Public Health Commons^™

Serum Exosomal Microrna Pathway Activation In Placenta Accreta Spectrum: Pathophysiology And Detection, Jessian L Munoz, Brett D Einerson, Robert M Silver, Sureshkumar Mulampurath, Lauren S Sherman, Pranela Rameshwar, Egle Bytautiene Prewit, Patrick S Ramsey

Faculty, Staff and Students Publications

BACKGROUND: Placenta accreta spectrum disorders are a complex range of placental pathologies that are associated with significant maternal morbidity and mortality. A diagnosis of placenta accreta spectrum relies on ultrasonographic findings with modest positive predictive value. Exosomal microRNAs are small RNA molecules that reflect the cellular processes of the origin tissues.

OBJECTIVE: We aimed to explore exosomal microRNA expression to understand placenta accreta spectrum pathology and clinical use for placenta accreta spectrum detection.

STUDY DESIGN: This study was a biomarker analysis of prospectively collected samples at 2 academic institutions from 2011 to 2022. Plasma specimens were collected from patients with …

Tetravalent Sars-Cov-2 S1 Subunit Protein Vaccination Elicits Robust Humoral And Cellular Immune Responses In Siv-Infected Rhesus Macaque Controllers, Rachel C Vanderkruik, Craig Ferguson, Lauren A Kobylski, Joseph J Locascio, Gabriella E Hamlett, Parker C Killenberg, Robert Lewis, Noah Jones, Ella T Rossa, Hannah Dineen, Rosalind Picard, Lee S Cohen

Faculty, Staff and Student Publications

BACKGROUND: Depression during pregnancy is increasingly recognized as a worldwide public health problem. If untreated, there can be detrimental outcomes for the mother and child. Anxiety is also often comorbid with depression. Although effective treatments exist, most women do not receive treatment. Technology is a mechanism to increase access to and engagement in mental health services.

OBJECTIVE: The Guardians is a mobile app, grounded in behavioral activation principles, which seeks to leverage mobile game mechanics and in-game rewards to encourage user engagement. This study seeks to assess app satisfaction and engagement and to explore changes in clinical symptoms of depression …

Epha2- And Hdac-Targeted Combination Therapy In Endometrial Cancer, Robiya Joseph, Santosh K Dasari, Sujanitha Umamaheswaran, Lingegowda S Mangala, Emine Bayraktar, Cristian Rodriguez-Aguayo, Yutuan Wu, Nghi Nguyen, Reid T Powell, Mary Sobieski, Yuan Liu, Mark Seungwook Kim, Sara Corvigno, Katherine Foster, Pahul Hanjra, Thanh Chung Vu, Mamur A Chowdhury, Paola Amero, Clifford Stephan, Gabriel Lopez-Berestein, Shannon N Westin, Anil K Sood

Faculty, Staff and Student Publications

Endometrial cancer is the most frequent malignant tumor of the female reproductive tract but lacks effective therapy. EphA2, a receptor tyrosine kinase, is overexpressed by various cancers including endometrial cancer and is associated with poor clinical outcomes. In preclinical models, EphA2-targeted drugs had modest efficacy. To discover potential synergistic partners for EphA2-targeted drugs, we performed a high-throughput drug screen and identified panobinostat, a histone deacetylase inhibitor, as a candidate. We hypothesized that combination therapy with an EphA2 inhibitor and panobinostat leads to synergistic cell death. Indeed, we found that the combination enhanced DNA damage, increased apoptosis, and decreased clonogenic survival …

Evaluation Of Potential Biomarkers For Lenvatinib Plus Pembrolizumab Among Patients With Advanced Endometrial Cancer: Results From Study 111/Keynote-146, Vicky Makker, Matthew H Taylor, Carol Aghajanian, Allen L Cohn, Marcia S Brose, Christopher Di Simone, Zhu Alexander Cao, Leah Suttner, Andrey Loboda, Razvan Cristescu, Petar Jelinic, Robert Orlowski, Lea Dutta, Junji Matsui, Corina E Dutcus, Yukinori Minoshima, Mark J Messing

Faculty, Staff and Student Publications

BACKGROUND: Lenvatinib plus pembrolizumab demonstrated clinically meaningful benefit in patients with previously treated advanced endometrial carcinoma in Study 111/KEYNOTE-146 (NCT02501096). In these exploratory analyses from this study, we evaluated the associations between clinical outcomes and gene expression signature scores and descriptively summarized response in biomarker subpopulations defined by tumor mutational burden (TMB) and DNA variants for individual genes of interest.

