University of Illinois at Chicago
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Epigenetic Changes Regulating Epithelial–Mesenchymal Plasticity in Human Trophoblast Differentiation
No full textThe phenotype of human placental extravillous trophoblast (EVT) at the end of pregnancy reflects both differentiation from villous cytotrophoblast (CTB) and later gestational changes, including loss of proliferative and invasive capacity. Invasion abnormalities are central to major obstetric pathologies, including placenta accreta spectrum, early onset preeclampsia, and fetal growth restriction. Characterization of the normal differentiation processes is, thus, essential for the analysis of these pathologies. Our gene expression analysis, employing purified human CTB and EVT cells, demonstrates a mechanism similar to the epithelial-mesenchymal transition (EMT), which underlies CTB-EVT differentiation. In parallel, DNA methylation profiling shows that CTB cells, already hypomethylated relative to non-trophoblast cell lineages, show further genome-wide hypomethylation in the transition to EVT. A small subgroup of genes undergoes gains of methylation (GOM), associated with differential gene expression (DE). Prominent in this GOM-DE group are genes involved in epithelial-mesenchymal plasticity (EMP). An exemplar is the transcription factor RUNX1, for which we demonstrate a functional role in regulating the migratory and invasive capacities of trophoblast cells. This analysis highlights epigenetically regulated genes acting to underpin the epithelial-mesenchymal plasticity characteristic of human trophoblast differentiation. Identification of these elements provides important information for the obstetric disorders in which these processes are dysregulated.</p
Identity Development, Attraction, and Behavior of Heterosexual-Identified Men Who Have Sex with Men: A Scoping Review
No full textAbstractIntroductionHeterosexual-identified men who have sex with men (H-MSM) experience sexual identity and behavior discordance. H-MSM may comprise 0.5–3.5% of adult heterosexual men. Understanding and accepting H-MSM as they self-identify may be necessary to implement effective public health and psychosocial interventions. This scoping review synthesizes research on H-MSM’s identity development, attraction, and behavior.MethodsThirteen databases were searched and, using Covidence software, two independent reviewers screened 3617 titles and abstracts and 269 full texts to arrive at 124 articles meeting entry criteria. Ten independent reviewers then conducted thematic content analysis.ResultsH-MSM either expressed sexual identity uncertainty or justified maintaining heterosexual identity, due to fear of discrimination and little or no social support. H-MSM compartmentalized sexual behaviors as isolated events unrepresentative of their sexual identity. H-MSM further minimized same-sex behaviors to infrequent, recreational/sport, or economic coincidences with little partner communication regarding HIV and sexual health. Many H-MSM depersonalized male sex partners, denied same-sex attraction, and avoided gay-identified venues. Reviewed articles further reported H-MSM had negative emotional responses to sex with men (e.g., guilt, shame, disgust).ConclusionsH-MSM are unlike other heterosexual men and other MSM and require unique considerations for social policy and approaches for care.Policy ImplicationsFindings suggest H-MSM are mislabeled as “behaviorally bisexual” in sexual health screening, which may cause inaccurate epidemiology of sexually transmitted and blood borne infections.</p
Holter Monitor Rhythm Parameters in Healthy Infants, Children, and Adolescents: Defining Reference Limits With Meta‐Analysis
No full textBACKGROUND: Ambulatory electrocardiography has been in clinical use for 5 decades. However, reference limits for rhythm parameters in healthy infants, children, and adolescents have not been adequately defined. We sought to determine these reference ranges using meta-analysis of existing published studies of 24-hour Holter monitoring in healthy pediatric populations.
METHODS: Multiple literature databases were searched from 1969 to May 2024 for relevant studies. Data extraction and analysis were completed according to the Meta-Analysis of Observational Studies in Epidemiology guidelines. The prevalence of cardiac ectopy and conduction delays along with mean±SD of heart rates were obtained and grouped by the following age ranges: neonates (birth to 4 weeks), older infants (1-12 months), younger children (1-6 years), older children (7-12 years), and adolescents (13-18 years). Ninety-five percent reference ranges for all rhythm variables were estimated in each age group.
RESULTS: Forty-five studies including 3886 participants were identified and analyzed. Minimum, average, and maximum heart rates during Holter monitoring decreased with age as expected. Prevalence of transient first-degree atrioventricular block and Wenckebach second-degree atrioventricular block increased with age to around 14% in adolescence. Prevalence rates for any premature atrial complexes and premature ventricular complexes were also highest in adolescence at 50% and 29%, respectively. The upper limits for the number of premature atrial complexes per day were 150 in infants and 50 in the older age groups and for premature ventricular complexes were 50 in all age groups.
