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The Status of Scholarly Efforts of Librarians in Health Literacy: A Bibliometric Analysis
Get PDFObjective: In order to determine the status of scholarly efforts on health literacy by librarians, researchers examined the characteristics of health literacy publications authored by librarians from 2000 to 2020.
Methods: Bibliometrics were used to assess the productivity, affiliations, collaboration, and citation metrics of librarians in health literacy-related research. Data were collected using the Scopus database and articles were screened for inclusion in Rayyan software before importation into Microsoft Excel for analysis. SPSS statistical software used to run basic descriptive statistics.
Results: Of 797 search results, 460 publications met the inclusion criteria of librarian authorship. There was a significant linear trend upwards in publications since 2001 with an average increase of 1.52 papers per year. The number of publications per year peaked in 2019 (n=59). Journal of Consumer Health on the Internet was the most prolific journal. The majority of publications were authored by at least two authors and by multidisciplinary teams. 19% (n=107) of the librarian authors were responsible for more than one publication. In terms of citation impact, 84.1% of publications were cited at least once.
Conclusions: In the last two decades, librarian involvement in health literacy publications has exponentially increased, most markedly in the years following 2014. Librarian authors are highly collaborative with the majority of articles authored by interdisciplinary teams. The productivity, interdisciplinary collaboration efforts, and consistent growth in literature show how engaged librarians are in health literacy scholarship. Further research is needed to examine the impactful efforts made by librarians that aren\u27t published
MUC13 Enhances Colorectal Cancer Metastasis
Get PDFColorectal cancer (CRC) is one of the most prevalent cancer worldwide with a 5% lifetime incidence in developed countries. It is third most common cause of cancer related death in the United States and the second deadliest when men and women are combined. Encouragingly due to changes in dietary lifestyle, screening colonoscopy, and advancement in treatments the mortality has decreased in recent years. Most sporadic CRCs develop from polyploid adenomas and are preceded by intramucosal carcinomas (stage 0), which can progress into more malignant forms. This developmental process is known as the adenoma-carcinoma sequence. Early detection and endoscopic removal are crucial for CRC management. The overall 5-year survival of CRC jumps noticeably from 66% to 91% if it can be diagnosed and treated at early stages but drops down to 14% when the disease has metastasized. Metastasis is the cause of 90% of all cancer related deaths, which necessitates the need to understand the mechanisms regulating different progression steps. Metastasis is a complex and multistep process, whereby cancer cells leave the primary tumor and colonize in new tissues. However, only about 0.02% of tumor cells that detach from the primary tumor are successful in forming a metastatic lesion. After intravasation, anchorage independent survival (Anoikis resistance) of primary tumor cell is one of the key steps in metastasis.
The mucin MUC13 when aberrantly overexpressed in cancer has been found to lead to poor outcomes in Pancreatic, Ovarian, Liver, and Colorectal cancer. When overexpressed in these cancers MUC13 has been shown to increase the oncogenic activity and survival of cancer cells. The oncogenic nature of MUC13 indicates a possible role in the development of Anoikis resistance and CRC metastasis.
To understand the mechanism behind Anoikis resistance we developed and optimized an Anoikis induction model using the low adhesion poly hema coated cell culture dishes. Two isogenic cell lines SW480 (primary tumor site) and SW620 (metastatic tumor site) were used for this study. In our initial experiments SW620 demonstrated less cell death compared to SW480 during Anoikis induction. High MUC13 expression was observed in SW620 between 24-36 hours compared at 0 hours. SW620 further showed an increase in the expression of anti-apoptotic protein Bcl2 also. Overexpression of MUC13 in SW480 (SW480+MUC13) cells increased oncogenic phenotype such as invasion, migration, proliferation, and colony size as compared to SW480+Vector control cells. Downregulation of MUC13 in SW620 cells resulted in decreased oncogenic traits.
The role of MUC13 in Anoikis resistance was further investigated in the overexpression and knockdown cell lines. When overexpressing MUC13 in SW480 cells we found increased survival compared to SW480+Vector cells. Bcl2 expression increased while Cleaved-Caspase 3 showed decreased expression in SW480+MUC13 compared to SW480+Vector cells. Increased MUC13 expression also increased the metastatic potential of SW480 cells in mice. After 36 hours of Anoikis induction and then injection into mice through the tail vein, MUC13 mice had an increased tumor burden compared to Vector mice, with METs forming in the liver, kidneys, and lungs. This would indicate that MUC13 plays a larger part in CRC metastasis and specific in the development of Anoikis resistance.
