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Open Access Publications from the University of California

Scholarly Works (6 results)

  • Article
  • Peer Reviewed
Journal of Education and Teaching in Emergency Medicine, Volume 2, Issue 2 (2017)
    Cover page: Presentation of Significant Subarachnoid Hemorrhage without Loss of ConsciousnessCreative Commons 'BY' version 4.0 license
    • Article
    • Peer Reviewed
    UC San Diego Previously Published Works (2022)
    Context: Anti-Black racism is firmly rooted in US healthcare, but many clinicians do not have the tools and language to question their biases and address racism in clinical practice, eg biased communication practices such as non-compliance in medical documentation. Objective: Presence 5 for Racial Justice (P5RJ) leverages the Presence 5 patient-provider communication framework to identify anti-racism communication practices that support trusting relationships between physicians and Black patients and empower Black individuals in clinical care. Study design: For this multi-phased community-based participatory research (CBPR) overseen by an advisory board of clinicians and patients at four community clinics, we conducted a literature review, interviews with Black patients, clinician small-group discussions, and design thinking interviews with non-medical professionals. We mapped emergent communication practices to Presence 5 domains to create P5RJ. Setting: Four primary care clinics primarily serving Black patients in Oakland CA; Rochester NY; Leeds AL; Memphis TN. Population Studied: Total 113 participants (40 non-medical interviews, 37 Black patients interviewed, 12 advisory board members, 24 clinicians in discussion); 30 reviewed articles. Outcomes: Strategies on how providers, through communication and connection in the clinical visit, can navigate and address structural, institutional, and personally mediated forms of racism faced by Black patients. Results: P5RJ practices included: 1) Prepare with intention by reflecting on identity, bias, and power dynamics; and creating structures to address emergent bias and social determinants of health; 2) Listen intently and completely by using focused interpersonal listening without interruption and deep listening for racism impacts; give patients time and space to tell their story; 3) Agree on what matters most by having explicit conversations about patient goals, treatment comfort, consent, and referral planning; 4) Connect with the patients story by acknowledging socio-political factors influencing patient health and focusing on positive efforts/events to encourage patient agency; 5) Explore emotional cues by noticing and naming patient emotions and considering how racial trauma might influence these emotions. Conclusion: P5RJ practices offer strategies to reflect on clinician biases, address racism and known gaps in care for Black patients and promote health equity in their clinical care.
      Cover page: Presence for racial justice: disrupting racism through physician-patient communication.
      • Article
      • Peer Reviewed
      UC Irvine Previously Published Works (2015)
      Melanocortin-1 receptor (MC1R) is a marker of melanoma risk in populations of European ancestry. However, MC1R effects on survival are much less studied. We investigated associations between variation at MC1R and survival in an international, population-based series of single primary melanoma patients enrolled into the Genes, Environment, and Melanoma study. MC1R genotype data was available for 2,200 participants with a first incident primary melanoma diagnosis. We estimated the association of MC1R genotypes with melanoma-specific survival (i.e., death caused by melanoma) and overall survival using COX proportional hazards modeling, adjusting for established prognostic factors for melanoma. We also conducted stratified analyses by Breslow thickness, tumor site, phenotypic index, and age. In addition, we evaluated haplotypes involving polymorphisms near the Agouti signaling protein gene (ASIP) locus for their impacts on survival. Melanoma-specific survival was inversely associated with carriage of MC1R variants in the absence of consensus alleles compared to carriage of at least one consensus allele (hazard ratio (HR) = 0.60; 95% confidence interval (CI): 0.40, 0.90). MC1R results for overall survival were consistent with no association. We did not observe any statistical evidence of heterogeneity of effect estimates in stratified analyses. We observed increased hazard of melanoma-specific death among carriers of the risk haplotype TG near the ASIP locus (HR = 1.37; 95% CI: 0.91, 2.04) when compared to carriers of the most common GG haplotype. Similar results were noted for overall survival. Upon examining the ASIP TG/TG diplotype, we observed considerably increased hazard of melanoma-specific death (HR = 5.11; 95% CI: 1.88, 13.88) compared to carriers of the most common GG/GG diplotype. Our data suggest improved melanoma-specific survival among carriers of two inherited MC1R variants.
        Cover page: Inherited variation at MC1R and ASIP and association with melanoma‐specific survival
        • Article
        • Peer Reviewed
        UC Irvine Previously Published Works (2015)
        Variation in the melanocortin-1receptor (MC1R) gene is associated with pigmentary phenotypes and risk of malignant melanoma. Few studies have reported on MC1R variation with respect to tumor characteristics, especially clinically important prognostic features. We examined associations between MC1R variants and histopathological melanoma characteristics. Study participants were enrolled from nine geographic regions in Australia, Canada, Italy and the United States and were genotyped for MC1R variants classified as high-risk [R] (D84E, R142H, R151C, R160W, and D294H, all nonsense and insertion/deletion) or low-risk [r] (all other nonsynonymous) variants. Tissue was available for 2,160 white participants of the Genes, Environment and Melanoma (GEM) Study with a first incident primary melanoma diagnosis, and underwent centralized pathologic review. No statistically significant associations were observed between MC1R variants and AJCC established prognostic tumor characteristics: Breslow thickness, presence of mitoses or presence of ulceration. However, MC1R was significantly associated with anatomic site of melanoma (p = 0.002) and a positive association was observed between carriage of more than one [R] variant and melanomas arising on the arms (OR = 2.39; 95% CI: 1.40, 4.09). We also observed statistically significant differences between sun-sensitive and sun-resistant individuals with respect to associations between MC1R genotype and AJCC prognostic tumor characteristics. Our results suggest inherited variation in MC1R may play an influential role in anatomic site presentation of melanomas and may differ with respect to skin pigmentation phenotype.
          Cover page: Inherited Variation at MC1R and Histological Characteristics of Primary MelanomaCreative Commons 'BY' version 4.0 license
          • Article
          • Peer Reviewed
          UC Irvine Previously Published Works (2016)
          Although nevus count is an established risk factor for melanoma, relationships between nevus number and patient and tumor characteristics have not been well studied and the influence of nevus count on melanoma-specific survival is equivocal. Using data from the Genes, Environment and Melanoma (GEM) study, a large population-based study of primary cutaneous melanoma, we evaluated associations between number of nevi and patient features, including sun-sensitivity summarized in a phenotypic index, and tumor characteristics. We also assessed the association of nevus count with melanoma-specific survival. Higher nevus counts were independently and positively associated with male gender and younger age at diagnosis, and they were inversely associated with lentigo maligna histology. We observed a borderline significant trend of poorer melanoma-specific survival with increasing quartile of nevus count, but little or no association between number of nevi and pigmentary phenotypic characteristics or prognostic tumor features.
            Cover page: Nevus count associations with pigmentary phenotype, histopathological melanoma characteristics and survival from melanoma
            • Article
            • Peer Reviewed
            Plexus (2017)

