Upstream oncology: identifying social determinants of health in a gynecologic oncology population

Introduction: Social determinants of health (SDoH) are the factors that affect a patient’s health quality and outcomes and contribute to health disparities. Evidence suggests that clinical care contributes only 20% to patients’ health outcomes, while the remainder is under the influence of upstream factors. The upstream approach to healthcare aims to address SDoH before they contribute to less ideal outcomes downstream. Several SDoH may contribute to outcomes for cancer patients. This Upstream Gynecologic Oncology Initiative seeks to identify which SDoH affect a population of patients with gynecologic malignancies. Hypothesis: This study hypothesizes that women receiving care for gynecologic malignancies are affected by specific SDoH among the categories of housing, food, transportation, finances, health literacy and social support. This study aims to identify the frequency of these six social factors among the outpatient gynecologic oncology population at the University of Iowa. Methods: This needs assessment is the first phase in a quality improvement project assessing the SDoH affecting women with gynecologic cancers. Two hundred twenty-two patients receiving outpatient care for gynecologic malignancies completed an anonymous needs assessment survey. Validated survey questions regarding housing, food, transportation, finances, health literacy and social support were used to identify needs. Responses were considered positive if any degree of need was reported. Results: Responses demonstrated the most substantial need in the categories of social support (32%), health literacy (28%) and financial stability (24%). Less need was reported in the categories of food (11%), transportation (5%) and housing (4%). Fifty-seven percent of women reported at least one social need among the six categories screened. Conclusion: Upstream SDoH, most notably social support, health literacy and financial stability are identified to be present and likely contributing to health quality, outcomes, and disparities within this gynecologic oncology patient population. Overall, these findings support the idea that SDoH should be assessed for each unique patient population - and for each patient receiving care for gynecologic cancer. While social support was the most frequently reported SDoH, many patients already received adequate help at home; suggesting that meaningful efforts should next be directed at improving health literacy in the population. Appreciation and assessment of SDoH potential to impact care and management should be used to design a routine screening tool for the study population and organize resources to address or mitigate the identified needs

Star Formation Feedback and Metal Enrichment History Of The Intergalactic Medium

Using hydrodynamic simulations we compute the metal enrichment history of the intergalactic medium (IGM). We show that galactic superwind (GSW) feedback can transport metals to the IGM and that the properties of simulated metal absorbers match observations. The distance of influence of GSW is typically limited to >0.5Mpc and within regions of overdensity >10. Most CIV and OVI absorbers are located within shocked regions of elevated temperature (T>2x10^4K), overdensity (>10), and metallicity ([-2.5,-0.5]). OVI absorbers have typically higher metallicity, lower density and higher temperature than CIV absorbers. For OVI absorbers collisional ionization dominates over the entire redshift range z=0-6, whereas for CIV absorbers the transition occurs at moderate redshift z~3 from collisionally dominated to photoionization dominated. We find that the observed column density distributions for CIV and OVI in the range log N cm^2=12-15 are reasonably reproduced by the simulations. The evolution of mass densities contained in CIV and OVI lines, Omega_CIV and Omega_OVI, is also in good agreement with observations, which shows a near constancy at low redshifts and an exponential drop beyond redshift z=3-4. For both CIV and OVI, most absorbers are transient and the amount of metals probed by CIV and OVI lines of column log N cm^2=12-15 is only ~2% of total metal density at any epoch. While gravitational shocks from large-scale structure formation dominate the energy budget (80-90%) for turning about 50% of IGM to the warm-hot intergalactic medium (WHIM) by z=0, GSW feedback shocks are energetically dominant over gravitational shocks at z > 1-2. Most of the so-called "missing metals" at z=2-3 are hidden in a warm-hot (T=10^{4.5-7}K) gaseous phase, heated up by GSW feedback shocks. Their mass distribution is broadly peaked at $\delta=1-10$ in the IGM, outside virialized halos.Comment: 52 pages, 26 figures, published in the Astrophysical Journal, 2011, ApJ, 731, 1

EGFL7 loss correlates with increased VEGF-D expression, upregulating hippocampal adult neurogenesis and improving spatial learning and memory

Correction: Volume: 80 Issue: 8 DOI: 10.1007/s00018-023-04835-3 Article Number: 201 Published: AUG 2023Neural stem cells reside in the subgranular zone, a specialized neurogenic niche of the hippocampus. Throughout adulthood, these cells give rise to neurons in the dentate gyrus, playing an important role in learning and memory. Given that these core cognitive processes are disrupted in numerous disease states, understanding the underlying mechanisms of neural stem cell proliferation in the subgranular zone is of direct practical interest. Here, we report that mature neurons, neural stem cells and neural precursor cells each secrete the neurovascular protein epidermal growth factor-like protein 7 (EGFL7) to shape this hippocampal niche. We further demonstrate that EGFL7 knock-out in a Nestin-CreERT2-based mouse model produces a pronounced upregulation of neurogenesis within the subgranular zone. RNA sequencing identified that the increased expression of the cytokine VEGF-D correlates significantly with the ablation of EGFL7. We substantiate this finding with intraventricular infusion of VEGF-D upregulating neurogenesis in vivo and further show that VEGF-D knock-out produces a downregulation of neurogenesis. Finally, behavioral studies in EGFL7 knock-out mice demonstrate greater maintenance of spatial memory and improved memory consolidation in the hippocampus by modulation of pattern separation. Taken together, our findings demonstrate that both EGFL7 and VEGF-D affect neurogenesis in the adult hippocampus, with the ablation of EGFL7 upregulating neurogenesis, increasing spatial learning and memory, and correlating with increased VEGF-D expression.Peer reviewe

