Health Services Research Commons^™

Adipocyte/Tumor Cell Crosstalk Via Igf-1/Txnip Axis Promotes Malignancy And Endocrine Resistance In Breast Cancer, Amanda Caruso, Felice Maria Accattatis, Cinzia Giordano, Luca Gelsomino, Piercarlo Del Console, Maria Francesca Fiorita, Balazs Gyorffy, Laura Bianchi, Alfonso Carleo, Rossana De Salvo, Bruno M Simões, Robert B Clarke, Lorenzo Memeo, Cristina Colarossi, Eleonora Aiello, Francesco Conforti, Suzanne A W Fuqua, Matilde Todaro, Giorgio Stassi, Catia Morelli, Diego Sisci, Daniela Bonofiglio, Stefania Catalano, Sebastiano Andò, Ines Barone

Faculty, Staff and Students Publications

Background: Despite significant improvements in the outcome of Estrogen Receptor (ER) α-positive breast cancer (BC) following the use of endocrine therapies, resistance remains a major challenge. Clinical studies proved that obesity, in addition to promote BC progression, is associated with a reduced efficacy to these treatments, but mechanisms remain unclear.

Methods: We used co-culture systems followed by validation through an ‘ex vivo’ model of human mammary obese (Ob) adipocytes and obese endocrine-resistant metastatic Patient-Derived Organoids (PDOs). Transcriptomics with MixOmics-MINT and MetaCore Functional Tools along with lentiviral and pharmacological approaches provide insights into mechanisms. Clinical relevance was investigated using public datasets, …

The Evolvement Of The 100 Most Cited Articles In Spine Surgery In The Last Decade Compared To All-Time, Mark Miller, Matthew Meade, Ruchir Nanavati, William T Diciurcio, Maneesha Palakurthi, Adam Kohring, Justin Le, Christopher Giuditta, Christopher Kepler, Barrett Woods

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Decision-making in spine surgery is continuously shaped by advancements in the field through evidence-based medicine. This is demonstrated through the evolution of the quality and impact of scientific research within the field of spine surgery. To date, there is limited literature investigating interval changes in methodological rigor of scientific investigation within the field of spine surgery.

METHODS: The top 100 cited articles were recorded for manuscripts from January 1, 2013, to December 31, 2023, and the top 100 most cited manuscripts of all time for spine surgery, via the Scopus abstract and citation database. Data collected included year of …

Intersectoral Interventions: Integration For Impact On Preterm Birth, Etienne V. Langlois, Maria El Bizri, Kelly Thompson, Amy Reid, Merette Khalil, Giulia Gasparri, Joy E. Lawn, Teesta Dey, Judith Robb-Mccord, Marleen Temmerman

Centre of Excellence in Women and Child Health

Progress: The last two decades have seen a growing focus on intersectoral interventions to improve maternal and newborn health and well-being outcomes, as refected in eforts to achieve the Millennium Development Goals (MDGs) and advance the Sustainable Development Goals (SDGs). Preterm births are linked to cross-sectoral determi‑ nants that afect health outcomes and human capital across the life-course, necessitating an intersectoral approach that addresses these multifaceted challenges.

Programmatic priorities: Recognizing that social, biological and economic determinants signifcantly infuence health outcomes, it is critical that robust health systems are reinforced by a comprehensive intersectoral approach. Evidence suggests that the factors infuencing …

How Do Health Insurer Practices Affect Health Equity For Gay And Bisexual Men And Transmasculine Individuals? A Qualitative And Health Policy Assessment, Alexa D'Angelo

Dissertations and Theses

In the U.S. there continue to be stark disparities in health that affect LGBTQ+ communities. These disparities include those related to mental health, sexually transmitted infections, along with chronic illnesses and some cancers. Higher health needs across diagnostic categories mean that LGBTQ+ individuals require access to the healthcare system both to prevent conditions disproportionately affecting the community, and to treat conditions as they arise. In the U.S., access to healthcare often requires either reliable insurance coverage or another payer to cover costs associated with care. Thus, health insurance status and coverage of care, along with coverage regulations and health policies …

Access To Healthcare For Rural Transgender Adults In The United States, Devon Smith