            PLEXUS is a student-organized publication that showcases artwork by the UCI School of Medicine students, physicians, faculty, staff, and patients.

            True to its name, PLEXUS aspires to connect those who seek to heal and to be healed through the unifying language of art. This year we continued to expand our presence in the UCI medical community and beyond.

            For our 18th edition of PLEXUS, we chose the theme of “Beneath the Surface, Between the Lines.” Throughout our lives and in medicine, there is more than meets the eye – a story untold. There is so much left unseen if we simply look at the surface. Every year we are amazed by the emotions, reflections, stories, richness, and creativity of the submissions. We thank all of our submitters for their time and thought. Additionally, please find our performing arts pieces on our website, www.uciplexus.org. Previous publications and submissions are also available online.

            Winners of the PLEXUS medical student competitions were made possible by the Program in Medical Humanities & Arts. Congratulations to this year’s winners:

            Writing competition: 1st: Nazin Sedehi, MS1 “When Your Dad Gets the C-Word”; 2nd: Adam Kalawi, MS3 “A Reflection on Anatomy Lab”; 3rd: Lauren DeDecker, MS1 “The Longest Trip”

            Visual competition: 1st: Andy Trang, MS3 “Human Hands”; 2nd: Richelle Homo, MS1 “Vitality”; 3rd: Jamie Miller, MS3 “Restoration”

            Performing arts competition: 1st: Jeremy Martin & Nathan Calixto, MS2s “Stars”; 2nd: Tiffany Pham, MS3 “Bleach and Scrub”; 3rd: Faith Njoku, MS1 “Integrate”

            Thank you to our superb editors, staff, and faculty for their support in making this 18th edition possible. We would like to give special thanks to our faculty advisor, Dr. Johanna Shapiro and Dr. Ellena Peterson, Associate Dean of Admissions & Outreach - this book would not have been possible without your continuous support and guidance.

            We hope you enjoy PLEXUS 2017 – Beneath the Surface, Between the Lines

            Plexus Editor-In-Chief: Sunober Siddiqi

            Project HX Editor-In-Chief: Soe Thein

            Creative Writing & Visual Arts Editors: Celia Cheung, Kaavya Raman, Joanna Turkiewicz Will Novey

            Design Editors: Ben Nguyen, Sunober Siddiqi

            Design Team: Christina Kong, Stephanie Noh, Nahzaneen Sedehi

            Performing Arts Team: Nathan Calixto. Jeremy Martin. Melinda Schneider

            Community Outreach & Selection Committee: Shreya Condamoor, Richelle Homo, Olivia Kaminsky, Carlin Lee, Olivia Marik-Reis, Faith Njoku, Violeta Osegueda, Patrick Penalosa, Tiffany Pham, Hyder Said, Rachel Sunico, Jamie Yabuno

            1st place winner: Nazin Sedehi

            2nd place winner: Adam Kalawi

            3rd place winner:  Lauren DeDecker

             To contribute to PLEXUS or to request a PLEXUS exhibit at your event, please visit www.uciplexus.org

            Follow us at www.facebook.com/uciplexus

              Cover page: Plexus 2017:&nbsp;<em>Beneath the Surface, Between the Lines</em>Creative Commons 'BY' version 4.0 license
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