To understand the mechanism involving MUC13 in Anoikis resistance, we studied kinases after Anoikis induction in the cell lines, followed by quantitative proteomics. We were able to find changes in transcription factor YAP1 and YAP1 and β-catenin, which are known to play vital roles in cellular development. In recent studies YAP1 and β-catenin have been shown to form a complex that promotes tumor cell survival and increased tumorigenesis. High MUC13 expression between 24-36hrs was observed, leading to an increase in nuclear localization of the known survival complex YAP1/β-catenin. Further in-vitro analysis indicated that MUC13 plays a vital role through direct cooperation with YAP1 and β-catenin, and together with increased nuclear localization of YAP1/MUC13 and β-catenin/MUC13 complexes, results in increase expression of pro-survival genes. This relationship was further examined and validated in an in-vivo mouse model, in which high MUC13 expression led to increased YAP1 and β-catenin expression and tumorigenesis. A correlation was further observed between MUC13 and YAP1 expression in human CRC patient tissue samples with high expression in tumor tissues compared to NAT and increased nuclear localization with elevated expression for both MUC13 and YAP1. The novel interaction between YAP1 and MUC13 defines a new mechanism in which cells develop Anoikis resistance in CRC.
Genetic variations in genes are a well-known aspect of most diseases. This is especially true for cancer. Genetic variations in mucins such as MUC1 and MUC5AC have been found to increase the risk of stomach cancer and certain Allele mutations nearly doubling that risk in. We investigated if MUC13 had any genetic variants and found 5 different splice variants. Three of those splice variants were found to be non-coding. We then investigated the two protein coding variants consisted of a 512aa (Long form) and 187aa (Short form). We found that MUC13-LF was responsible for generating the oncogenic phenotype associated with adherent MUC13 expression. MUC13-SF however, showed a decrease in migration and invasion when overexpressed in MUC13 null cell lines.
These studies suggest an oncogenic function of MUC13 in CRC via influencing multiple signaling pathways however, its role in cancer metastasis is remains elusive. In this study, we discovered how MUC13 facilitates metastasis after dissemination of tumor cells from the primary tumor site through influencing interaction and nuclear translocation of YAP1 and β-catenin followed by the expression of their downstream pro-survival and metastasis genes. After escaping from the primary tumor this MUC13 driven molecular mechanism provides a crucial survival advantage to anchorage independent circulating tumor cells, leading to successful and extravasation and homing new distant site for cancer metastasis. The interaction between YAP1 and MUC13 provides a new therapeutic in the prevention of metastasis that in combination with current chemotherapy could limit the tumor to its primary site
Dexmedetomidine vs Fentanyl in Attenuating the Sympathetic Surge During Endotracheal Intubation: A Scoping Review
Get PDFPurpose/Background Direct laryngoscopy and endotracheal intubation after induction of anesthesia can cause a reflex sympathetic surge of catecholamines caused by airway stimulation. This may cause hypertension, tachycardia, and arrhythmias. This reflex can be detrimental in patients with poor cardiac reserve and can be poorly tolerated and lead to adverse events such as myocardial ischemia. Fentanyl, a potent opioid, with a rapid onset and short duration of action is given during induction to block the sympathetic response. With a rise in the opioid crisis and finding ways to change the practice in medicine to use less opioids, dexmedetomidine, an alpha 2 adrenergic agonist, can decrease the release of norepinephrine, has analgesic properties, and can lower the heart rate.
Methods In this scoping review, studies published between 2009 and 2021 that compared fentanyl and dexmedetomidine during general anesthesia induction and endotracheal intubation of surgical patients over the age of 18 were included. Full text, peer-reviewed studies in English were included with no limit on country of study. The outcomes included post-operative reviews of decrease in pain medication usage and hemodynamic stability. Studies that were included focused on hemodynamic variables such as systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, and use of opioids post-surgery.
Result Of 2,114 results from our search, 10 articles were selected based on multiple eligibility criteria of age greater than 18, patients undergoing endotracheal intubation after induction of general anesthesia, and required either a dose of dexmedetomidine or fentanyl to be given prior to intubation. Dexmedetomidine was shown to effectively attenuate the sympathetic surge during intubation over fentanyl. Dexmedetomidine showed a greater reduction in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure than fentanyl, causing better hemodynamic stability in patients undergoing elective surgery.Implications for Nursing Practice Findings during this scoping review indicate that dexmedetomidine is a safe and effective alternative to fentanyl during induction of general anesthesia and endotracheal intubation in attenuating the hemodynamic response. It is also a safe choice for opioid-free anesthesia
Adverse Childhood Experiences and Urinary Incontinence in Elementary School Aged Children
Get PDFPurpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.
Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient urology office for an initial visit with a primary diagnosis of urinary incontinence. Charts were reviewed for documentation of individual or family risk factors for ACEs exposure, community risk factors for ACEs exposures, and records where no related documentation was included.
