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Cellular Level Changes Induced in Cancer Cells Due to Microgravity
Get PDFThe increase in human activity in space has revealed several kinds of physiological challenges brought on by the absence of Earth\u27s gravitational pull. NASA observed that during spaceflight, astronauts experience a 1-1.5% monthly loss in the mineral density of weight-bearing bones, with rehabilitation efforts on Earth often proving ineffective. This issue extends to muscles, the neuro vestibular system, the cardiovascular system, and vision. Cancer has emerged as a significant cause of mortality among astronauts, with studies up to 2017 showing that 41.3% of natural cause deaths among U.S. astronauts were due to cancer, primarily due to space radiation exposure. Cancer remains a major global health challenge, with no definitive prevention or treatment strategies despite advances in medical science. This review aims to examine the cellular-level changes in cancer cells exposed to reduced gravity, focusing on cancerous cell behavior. The microgravity environment in space notably influences cancer cell behavior, suggesting new therapeutic strategies for cancer treatment. These findings not only underscore the risks faced by astronauts but also pave the way for innovative cancer research and treatment methodologies. It speculates that microgravity might serve as a complementary tool for future cancer treatment, opening new avenues for clinical therapies. By providing a comprehensive report on the cellular aspects of cancer cell research, this review seeks to establish therapeutic links between microgravity and cancer treatment, potentially revolutionizing oncology practices
Evaluating the role of glucocorticoids on the host response to Helicobacter pylori infection
Get PDFGastric cancer is the fifth most common cancer and the fifth leading cause of cancer deaths worldwide. Helicobacter pylori infection is the number one risk factor for gastric cancer development. Roughly 50% of the world’s population is infected with H. pylori, though only 1-3% of those infected will develop cancer. H. pylori drives chronic inflammation that creates the requisite environment for carcinogenesis, yet it remains unclear why some individuals develop cancer and others do not. Most mechanistic studies are done in mice, however H. pylori is not a natural mouse pathogen. Research is typically done either with mouse-adapted strains of H. pylori or the natural mouse pathogen Helicobacter felis. While both are common models, few have directly compared their effects on mice. We hypothesize that inflammation caused by H. felis better models the inflammation caused by H. pylori in humans, thereby making it a better model for H. pylori pathogenesis. We began by co-culturing the PMSS1 H. pylori strain or the CS1 H. felis strain with mouse peritoneal macrophages to assess their immunostimulatory effects. The bacteria induced similar cytokine production from the cultured macrophages, indicating similar immunostimulatory effects in vitro. We then infected C57BL/6J mice with H. pylori or H. felis. Two months post-inoculation, H. pylori caused modest gastric inflammation and no significant atrophy while H. felis induced severe inflammation and caused significant glandular atrophy. H. felis exhibited increased immunogenicity in vivo, there was increased CD4+ T cell activation, which is associated with gastric cancer risk in humans. Based on our data, we concluded that H. felis is better suited for studies on gastric inflammation and tumorigenesis while H. pylori is better suited for studies on colonization and effects on the microbiome. Inflammation is a key factor that drives H. pylori-mediated carcinogenesis. Research has shown that immune-deficient mice do not exhibit the disease progression seen in immune-sufficient mice. Our lab has previously shown that glucocorticoids are critical mediators of gastric immune homeostasis. To determine the role of endogenous glucocorticoids on Helicobacter-mediated disease, we adrenalectomized (ADX) C57BL/6J mice and infected them with H. felis within a week of surgery. Two months post-infection, intact-infected and ADX-infected mice had similar levels of gastric atrophy and pyloric metaplasia development. However, ADX-infected mice had significantly increased T cell infiltration, specifically CD4+ T cells. Quantitativ real-time PCR (qRT-PCR) indicated that ADX-infected mice had higher T cell activation as well. The ADX-infected mice consistently eliminated their infections by the two month timepoint. When mice were treated with antibiotics two months post-inoculation, the intact group was able to recover but not the ADX group. When treated with antibiotics and then given corticosterone replacement therapy, both intact and ADX groups were able to recover, indicating that glucocorticoids are necessary to restore homeostasis. Data one year post-inoculation revealed that while intact-infected mice dependably had more inflammation and dysplastic changes to the gastric mucosa, ADX-infected mice tended to be protected yet there was an outlier group of mice still exhibiting neoplastic lesions and inflammation. These data suggest that glucocorticoid signaling in the stomach prevents from pathogenic inflammation, however this limits the effectiveness of the immune response. Chronic inflammation persists and predisposes intact mice to neoplastic lesions. This challenges the longstanding idea that tolerance, rather than immunity, protects from carcinogenesis
Improving Patient Self-Advocacy and Communication with Providers through Diabetes Self-Management Education: Analyses from a Randomized Controlled Trial
Get PDFBackground: West Virginia (WV), a rural state in Appalachia, has the highest type 2 diabetes mellitus (T2DM) prevalence in the United States. Open communication in the patient-provider relationship is an integral part of comprehensive chronic disease management. This is especially true for patients living with T2DM, a disease that requires many complex, daily self-management activities and is associated with increased emotional distress. However, patients living with T2DM are often reluctant to openly share their concerns regarding self-care with their provider. This study aimed to test the effectiveness of the Diabetes and Hypertension Self-Management Program (DHSMP), a 12-week group lifestyle intervention implemented in two WV churches, on improving patients’ self-advocacy and patient-provider regarding their T2DM management.
