Campbell University
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Molecular mechanisms of action of metformin: latest advances and therapeutic implications
No full textCharacteristics of emergency medicine residency programs with unfilled positions in the 2023 match
No full textCharacterizing Social Insecurity in a Rural North Carolina Emergency Department
No full textINTRODUCTION: Social insecurity, a form of deprivation of social amenities, if present among patients presenting in a rural emergency department (ED) can be a source of medical burden and poor health outcomes. Although knowledge and understanding of the insecurity profile of such patients is necessary for targeted care that improves their health outcomes, the concept has not been comprehensively quantified. In this study we explored, characterized, and quantified the social insecurity profile of ED patients at a rural teaching hospital in southeastern North Carolina with a large Native American population. METHODS: A paper survey questionnaire was administered by trained research assistants between May-June 2018 to patients who presented to the ED and consented to participate in this cross-sectional, single-center study. The survey was anonymous with no identifying information collected on the respondents. A general demographic section and questions derived from the literature capturing sub-constructs of social insecurity-communication access, access to transportation, housing insecurity and home environment, food insecurity, and exposure to violence-were captured in the survey. We assessed the factors included in the index of social insecurity based on a rank ordering using the magnitude of their coefficient of variation and the Cronbach\u27s alpha reliability index of the constituent items. RESULTS: Overall, we collected 312 surveys from the approximately 445 administered and included them in the analysis, representing a response rate of about 70%. The average age of the 312 respondents was 45.1 (±17.7) years with a range of 18.0-96.0. More females (54.2%) than males participated in the survey. Native Americans (34.3%), Blacks (33.7%), and Whites (27.6%) comprised the three major racial/ethnicity groups of the sample, which are representative of the study area\u27s population distribution. Social insecurity was observed among this population regarding all the subdomains and an overall measure (P \u3c.001). We identified three key determinants of social insecurity-food insecurity, transportation insecurity, and exposure to violence. Social insecurity significantly differed overall and among the three of its key constituent domains by patients\u27 race/ethnicity and gender (P \u3c.05). CONCLUSION: Emergency department visits in a rural North Carolina teaching hospital are characterized by a diverse patient population, including patients with some degree of social insecurity. Historically marginalized and minoritized groups including Native Americans and Blacks demonstrated overall higher rates of social insecurity and higher indexes on exposure to violence than their White counterparts. Such patients struggle with basic needs such as food, transportation, and safety. As social factors play a critical role in health outcomes, supporting the social well-being of a historically marginalized and minoritized rural community would likely help build the foundation for safe livelihood with improved and sustainable health outcomes. The need for a more valid and psychometrically desirable measurement tool of social insecurity among ED populations is compelling
Molecular mechanisms of action of metformin: latest advances and therapeutic implications
No full textMetformin is among the most widely used antidiabetic drugs. Studies over the past few years have identified multiple novel molecular targets and pathways that metformin acts on to exert its beneficial effects in treating type 2 diabetes as well as other disorders involving dysregulated inflammation and redox homeostasis. In this mini-review, we discuss the latest cutting-edge research discoveries on novel molecular targets of metformin in glycemic control, cardiovascular protection, cancer intervention, anti-inflammation, antiaging, and weight control. Identification of these novel targets and pathways not only deepens our understanding of the molecular mechanisms by which metformin exerts diverse beneficial biological effects, but also provides opportunities for developing new mechanistically based drugs for human diseases
Investigating the mechanism of prolotherapy: the fibroblast response to dextrose in vitro
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