METHODS: Patients with histologically confirmed metastatic endometrial carcinoma received oral lenvatinib 20 mg once daily plus intravenous pembrolizumab 200 mg every 3 weeks for 35 cycles. Archived formalin-fixed paraffin-embedded tissue was obtained from all patients. T-cell-inflamed gene expression profile (Tcell …

Analysis Of Breast Cancer Mortality In The Us-1975 To 2019, Jennifer L Caswell-Jin, Liyang P Sun, Diego Munoz, Ying Lu, Yisheng Li, Hui Huang, John M Hampton, Juhee Song, Jinani Jayasekera, Clyde Schechter, Oguzhan Alagoz, Natasha K Stout, Amy Trentham-Dietz, Sandra J Lee, Xuelin Huang, Jeanne S Mandelblatt, Donald A Berry, Allison W Kurian, Sylvia K Plevritis

Faculty, Staff and Student Publications

IMPORTANCE: Breast cancer mortality in the US declined between 1975 and 2019. The association of changes in metastatic breast cancer treatment with improved breast cancer mortality is unclear.

OBJECTIVE: To simulate the relative associations of breast cancer screening, treatment of stage I to III breast cancer, and treatment of metastatic breast cancer with improved breast cancer mortality.

DESIGN, SETTING, AND PARTICIPANTS: Using aggregated observational and clinical trial data on the dissemination and effects of screening and treatment, 4 Cancer Intervention and Surveillance Modeling Network (CISNET) models simulated US breast cancer mortality rates. Death due to breast cancer, overall and by …

A Life-Threatening Emergency Exacerbated By Untreated Mental Illness In A Low-Barrier Health Center, Brendan J. Prast, Byron Marshall

Journal of Maine Medical Center

Introduction: We report on a patient with untreated severe mental illness who presented with a life-threatening emergency: retained products of conception and hemorrhage.

Clinical Findings: A female patient experiencing homelessness developed life-threatening hemorrhage. Her mental illness impaired effective communication and treatment.

Clinical Course: The patient presented with fatigue, vaginal bleeding, and known retained products of conception. Her active mental illness complicated the situation as it limited effective communication and treatment due to delusions. She requested only treatment for an infectious cause of her symptoms. She refused most interventions and had a self-directed discharge from the hospital. Throughout this process, we …

Editorial: Care During Pregnancy And Early Childhood For Growth And Development In Low- And Middle- Income Countries, Ranadip Chowdhury, Ravi Prakash Upadhyay, Bireshwar Sinha, Nita Bhandari, Sunita Taneja, Jai K. Das

Centre of Excellence in Women and Child Health

No abstract provided.

Mastitis And Mammary Abscess Management Audit (Mamma) In The Uk And Ireland, Alona Courtney, Jonathon Clymo, Ruth Parks, Alexander Wilkins, Ruth Brown, Rachel O'Connell, Rajiv Dave, Marianne Dillon, Hiba Fatayer, Rachel Gallimore, Ashu Gandhi, Matthew Gardiner, Victoria Harmer, Lyndsey Hookway, Gareth Irwin, Charlotte Ives, Helen Mathers, Juliette Murray, D Peter O'Leary, Neill Patani, Sophie Paterson, Shelley Potter, Ruth Prichard, Giovanni Satta, T G Teoh, Paul Ziprin, Stuart Mcintosh, Michael R Boland, Daniel Richard Leff, Mamma Research Collaborative

Faculty, Staff and Student Publications

BACKGROUND: The aim of this multicentre prospective audit was to describe the current practice in the management of mastitis and breast abscesses in the UK and Ireland, with a specific focus on rates of surgical intervention.

METHODS: This audit was conducted in two phases from August 2020 to August 2021; a phase 1 practice survey and a phase 2 prospective audit. Primary outcome measurements for phase 2 included patient management pathway characteristics and treatment type (medical/radiological/surgical).

RESULTS: A total of 69 hospitals participated in phase 2 (1312 patients). The key findings were a high overall rate of incision and drainage …

Cell State Of Origin Impacts Development Of Distinct Endometriosis-Related Ovarian Carcinoma Histotypes, Ian Beddows, Huihui Fan, Karolin Heinze, Benjamin K Johnson, Anna Leonova, Janine Senz, Svetlana Djirackor, Kathleen R Cho, Celeste Leigh Pearce, David G Huntsman, Michael S Anglesio, Hui Shen

Faculty, Staff and Student Publications

Clear cell ovarian carcinoma (CCOC) and endometrioid ovarian carcinoma (ENOC) are ovarian carcinoma histotypes, which are both thought to arise from ectopic endometrial (or endometrial-like) cells through an endometriosis intermediate. How the same cell type of origin gives rise to two morphologically and biologically different histotypes has been perplexing, particularly given that recurrent genetic mutations are common to both and present in nonmalignant precursors. We used RNA transcription analysis to show that the expression profiles of CCOC and ENOC resemble those of normal endometrium at secretory and proliferative phases of the menstrual cycle, respectively. DNA methylation at the promoter of …

Research Action Brief: Healthcare Experiences And Perceptions As Drivers Of Gaps In Mammography, Core (Center For Outcomes Research & Education)

Reports

No abstract provided.