University Honors Theses

Urban and rural healthcare differ significantly in the amount of facilities, providers and kinds of specialty care that are offered in each environment. The United States is split into urban and rural counties in any given region, and based on those population sizes, are the allocation of healthcare resources for residents. In rural areas in the U.S., transgender adults lack access to gender-affirming care and encounter a lack of gender-affirming care providers due to workforce shortages, discrimination, and a lack of cultural competency. To determine if these residents lacked access to care compared with their urban counterparts, I performed a …

Corrigendum To "Effects Of Dialysate Potassium Concentration Of 30 Mmol/L With Sodium Zirconium Cyclosilicate On Dialysis-Free Days Versus Dialysate Potassium Concentration Of 20 Mmol/L Alone On Rates Of Cardiac Arrhythmias In Hemodialysis Patients With Hyperkalemia" Kidney International 2025;107:169-179, David M Charytan, Wolfgang C Winkelmayer, Christopher B Granger, John P Middleton, Charles A Herzog, Glenn M Chertow, James M Eudicone, Jeremy D Whitson, James A Tumlin, Adapt Investigators

Faculty, Staff and Students Publications

No abstract provided.

Targeting S1pr2 In Sepsis, One Fragmented Mitochondrion At A Time, Chao He, Jennifer L Larson-Casey

Faculty, Staff and Students Publications

No abstract provided.

Nursing Education Research In Sub-Saharan Africa: A Systematic Review And Bibliometric Analysis, Beth Waweru, Peter Gatiti, Serah Wachira

School of Nursing & Midwifery, East Africa

Nursing education is pivotal for ensuring competent healthcare professionals, and its improvement is essential for enhancing the quality of health care systems globally. This study focuses on nursing education research in Sub-Saharan Africa (SSA) over the last decade, employing both bibliometric analysis and systematic review methodologies. The bibliometric analysis reveals an evolving landscape of nursing education research in SSA, offering insights into trends, key countries, journals, and predominant research themes. Notably, the study identifies a scarcity of literature using bibliometric approaches in nursing research, addressing this gap by providing a comprehensive overview of the field.The systematic review, guided by the …

Performance Of Stool-Based Molecular Tests And Processing Methods For Paediatric Tuberculosis Diagnosis: A Systematic Review And Meta-Analysis, Lucía Carratalà-Castro, Shilzia Munguambe, Belén Saavedra-Cervera, Petra De Haas, Alexander Kay, Olivier Marcy, Pamela Nabeta, Willy Ssengooba, Elisabetta Ghimenton-Walters, Sozinho Acácio, Maryline Bonnet, Joanna Ehrlich, Andrew R Dinardo, Anca Vasiliu, Christoph Lange, Sabine Hermans, Anna M Mandalakas, Elisa López-Varela, Alberto L García-Basteiro

Faculty, Staff and Students Publications

Background: There has been a global pursuit to improve the diagnosis of tuberculosis in young children by applying diagnostic methods on accessible biospecimens such as stool. We aimed to conduct a systematic review on the accuracy of stool-based molecular tests for tuberculosis diagnosis in children and to assess the impact of the available pre-processing methods and other design characteristics.

Methods: In this systematic review and meta-analysis, we evaluated studies in children younger than 16 years with presumptive tuberculosis that were published in English, Spanish, French, and Portuguese from Jan 1, 2000, to May 3, 2024, in MEDLINE, Embase, and Embase …

Protein Biomarkers Of Interstitial Lung Abnormalities In Relatives Of Patients With Pulmonary Fibrosis, Jonathan A Rose, Mark P Steele, Esteban J Kosak Lopez, Gisli Thor Axelsson, Andrea G Galecio Chao, Alan Waich, Katie Regan, Swati Gulati, Anthony H Maeda, Sharmin Sultana, Claire Cutting, Ann-Marcia C Tukpah, Andrew J Synn, Mary B Rice, Hilary J Goldberg, Joyce S Lee, David A Lynch, Rachel K Putman, Hiroto Hatabu, Benjamin A Raby, David A Schwartz, Ivan O Rosas, Gary M Hunninghake

Faculty, Staff and Students Publications

Rationale: First-degree relatives of patients with pulmonary fibrosis (referred to here as relatives) are at high risk for interstitial lung abnormalities (ILA), highlighting the need for biomarkers for risk prediction. We aimed to identify blood proteins associated with and predictive of ILA among relatives of patients with pulmonary fibrosis.