Results: For the thirty-nine patients identified, no community risk factors were noted in the charts. Seventy-nine percent of patients had one or more individual or family risk factors documented. Implications for Nursing Practice This chart review indicates that a significant percentage of pediatric, school-aged patients presenting with urinary incontinence have exposure to ACEs. A formal assessment for ACEs at the time of initial presentation would be helpful to identify those at highest risk.
References: Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998;14:245–258
Hughes, K., Bellis, M.A., Hardcastle, K.A., Sethi, D., Butchart, D., Mikton, C., Jones, L., Dunne, M.P. (2017) The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health, 2(8): e356–e366. Published online 2017 Jul 31.doi: 10.1016/S2468-2667(17)30118-4
Lai, H., Gardner, V., Vetter, J., & Andriole, G. L. (2015). Correlation between psychological stress levels and the severity of overactive bladder symptoms. BMC urology, 15, 14. doi:10.1186/s12894-015-0009-
A Novel Elvitegravir Nanoformulation for Drug Delivery Across the Blood-Brain Barrier to Suppress HIV-1 in Macrophages and Microglia
Get PDFOver the last two decades, the use of antiretroviral therapy (ART) has remarkably decreased the morbidity associated with HIV-1 infection. However, the prevalence of HIV-1-associated neurocognitive disorders (HAND) is still increasing. The appearance and persistence of HAND are partially due to the entry of HIV-1-infected monocytes into the brain. Within the central nervous system (CNS), HIV-1-infected macrophages and microglia serve as the major viral reservoirs and provide active viral replication even when systemic viral suppression has been achieved by ART. Efficient viral suppression of CNS macrophages and microglia is important for an effective HIV-1 treatment in the brain. The primary hindrance to the treatment of HAND is mainly contributed by the inability of antiretrovirals (ARVs) to cross the blood-brain barrier (BBB) after the systemic administration. Conventional regimens of ARVs are not sufficient to penetrate the BBB or improve outcomes in HAND. Thus, there is a need for novel treatment regimens that cross the BBB and deliver therapeutic ARVs into the CNS to suppress the HIV-1 replication in these viral reservoirs. Our objective in this study was to improve the efficacy of ART in CNS HIV-1 reservoirs, specifically in macrophages and microglia. Our central hypothesis was that the selected ARV, elvitegravir (EVG), in nanoformulation would have increased transmigration across the BBB, as well as increased drug uptake in macrophages and microglia after crossing the BBB, leading to increased antiviral activity in macrophages and microglia, relative to the native drug. This study was expected to provide an optimized treatment strategy that has potential for therapeutic interventions in reducing HAND.In this study, poly (lactic-co-glycolic acid) (PLGA)-based elvitegravir nanoparticles (PLGA-EVG NPs) were prepared by nano-precipitation. Firstly, we analyzed the physicochemical properties of PLGA-EVG NPs using transmission electron microscopy, dynamic light scattering (DLS), and Fourier-transform infrared spectroscopy (FTIR). We measured cellular uptake of PLGA NPs by fluorescence microscopy and flow cytometry. We also measured the intracellular drug concentration and viral replication in HIV-1-infected macrophages by using LC-MS/MS and p24 ELISA, respectively. The PLGA-
Novel Paclitaxel Nanoparticles for Enhanced Therapeutic Effects in Breast Cancer
Get PDFDrug delivery to triple negative breast cancer (TNBC) remains a formidable challenge. Given the lack of expressions of estrogen (ER), progesterone (PR) and human epidermal growth factor receptor (HER2), there is no specific prognostic marker for targeting this aggressive cancer. In spite of rapid advancement in breast cancer with agents such as Trastuzumab in HER2 positive, chemotherapy with cytotoxic agents remains the mainstay treatment for TNBC. Although these cytotoxic agents are potent in managing the tumor progression, yet they pose adverse effects on healthy tissues. Paclitaxel (PTX) has been used as a gold standard chemotherapeutic agent for breast, ovarian, pancreatic and non-small cell lung carcinoma. Till date, PTX has been used as the first line of treatment for metastatic breast cancer. However, being biopharmaceutical classification system (BCS) class IV agent PTX suffers low solubility, poor permeability and remains a major challenge for efficient delivery specific to the tumor sites. Various formulations of PTX have been developed and approved in some countries, however due to serious adverse effects, suffer from poor patient outcomes.In this regard, we choose PTX as our model drug to generate, a safe and efficacious nanoparticle formulation by nanoprecipitation technique. For this, we screened commonly used pharmaceutical excipients and polymers and found the best candidate with built-in chemosensitization motifs (tannic acid: TA) and polyvinyl/pyrrolidone (PVP), given their innate potential to prevent drug efflux and capability to form the structured nanoparticle core due to extensive hydrogen bonding. The optimized formulation of TA and PVP nanoparticles had an average diameter of 102.22 ± 14.05 nm and 140.53 ± 7.08 nm, respectively. A drug encapsulation efficiency of ~ 96% was evaluated by LC-MS/MS. Improved in vitro and in vivo efficacies were achieved with respect to plain drug, attributed to the inhibitory P-gp effects of TA. To expand the scope of the developed formulation for enhanced specificity to TNBC tumors, we screened endogenous cell membranes (Human neutrophil, Mesenchymal