Health Systems Partnership For Collaborative Anti-Racist Perinatal Care: A Case Study Of Black Community Based Perinatal Care, Roberta Hunte, Monique Gill, Kevin Cherry, Desha Reed-Holden

Reports

No abstract provided.

The Effects Of Adverse Childhood Experiences And Racism On The Risk For Poor Birth Outcomes In Women Of Color, Audrey Hermosura

Nursing | Senior Theses

Background: Adverse childhood experiences, or ACEs, are traumatic challenges experienced before the age of 18. These adversities have lifelong effects on physiologic and mental health. A relationship has been made between the number of ACEs and occurrences of poor birth outcomes. The toxic stress that accumulates from ACEs compounded by racism increases the risk for poor birth outcomes in women of color. Understanding the importance of screening for these events can mitigate the negative effects on women’s health during and after gestation. Purpose: This current paper, in addition to a literature review, proposes a research design to validate the feasibility …

Doulas In Modern Health Care, Gabriella J. Lawrence

Soaring: A Journal of Undergraduate Research

This paper looks into whether the implementation of doulas by all hospitals would benefit mothers before, during, and after childbirth. Through previous research it is shown how traumatizing birth can be for mothers who don't feel that they have control within the labor and delivery room. High rates of augmentation, epidural anesthesia, and cesarean sections within hospitals are all causes of postpartum anxiety and depression among new mothers. By researching who a doula is and what they can do for mothers during childbirth, we can get a better understanding on how to prevent mental health disorders that are caused by …

Inequalities In Use Of Hospitals For Childbirth Among Rural Women In Sub-Saharan Africa: A Comparative Analysis Of 18 Countries Using Demographic And Health Survey Data., Manuela Straneo, Claudia Hanson, Thomas Van Den Akker, Bosede Afolabi, Anteneh Asefa, Alexandre Delamou, Mardieh Dennis, Luis Gadama, Nyika Mahachi, Welcome Mlilo

Centre of Excellence in Women and Child Health

Introduction; Rising facility births in sub-Saharan Africa (SSA) mask inequalities in higher-level emergency care— typically in hospitals. Limited research has addressed hospital use in women at risk of or with complications, such as high parity, linked to poverty and rurality, for whom hospital care is essential. We aimed to address this gap, by comparatively assessing hospital use in rural SSA by wealth and parity.

Methods; Countries in SSA with a Demographic and Health Survey since 2015 were included. We assessed rural hospital childbirth stratifying by wealth (wealthier/poorer) and parity (nulliparity/high parity≥5), and their combination. We computed percentages, 95% CIs and …

Too Hot To Thrive: A Qualitative Inquiry Of Community Perspectives On The Effect Of High Ambient Temperature On Postpartum Women And Neonates In Kilifi, Kenya., Adelaide Lusambili, Sari Kovats, Britt Nakstad, Veronique Filippi, Peter Khaemba, Nathalie Roos, Cherie Part, Stanley Luchters, Matthew Chersich, Jeremy Hess

Institute for Human Development, East Africa

Objectives; To understand community perspectives on the effects of high ambient temperature on the health and wellbeing of neonates, and impacts on post-partum women and infant care in Kilifi.

Design; Qualitative study using key informant interviews, in-depth interviews and focus group discussions with pregnant and postpartum women (n = 22), mothers-in-law (n = 19), male spouses (n = 20), community health volunteers (CHVs) (n = 22) and stakeholders from health and government ministries (n = 16).

Settings; We conducted our research in Kilifi County in Kenya’s Coast Province. The area is largely rural and during …

Exploring The Willingness Toward Hiv Immediate Test And Treat Among Msm In Nairobi And Its Environs: A Cross-Sectional Study., Kingori Ndungu, Peter Gichanga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: In the test and treat initiative, high-risk populations are screened for human immunodeficiency virus (HIV) infection and start early treatment if diagnosed positive. This study explores factors associated with willingness to initiate testing and immediate treatment among men who have sex with men (MSM) in Nairobi and its environs. The study was informed by a conceptual framework combining the AIDS Risk Reduction Model (ARRM) and the Modified Social Ecological Model.