Improved Tool for Fingerspelling Recognition

Conference proceedings from the Technology and Persons with Disabilities Conference-2006. California State University at Northridge, Los Angeles, CA March 20-25, 2006

Naturally Occurring Mentorship in a National Sample of First-Generation College Goers: A Promising Portal for Academic and Developmental Success.

Attending college is increasingly important to compete in this global world; however, young people whose parents did not attend college are significantly less likely to enroll in and finish college. Formal programs to support first-generation college goers are common, but not scalable to provide support to all young people who need it. Instead, mentoring that naturally occurs on these students\u27 journeys into and out of college may be a more practical avenue for supporting their success. This study investigated the role community members, relatives, and educators play in first-generation college goers\u27 educational outcomes. Data from 4,181 participants of the National Longitudinal Study of Adolescent and Adult Health were used to test differences in supports received between first-generation, continuing-generation, and non-college goers. Results demonstrated that mentorship in adolescence moderated the relationship between parental college attendance and educational attainment in adulthood. Next, findings suggested that first-generation students received less support for identity development from their mentors than continuing-generation students. This study has program implications for facilitating college attendance and fostering the development and success of first-generation students. Moreover, this project continues to concretize an emerging taxonomy of mentoring functions for youth and emerging adults

The Mechanism of Carbon Dioxide Adsorption in an Alkylamine-Functionalized Metal-Organic Framework

The mechanism of CO2 adsorption in the amine-functionalized metal-organic framework mmen-Mg2(dobpdc) (dobpdc4- = 4,4′-dioxidobiphenyl-3,3′-dicarboxylate; mmen = N,N′- dimethylethylenediamine) was characterized by quantum-chemical calculations. The material was calculated to demonstrate 2:2 amine:CO2 stoichiometry with a higher capacity and weaker CO2 binding energy than for the 2:1 stoichiometry observed in most amine-functionalized adsorbents. We explain this behavior in the form of a hydrogen-bonded complex involving two carbamic acid moieties resulting from the adsorption of CO2 onto the secondary amines. © 2013 American Chemical Society

Opportunistic screening for skin cancer using a mobile unit in Brazil

Abstract Background Skin cancer is the most common malignancy in the white population worldwide. In Brazil, the National Cancer Institute (INCA) estimates that in 2010 there will be 119,780 and 5,930 new cases of non-melanoma skin cancer and melanoma, respectively. The aim of this study was to evaluate the use of a mobile unit in the diagnosis and treatment of skin cancer in several poor regions of Brazil. Methods The diagnosis of skin cancer was accomplished through active medical screening in the prevention Mobile Unit (MU) of Barretos Cancer Hospital (BCH). The study population consisted of patients examined in the MU between 2004 and 2007, and their suspicious lesions were subjected to histopathological evaluation. Data were collected prospectively from standardized forms and analyzed. Results During the screening, 17,857 consultations were carried out. A total of 2012 (11.2%) cases of skin cancer were diagnosed. The predominant histological type reported was basal cell carcinoma (n = 1,642 or 81.6%), followed by squamous cell carcinoma (n = 303 or 15.1%), Bowen's disease (n = 25 or 1.2%), malignant melanoma (n = 23 or 1.1%), basosquamous cell carcinoma (n = 3 or 0.1%), miscellaneous lesions (12 or 0.6%), and metatypical carcinoma (n = 4 or 0.2%). Only 0.6% of lesions were stage III. There were no stage IV non-melanoma skin lesions, as well as no melanomas stages III and IV, found. Conclusions It was observed that the MU can be a useful tool for early skin cancer diagnosis and treatment. This program probably is important, especially in developing countries with inadequate public health systems and social inequality

"Alexa is a Toy": Exploring Older Adults' Reasons for Using, Limiting, and Abandoning Echo

Intelligent voice assistants (IVAs) have the potential to support older adults' independent living. However, despite a growing body of research focusing on IVA use, we know little about why older adults become IVA non-users. This paper examines the reasons older adults use, limit, and abandon IVAs (i.e., Amazon Echo) in their homes. We conducted eight focus groups, with 38 older adults residing in a Life Plan Community. Thirty-six participants owned an Echo for at least a year, and two were considering adoption. Over time, most participants became non-users due to their difficulty finding valuable uses, beliefs associated with ability and IVA use, or challenges with use in shared spaces. However, we also found that participants saw the potential for future IVA support. We contribute a better understanding of the reasons older adults do not engage with IVAs and how IVAs might better support aging and independent living in the future