and training in [...] Read more.

On 30 October 2017, selected faculty and administrators from Research Centers in Minority Institutions (RCMI) grantee institutions gathered to share first-hand accounts of the devastating impact of Hurricanes Harvey, Irma, and Maria, which had interrupted academic activities, including research, education, and training in Puerto Rico, Florida, and Texas. The presenters reviewed emergency response measures taken by their institutions to maintain community health care access and delivery, the storm-related impact on clinical and research infrastructure, and strategies to retain locally grown clinical expertise and translational science research talent in the aftermath of natural disasters. A longer-term perspective was provided through a comparative review of lessons learned by one New Orleans-based institution (now more than a decade post-storm) in the aftermath of Hurricane Katrina. Caring for the internal and external communities associated with each institution and addressing the health disparities exacerbated by storm-related events is one key strategy that will pay long-term dividends in the survival of the academic institutions and the communities they serve. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

10 pages, 964 KiB

Open AccessBrief Report

Sanger and Next Generation Sequencing Approaches to Evaluate HIV-1 Virus in Blood Compartments

by Andrea Arias, Pablo López, Raphael Sánchez, Yasuhiro Yamamura and Vanessa Rivera-Amill

Int. J. Environ. Res. Public Health 2018, 15(8), 1697; https://doi.org/10.3390/ijerph15081697 - 9 Aug 2018

Cited by 30 | Viewed by 6475

Abstract

The implementation of antiretroviral treatment combined with the monitoring of drug resistance mutations improves the quality of life of HIV-1 positive patients. The drug resistance mutation patterns and viral genotypes are currently analyzed by DNA sequencing of the virus in the plasma of [...] Read more.

The implementation of antiretroviral treatment combined with the monitoring of drug resistance mutations improves the quality of life of HIV-1 positive patients. The drug resistance mutation patterns and viral genotypes are currently analyzed by DNA sequencing of the virus in the plasma of patients. However, the virus compartmentalizes, and different T cell subsets may harbor distinct viral subsets. In this study, we compared the patterns of HIV distribution in cell-free (blood plasma) and cell-associated viruses (peripheral blood mononuclear cells, PBMCs) derived from ART-treated patients by using Sanger sequencing- and Next-Generation sequencing-based HIV assay. CD4⁺CD45RA⁻RO⁺ memory T-cells were isolated from PBMCs using a BD FACSAria instrument. HIV pol (protease and reverse transcriptase) was RT-PCR or PCR amplified from the plasma and the T-cell subset, respectively. Sequences were obtained using Sanger sequencing and Next-Generation Sequencing (NGS). Sanger sequences were aligned and edited using RECall software (beta v3.03). The Stanford HIV database was used to evaluate drug resistance mutations. Illumina MiSeq platform and HyDRA Web were used to generate and analyze NGS data, respectively. Our results show a high correlation between Sanger sequencing and NGS results. However, some major and minor drug resistance mutations were only observed by NGS, albeit at different frequencies. Analysis of low-frequency drugs resistance mutations and virus distribution in the blood compartments may provide information to allow a more sustainable response to therapy and better disease management. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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