Methods: This cross-sectional exploratory study targeted MSM (aged 18–60 years) reporting active engagement in anal or oral sex with men in Nairobi and its surrounding areas. Purposive sampling was …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Antenatal Depression And Its Associated Factors: Findings From Kuwait Birth Cohort Study, Reem Al-Sabah, Abdullah Al-Taiar, Ali H. Ziyab, Saeed Akhtar, Majeda S. Hammoud

Community & Environmental Health Faculty Publications

Background: Pregnant and postpartum women are at high risk of depression due to hormonal and biological changes. Antenatal depression is understudied compared to postpartum depression and its predictors remain highly controversial.

Aim: To estimate the prevalence of depressive symptoms during pregnancy and investigate factors associated with this condition including vitamin D, folate and Vitamin B₁₂ among participants in the Kuwait Birth Study.

Methods: Data collection occurred as part of the Kuwait Birth Cohort Study in which pregnant women were recruited in the second and third trimester during antenatal care visits. Data on antenatal depression were collected using the Edinburgh …

Cervical Cancer Education & Prevention For Women In The Philippines, Kate Isabel Juanillo

Nursing | Senior Theses

Although cervical cancer is preventable, it continues to pose a significant health concern in the Philippines as evidenced by high cervical cancer diagnosis rates. The purpose of this quantitative study is to investigate low cervical cancer screening rates and the effectiveness of educational interventions in increasing awareness and screening rates. A literature review will examine topics such as low cervical cancer screening rates, cervical cancer screening methods, and barriers. This research proposal involves a quasi-experimental study that investigates education as an intervention for increasing cervical cancer awareness and cervical cancer screening rates. Fifty Filipino women will be randomly assigned to …

Examining Menstrual Health Experiences In Philadelphia, Pa: A Qualitative Investigation, Allison Casola, Oriana Pando, Lynette Medley, Brianna Kunes, Nya Mcglone, Olivia Rea

Department of Family & Community Medicine Faculty Papers

BACKGROUND: While menstruation is a physiologic process, it remains highly stigmatized. Despite the sheer number of menstruators, menstruation is a highly individualized experience, with wide variation in duration, symptoms, and management. This wide variability lends itself to large disparities in access to menstruation management products and subsequently the lived experience of menstruators.

OBJECTIVES: The research team sought to understand lived menstrual experiences, symptoms, management tactics, and commonly used and desired resources among 20 cisgendered women aged 18-45 years in Philadelphia.

DESIGN: This project was a qualitative research study.

METHODS: We used a collaborative, community-based participatory research approach with No More …

The Education Prescription: Exploring The Potential Of Patient Education To Reduce Mental Health Issues In Hormonal Contraceptive Users, Maria Abraham

Nursing | Senior Theses

The many birth control options available impact a woman’s life, as hormonal contraceptives are commonly used but often misunderstood. These contraceptives, which contain progestin only, or estrogen and progestin combined, can come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches. They offer benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they may lead to adverse side effects which can include increased blood pressure, nausea, headaches, breakthrough bleeding, and a higher risk of blood clots, with research indicating a potential link between oral contraceptive use and a decline in the user’s …

Empowering Low-Income Women With Breast Cancer: Promoting Acupuncture At Community Health Fairs, Katrina Ramos

Nursing | Senior Theses

While research has explored the positive effects of acupuncture on cancer and cancer treatment symptoms, a notable gap exists in understanding its impact on lower-income populations. These individuals encounter barriers to accessing acupuncture, such as limited availability, cost, and provider knowledge. This longitudinal study aims to assess the impact of community health fairs, featuring acupuncture information for breast cancer and chemotherapy-induced symptoms, on the acceptance and utilization rates of acupuncture among low-income women with breast cancer. Collaborating with the Women’s Cancer Resource Center and a local non-profit integrative cancer care clinic in Oakland, we will conduct a three-day health fair …

Effects Of Menopause On Coronary Artery Disease, Angelica Gonzales

Nursing | Senior Theses

Menopausal women, 40 to 60 years old, have an increased risk of developing coronary artery disease (CAD) when they experience hormonal changes. Which then can lead to unwanted cardiac events. Within the literature review of this paper, it was found that there are factors of menopause that may further increase the risk of coronary artery disease in menopausal women. Such factors include whether a woman underwent surgical or natural menopause and the timing when menopause began. Additionally, within the review, hormone replacement therapy (HRT) was explored to determine whether the possible intervention can decrease the progression and risk of developing …