Methods: The DHSMP utilized health coaches to deliver group educational sessions and support participants (N = 98) in improving self-care behaviors. Using a randomized controlled trial (RCT) design and an integrated explanatory sequential mixed-method approach, the objectives of this study were to: evaluate the impact of the DHSMP at baseline, 12 weeks, & 24 weeks on relevant behavioral (patient self-advocacy, patient-provider communication), clinical (hemoglobin A1c, HbA1c), and psychosocial (diabetes distress) outcomes compared to the enhanced usual care (EUC) control group and to determine the relationships between the outcomes measured (Aim 1); to understand DHSMP participants’ experiences and perceptions of barriers and facilitators to patient-provider communication regarding diabetes self-management and care (Aim 2a); to understand DHSMP participants’ perceptions of DHSMP components that may have influenced their propensity for self-advocacy, and how they communicate their concerns regarding diabetes self-care with their provider(s) (Aim 2b); and to assess qualitative differences in self-advocacy and patient-provider communication based on DHSMP participants’ characteristics using an integrated mixed-method analysis (Aim 3). Differences in outcomes within the intervention and control groups were assessed using paired t-tests and Wilcoxon Signed Rank tests at 12 weeks and 24 weeks from baseline. Generalized estimating equation modeling was used to assess group by time interaction effects for the primary outcome variables controlling for other relevant covariates. Semi-structured interviews (n = 45) and 7 focus groups (n = 25) were also conducted with participants post-program. Qualitative data were coded by four independent coders who used thematic analysis to identify themes and subthemes related to diabetes-specific self-advocacy and communication. Coded qualitative data were then integrated with participants’ quantitative data and were assessed using quote matrices.
Results: A significant increase in patient self-advocacy was noted at 12 weeks (Diff = +11.17; p = 0.021) but was not sustained at 24 weeks for the intervention group (Diff = +0.01; p = 0.746); no significant change in self-advocacy was found in the EUC control group. There was no significant change in patient-provider communication after the intervention for both the intervention and EUC control groups. After controlling for covariates in the model, no significant group by time interaction effects were observed for self-advocacy. However, the EUC control group experienced a small decrease in patient-provider communication at 12 weeks (ß = -0.28, p = 0.017). Patient-provider communication (Est. = 1.50; p \u3c 0.001) and diabetes duration (Est. = 0.04, p = 0.032) were significantly associated with self-advocacy. In addition, self-advocacy (ß = 0.42, p \u3c 0.001), diabetes distress (ß = -0.24, p = 0.022), and educational attainment (ß = -0.29, p = 0.006) were associated with patient-provider communication. In contrast, qualitatively, intervention group participants perceived improvements both in their ability and confidence to communicate with providers their tailored diabetes care needs and preferences, unlike those in the EUC control group. Specifically, participants perceived the ability to self-advocate as important as it fosters partnership with their providers, brings attention to patient concerns, especially related to medication and the psychosocial aspects of T2DM management, and aids patient-provider discussion regarding self-care topics rather than just “the numbers” (HbA1c). Participants also noted that empowerment through education impacted their communication with providers. DHSMP participation improved knowledge about their disease which allowed for better engagement and questions/discussion with providers. On the other hand, provider-related themes included providers being attentive and nonjudgmental, open to patients discussing research or new treatments, and easy accessibility via phone or patient portal messaging as needed. Lastly, no qualitative differences in self-advocacy and patient-provider communication were noted based on participants’ demographic and clinical variables. However, four typologies based on participants’ self-advocacy and patient-provider communication quality were identified and enhanced understanding of the relationship between patient self-advocacy and patient-provider communication.
Discussion: This study is innovative in that it is the first RCT to test the impact of a lifestyle intervention on patient self-advocacy and patient-provider communication regarding diabetes care, management, and related distress. Our study demonstrated a strong relationship between patient self-advocacy skills and patient-provider communication. Furthermore, improved patient-provider communication was associated with reduced diabetes distress and subsequently reduced HbA1c in T2DM patients. These results highlight the importance of patient-provider communication in the psychosocial and clinical aspects of diabetes self-management. Quantitatively, modest improvements in self-advocacy scores were noted among the DHSMP intervention group as compared to the EUC control group at 12 weeks but were not sustained at the 24-week follow-up. However, qualitatively, intervention group participants perceived improvements both in their ability and confidence to communicate with providers their tailored diabetes care needs and preferences, unlike those in the EUC control group. These results suggest that diabetes self-management education (DSME) programs aiming to improve knowledge and skills may not inherently improve patient self-advocacy regarding their T2DM. Therefore, future research should test the additive effect of incorporating self-advocacy skill building and practice in DSME interventions. Lastly, this study confirmed that patient-provider communication quality influences patient self-advocacy, but challenges remain in intervening with providers due to lack of time and high patient volumes. Fortunately, “confidence in being able to obtain attention”, “being involved or assertive in care decisions”, “being prepared with questions”, “having health/diabetes knowledge”, and “being honest with providers” emerged as patient-specific themes that were not found to be dependent on provider communication quality. Therefore, these potentially modifiable patient characteristics should be considered as behavioral targets in future T2DM patient self-advocacy intervention studies
Retrospective Thank You Section
Get PDFThis section of the WVU Art in the Libraries Retrospective (2015-2024) includes a thank-you panel to the exhibition donors, and a thank-you panel to the Art in the Libraries committee
Retrospective Curator\u27s Statement
Get PDFThis section of the WVU Libraries Retrospective includes a statement by the exhibition curator
Retrospective Awards section
Get PDFThis section of the WVU Art in the Libraries Retrospective (2015-2024) includes a summary of awards given by the program to students, faculty and staff