Methods: Relatives enrolled in two independent cohorts had protein levels measured using an aptamer-based proteomic platform. ILA were assessed with computed tomography scans as per Fleischner Society recommendations. Protein associations with ILA were assessed using regression. Significant proteins were used with clinical variables to detect ILA.

Results: Of 237 relatives from …

Airway Immune Signatures In Severe And Fatal Infection With Covid-19, Naresh Doni Jayavelu, Jing Jing Qi, Slim Fourati, Farrah Kheradmand, Charles R Langelier, Lauren I R Ehrlich, Joann Diray-Arce, Annmarie Hoch, Monica Kraft, Patrice M Becker, Matthew C Altman, Ruth R Montgomery

Faculty, Staff and Students Publications

No abstract provided.

Aged Regulatory T Cells Fail To Control Autoimmune Lacrimal Gland Pathogenic Cd4+ T Cells, Kaitlin K Scholand, Laura Schaefer, Gowthaman Govindarajan, Zhiyuan Yu, Jeremias G Galletti, Cintia S De Paiva

Faculty, Staff and Students Publications

CD25KO mice are a model of Sjögren disease. CD25KO mice have severe inflammation and infiltrating lymphocytes to the lacrimal glands (LG). Whether the pathogenicity of CD25KO CD4+ T cells can be controlled in vivo by Tregs is unknown. Eight-week-old B6 and CD25KO mice LGs were submitted for RNA bulk sequencing. A total of 3481 genes were differentially expressed in CD25KO LG compared to B6. Tear washing analysis identified CD25KO mice had elevated protein levels of TNF, IFN-γ, and CCL5 and decreased protein levels of IL-12p40 and VEGF-A. Co-adoptive transfer of CD25KO CD4+ T cells with either young or aged B6 …

Stress, Employment Changes, And Psychological Distress Among Caregivers Of Patients With Head And Neck Cancer, Lama Abdurrahman, Vlad C Sandulache, Cielito Reyes-Gibby, Erich M Sturgis, Pavan Jhaveri, Hoda Badr

Faculty, Staff and Students Publications

Importance: Patients undergoing external beam radiation therapy (EBRT) for head and neck cancer (HNC) often experience adverse effects that require substantial caregiving. The burdens of caregiving can impact caregiver employment and mental health over time, yet this topic remains underexplored.

Objective: To examine the associations between caregiving for patients with HNC who undergo EBRT and caregiver stress, employment status, and psychological distress.

Design, setting, and participants: This was a secondary analysis of data from a longitudinal survey study that surveyed caregivers at baseline (ie, at initiation of EBRT) and at 4-month and 12-month follow-ups. The study was conducted at 2 …

Core Domain Set For Chronic And/Or Recurrent Manifestations Of Calcium Pyrophosphate Deposition Disease: Omeract Delphi Survey To Establish Consensus, Yiling Zhang, Sara K Tedeschi, Abhishek Abhishek, Owen Hensey, David Grossberg, Ken Cai, Beverley Shea, Jasvinder A Singh, Robin Christensen, Teodora Serban, Edoardo Cipolletta, Konstantinos Parperis, Cesar Diaz-Torne, Geraldine M Mccarthy, Fabio Becce, Tamer A Gheita, Silvia Sirotti, Sara Nysom Christiansen, Luis Coronel, Lisa K Stamp, Yousra H Abdel-Fattah, Tristan Pascart, Georgios Filippou, Lih En Hong, John Fitzgerald, Nicola Dalbeth

Faculty, Staff and Students Publications

Objective: To agree on important domains for the Outcome Measures in Rheumatology (OMERACT) core domain set for chronic and/or recurrent manifestations of calcium pyrophosphate deposition (CPPD) disease.

Methods: Patient research partners (PRPs) and other participants (mainly clinicians and researchers) contributed to three rounds of a consensus survey using Delphi methodology. Consensus was defined if ≥70% of both patients and other participants scored the domain as 'critically important domain to include'. In a subsequent ranking exercise, all participants were asked to select and rank up to 10 of the domains reaching consensus.