CONCLUSIONS: Holter monitor age-related reference limits for healthy infants, children, and adolescents are proposed.</p
Cervical cancer screening and treatment of VIA positive lesions among women living with HIV in Nairobi and Kajiado counties, Kenya: results from a targeted intervention implemented under the USAID Fahari ya Jamii project in supported HIV clinics
No full textBackgroundCervical cancer is the leading cause of cancer-related deaths and the second most common cancer amongst females in Kenya. Women living with HIV (WLHIV) have a six-fold increased risk of developing cervical cancer than women in the general population. As of October 2021, only 23% (34/149) of Fahari ya Jamii (FYJ) project-supported HIV clinics in Nairobi and Kajiado Counties were offering cervical cancer screening for WLHIV. Visual inspection with acetic acid (VIA) positive lesions identified were being treated in only 7% (11/34) of facilities. The project implemented an intervention and sought to determine its outcome on cervical cancer screening and treatment uptake.MethodsThis was a retrospective analysis of data from 1st July 2022 to 30th June 2023. The intervention focused on building the capacity of service providers, determining cervical cancer screening eligibility using Kenya National eligibility screening guidelines, providing screening supplies and commodities, creating service demand through health education by mentor mothers and peer educators, providing screening services and on-site treatment of VIA positive lesions. WLHIV aged 25 to 49 years and receiving care in 64 USAID–FYJ–supported facilities in Nairobi and Kajiado Counties were included in the analyses. Descriptive analyses were performed for sociodemographic characteristics, screening and treatment uptake.ResultsA total of 52% (11,089/21,324) WLHIV received cervical cancer screening services, representing a five-fold increase from pre-intervention figures (2,186). The number of facilities offering screening services increased from 23% (34/149) to 43% (64/149). Of the women screened, 2% (245) VIA positive cervical lesions were identified. Treatment uptake improved from 38% pre-intervention to 90%, with 90% (220/245) of identified cases receiving appropriate treatment. The intervention successfully integrated screening into routine HIV care, facilitated same-day treatment in equipped facilities, and strengthened provider capacity, leading to sustained service delivery improvements.ConclusionsThe intervention increased cervical cancer screening and treatment uptake for VIA positive lesions among WLHIV by integrating services into routine HIV care, enhancing provider training, and ensuring the availability of screening supplies. These findings highlight the potential for scaling up similar strategies in resource-limited settings. Sustained mentorship and continuous monitoring will be essential to further strengthen screening and treatment efforts toward cervical cancer elimination.</p
Landscape as Event: Geometrics and Geopoetics in Contemporary Spanish Cinema
No full textThis chapter focuses on landscape in Spanish cinema as a disruptive and destabilizing figure rather than an integral part in the forging of an identity or, indeed, any kind of national or regional affiliation. Landscape is here conceptualized as a transformative element rather than as the setting or staging for the films’ action. Through a close reading of three very different films in which landscape features prominently (though in very distinct ways), it seeks to question our notions regarding the configuration of space to place. To this end, it proposes landscape, rather than a natural phenomenon, as an artifice, the framed enclosure of space defined by geometrical parameters and poetic sensibilities.</p
Pesticide Safety Webinar Series (Spanish)
No full textDiagnosis and Management of Pesticide-Related Illness and How to Prevent Pesticide Poisoning in Farmworkers: Three-Part Webinar Series in Spanish</p
Assessing Academic Health Centers’ Readiness to Implement Social Accountability to Advance Health Equity
No full textThis dissertation examines how AHCs can advance healthcare equity by implementing social accountability (SA) into their structures, policies, and practices. research has significant implications for healthcare equity and social responsibility theory, practice, and policy.This research had two primary objectives. First, it explored how Academic Health Centers (AHCs) integrate social accountability (SA) across education, research, and clinical care, assessing how internal structures and policies either facilitate or hinder the implementation of a culture of social accountability. Second, it evaluated the extent to which AHCs prioritize health equity as a strategic priority and identified opportunities for enhancing their capacity for addressing health disparities. The study employed an exploratory, single-case mixed methods study methodology.</p
<b>Designing for Healthcare Equity: Implementation of Care Coordination within a Pediatric Healthcare System - </b><b>Application of Implementation Mapping</b>
No full textThis qualitative action research studies the implementation of health equity-focused care coordination within the pediatric context of Children's Mercy Kansas City (CMKC). Employing a pragmatic paradigm, the study integrates action research and case study methodologies, leveraging both inductive and deductive approaches to examine healthcare disparities and their impact on equitable care coordination. The research aligns with the phases of implementation mapping, encompassing a thorough needs assessment, development of performance and change objectives, and the formulation of tailored implementation strategies. The study utilizes purposive sampling to gather diverse perspectives from parents, community partners, and operational partners. Data sources include secondary analysis of existing interviews and small group discussions. A hybrid coding approach, incorporating elements of grounded theory, is applied to qualitative data analysis, ensuring a comprehensive exploration of the complexities involved in care coordination and healthcare equity. The study emphasizes the importance of collaborative engagement with community and operational partners, fostering co-creation of actionable strategies and alignment within the real-world healthcare context. By integrating theoretical constructs with practical insights, this study contributes to a nuanced understanding of care coordination implementation within pediatric healthcare systems, aimed at enhancing healthcare equity and outcomes</p
Qualitative & Mixed Methods Research Approaches in Public Health: An Introduction for Public Health Practitioners
No full textThis lecture provides an overview of qualitative and mixed methods research and their applications in public health settings. This session will discuss the differences and complements of qualitative and quantitative methods.By the end of the session, you should be able to:Describe qualitative and mixed research methods and their associated concepts.Distinguish qualitative and quantitative approaches.Identify how to use qualitative and mixed methods research in your research.</p
The State of Illinois’ FY 2024 Fiscal Situation: A Solid Performance but Threats Remain
No full textA new policy report provides a timely look at Illinois’ financial health and examines potential policy shifts, with a particular focus on the state’s sales tax structure. The report explores several ways in which broadening the Illinois sales tax to include the service economy would benefit state and local governments and enhance the fairness of the state’s tax code.The report leverages an “all-funds” methodological framework to assess Illinois’ financial standing. While the analysis reveals that Illinois achieved a marginal surplus in FY 2024 (July 1,2023 through June 30, 2024), it also underscores the presence of significant headwinds that warrant careful consideration by policymakers. These challenges include the impending expiration of pandemic-era federal aid, the potential for disruptive policy shifts at the federal level and persistent fiscal pressures impacting local governments throughout Illinois. A key focal point of the spotlight is the role of sales tax revenue within Illinois’ broader fiscal framework. Sales tax revenues are a critical component of the state’s funding mechanisms, with all-funds sales tax revenue reaching $16.4 billion in FY 2024. Notably, Illinois maintains a general sales tax rate of 6.25%, which exceeds the national average.</p
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