Systematic Reviews in Food Science, Nutrition, and Packaging Sciences: Bringing Together Medical and Agricultural Resources to Expand Services and Training
Get PDFThe objective of this paper session is to explore a case study of library service opportunities to support the unique systematic review needs of researchers in Food, Nutrition, and Packaging Sciences. In this session, we describe the collaboration necessary to provide support and training to these individuals, ways to assess the quality of services, and methods used to ensure individuals receive the blended training needed to successfully undertake the systematic review process. The development and implementation of a systematic review training program for graduate students and faculty in this department illustrates the ways that cross-subject specialist collaboration can be used to enhance the quality and guidance provided for teams conducting evidence-based research outside of the traditional scope of health sciences and medicine
How Generating PICO and Clinical Questions from PubMed Abstracts Challenges Instruction of PubMed Search Strategies to First-Year Dental Students
Get PDFObjective To provide continuity in an evidence-based dental course the librarian led students to convert the course director’s PICO (Population, Intervention, Comparison, Outcome) and Clinical Question examples derived from PubMed abstracts to viable PubMed search strategies.
Methods With student participation, a new course director diagrammed PICO elements from eight PubMed abstracts with different research methodologies to construct Clinical Questions. During the next class, the librarian led students to build a search strategies from six Clinical Question examples with Medical Subject Headings (MeSH) and keywords. Students viewed the accuracy and reliability of PubMed’s Automatic Term Mapping in Search Details, how to apply Boolean operators from the Search History, how to find the most appropriate MeSH in the MeSH Database and the MeSH Browser, and finding full-text documents. Students located MeSH listed in MEDLINE records and how to leverage Similar Articles and Cited By features. Students learned how to stratify the concepts in the Clinical Question by importance.
Results Deriving PICO from PubMed abstracts and building a Clinical Question is a practical method to generate PICO and Clinical Question experience in novice evidence-based medicine students without clinical experience. Students could see real-world examples of some concepts neatly mapping to MeSH and keyword synonyms while some other concepts require more investigation to convert to MeSH and keywords.
Conclusions The librarian appreciated the simplicity of building PICO and Clinical Questions from PubMed abstract text and more examples could be presented to students than in previous years. Students had to push beyond blind trust in Automatic Term Mapping to create better search strategies. The ranking of concepts allow novice learners to construct search strategies that overcome incorrect assignment of concepts to inappropriate PICO elements
Improving Access to Quality Health Information in Rural Communities through Little Free Libraries
Get PDFObjective: Little Free Libraries (LFLs) are neighborhood book-exchange boxes. Okeechobee County Public Library in Florida partnered with the University of Florida Health Science Center Libraries on a grant-funded project to add health education components to 30 new public library-sponsored LFLs built on rural county properties. The objective was to improve rural residents\u27 health literacy and awareness of NIH\u27s All of Us Research Program.
Methods: The libraries collaborated to select and purchase 424 consumer health books in English and Spanish. Online consumer health materials were selected and printed. Laptops and Wi-Fi hotspots were also purchased, as the public library will collaborate with their county Health Department to conduct mobile health reference hours at the LFLs when possible. Health librarians conducted a one-day training for county health educators and public library employees on: health reference techniques; evaluating and using online health resources; health literacy; strategies for successful health tabling; and conveying the benefits of All of Us to patrons. The eHEALS eHealth Literacy Scale was administered before and after the training.
Results: Nine LFLs have been installed in lower-income neighborhoods; all 30 will be completed by July 2021. To date, the most popular LFL location is at a sports complex with over 600 items circulated since April 2020. The most frequently restocked health resources are related to teaching children healthy habits. The eHEALS results demonstrated that the training day increased participants\u27 perceived ability to navigate health information online.
Conclusions: Although not yet complete, this project has already improved rural residents\u27 awareness of and access to authoritative consumer health resources. Overall, the LFLs and the planned health reference sessions will contribute towards reducing health information disparities amongst underserved populations, as county residents are empowered to make effective use of information for health decision-making