The Impact Of Roe V. Wade Overturning On Women’S Access To Medical Abortions: Exploring Alternative Care Models, Gillie Mason

Nursing | Student Research Posters

The Impact of Roe v. Wade Overturning on Women’s Access to Medical Abortions: Exploring Alternative Care Models

Medical abortion access is heavily influenced by state laws, with restrictive policies posing significant barriers for women seeking care. These barriers include limited local resources, travel burdens, and legal restrictions, which disproportionately affect marginalized populations. The Health Belief Model (HBM) highlights how individuals' perceptions of risks, benefits, and barriers shape their health decisions, making it an ideal framework for studying this issue (Rosenstock, 1974).

This research focuses on educating California-based providers to increase access to medical abortion services for patients in restrictive states. …

Health Consequences Of Racial Disparity In Access To Abortion: A Systematic Review, Lacy M. Frye, Calvin Odhiambo

University of South Carolina Upstate Student Research Journal

Prior to the 2022 Dobbs decision, Black women already experienced negative maternal health outcomes at an alarmingly disparate rate in comparison to White women. Given that the Dobbs decision emboldens state power to enforce abortion restrictions or protections, there has been significant strides made in both directions. Nonetheless, within states where reproductive rights have been significantly eroded, the heightened abortion restrictions may compound the limited access that Black women previously had before Dobbs. This, in turn will exacerbate the already disparate negative maternal outcomes that Black women experience. However, research on the relationship between the lack of access to abortion …

What’S Harm Reduction Got To Do With It? A Study Of The Implementation Of Substance Use Management Practices Among A Sample Of U.S. Domestic Violence Programs, Stephanie H. Ratliff

Theses and Dissertations--Social Work

Domestic violence programs are essential resources for survivors of intimate partner violence (IPV). Programs offer services that go beyond providing safety and shelter. To improve outcomes, program staff have expanded services to meet the needs of survivors. One population of survivors that has gained attention in the peer-reviewed literature is survivors who use substances (SWUS). These survivors have unique needs and are at increased risk of IPV due to substance misuse. Research about the support available to SWUS after they access shelter is scarce. Using cross-sectional data from a national sample of 97 U.S. domestic violence programs, this study describes …

Maternal-Adolescent Communication About Sex And Risky Sexual Behaviors: A Cross-Cultural Comparison Of Czech, Spanish, And Taiwanese Youth, Mckinley Hall

Theses and Dissertations--Family Sciences

This present study aimed to test the relationship between perceived maternal-adolescent communication about sex and risky sexual behaviors, while also considering the links between perceived maternal-adolescent closeness and maternal-adolescent conflict with risky sexual behaviors, across three culturally distinct countries, namely the Czech Republic (N=878, mean age of 17.93), Spain (N =1024, mean age of 18.79), and Taiwan (N =1443, mean age of 16.48). Samples of adolescents from each country were used and statistical analyses were conducted to test the hypothesized relationships. Based on path analysis carried out on each sample, the results revealed that Czech adolescents reported the highest levels …

Role Of Social Determinants Of Health And The Renin- Angiotensin Aldosterone System In Risk For Hypertensive Disorders Of Pregnancy And Related Adverse Outcomes., Esther Letushila Ndashaala

Theses and Dissertations--Nutrition and Food Systems

Background: Hypertensive disorders of pregnancy (HDP) represent a significant public health issue, contributing to maternal and fetal morbidity and mortality. Women from lower socioeconomic backgrounds or marginalized racial and ethnic groups face higher risks of HDP, which have been incompletely described. In addition, risk for HDP may be linked to a reduction in the normal activity of the renin-angiotensin-aldosterone system (RAAS). This study investigates the role of socioeconomic factors and RAAS components in the risk for HDP and adverse maternal and neonatal outcomes. Methods: This study is a secondary analysis of data from 180 pregnant individuals from a high-risk maternal-fetal …

Next Top Model: An Overview Of Breast Cancer Risk Assessment Models, Pooja Agrawal, Carolyn Audet, Laura Ernst, Katie Lang, Sonya Reid, Katie Davis, Rebecca Selove, Maureen Sanderson, Lucy Spalluto

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Enhancing Breast Cancer Screening In Kims Clinic: A Quality Improvement Initiative, Daniel J. Avila Castillo, Crystal Ike, Mina Choudhry

Gulf Coast Division GME Research Symposium 2024

No abstract provided.