Results: Fifteen domains reached consensus as critically important. Within …

Epidemiology Of Intestinal Parasite Infections And Multiparasitism And Their Impact On Growth And Hemoglobin Levels During Childhood In Tropical Ecuador: A Longitudinal Study Using Molecular Detection Methods, Rojelio Mejia, Irina Chis Ster, Martha E Chico, Irene Guadalupe, Andrea Arévalo-Cortés, Andrea Lopez, Aida Y Oviedo-Vera, Philip J Cooper

Faculty, Staff and Students Publications

Background: There are few longitudinal epidemiological studies of intestinal parasitic infections (IPI) and their health effects. We studied the epidemiology and determinants of IPI and multiparasitism during childhood using molecular methods for parasite detection and analysed their effects on growth and hemoglobin levels.

Methods: Random sample of 401 children from an Ecuadorian birth cohort followed up to 8 years of age. Data on environmental and sociodemographic characteristics were collected by questionnaires. Stool samples were collected, and weight, height, and hemoglobin levels were measured at 7 and 13 months, and 2, 3, 5, and 8 years. Stool samples were analysed using …

Dietary Interventions To Support And Improve Sleep Disturbances And Insomnia Disorder In Menopause: From Bench To Bedside, Rosie H Musgrave, Sara Nowakowski, Tamlyn J Watermeyer, Emily J Arentson-Lantz, Greg J Elder

Faculty, Staff and Students Publications

Sleep is essential for maintaining physical and psychological health, and also cognitive health (referred to as 'brain health'). However, the transition to menopause has a direct impact upon sleep. Sleep disturbances are reported by approximately 40%-60% of menopausal women, and insomnia disorder is also prevalent. Diet-based interventions could potentially be used to improve subjective sleep quality in this population, and although there are several promising interventions which have been used in other groups that could be trialled, the evidence base is currently lacking. One particularly promising area for future research is that these interventions might be used alongside, or instead …

Parp Inhibitor Response Is Enhanced In Prostate Cancer When Xrcc1 Expression Is Reduced, Kaveri Goel, Vani Venkatappa, Kimiko L Krieger, Dongquan Chen, Arun Sreekumar, Natalie R Gassman

Faculty, Staff and Students Publications

Prostate cancer (PCa) is the second most common cancer worldwide and the fifth leading cause of cancer-related deaths among men. The emergence of metastatic castration-resistant prostate cancer (mCRPC) after androgen deprivation therapy (ADT) exemplifies the complex disease management for PCa. PARP inhibitors (PARPis) are being tested to treat mCRPC in tumors with defective homologous recombination repair (HRR) to address this complexity. However, increasing resistance towards PARPi in HRR-deficient patients and the low percentage of HRR-defective mCRPC patients requires the identification of new genes whose deficiency can be exploited for PARPi treatment. XRCC1 is a DNA repair protein critical in the …

The Aging Ovary Stands On The Shoulders Of Giant Multinucleated Cells, Avery A Ahmed, Stephanie A Pangas

Faculty, Staff and Students Publications

Reproductive aging is associated with declining fertility and increasing inflammation, though these events are not well understood. An exciting new study in PLOS Biology utilizes cutting-edge technologies to characterize the role of multinucleated giant cells in ovarian aging.

Determinants Of Teenage Pregnancy In Tanzania, Harun Yussuf Ayoub, Kemal Nazaruddin Siregar

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Teenage pregnancies are among the leading public health problems in Tanzania. This was linked to limited education, socioeconomic disparities, cultural barriers, and inadequate access to healthcare centers. Thus, this study aims to explore the prevalence and predictors of teenage pregnancy among adolescent women using data from the 2022-2023 Tanzanian Demographic Health Survey (TDHS). The research design employed a cross-sectional approach and utilized TDHS data. The population for this study was female adolescents, while the sample was 7,545 adolescent women aged 15-24 years. Predictor variables were education level, socioeconomic status, place of residence, employment status, and lifestyle factors, including alcohol consumption …

Prosthesis, Alexander A. Grosek

Masters Theses

This thesis explores the hospital as a prosthetic—a structural and spatial support for the human body in moments of vulnerability. Like a crutch or cast, the hospital temporarily supports patients in their transition from horizontal (infirm) to vertical (mobile), yet its architecture often fails to contribute meaningfully to that healing process. While clinical treatment is prioritized, the spatial, emotional, and sensory dimensions of care are neglected. What supports what becomes a central question: the building holds the body, but the body also gives meaning to the building. Their relationship is reciprocal.

Rather than proving that good design improves health—an idea …