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Article ; Online: Neuregulin-1 attenuates hemolysis- and ischemia induced-cerebrovascular inflammation associated with sickle cell disease.

Chambliss, Christopher / Stiles, Jonathan K / Gee, Beatrice E

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2022 Volume 32, Issue 2, Page(s) 106912

Abstract: Objectives: Individuals with sickle cell disease (SCD) are at severely heightened risk for cerebrovascular injury and acute cerebrovascular events, including ischemic and hemorrhagic stroke, potentially leading to impaired development and life-long ... ...

Abstract	Objectives: Individuals with sickle cell disease (SCD) are at severely heightened risk for cerebrovascular injury and acute cerebrovascular events, including ischemic and hemorrhagic stroke, potentially leading to impaired development and life-long physical and cognitive disabilities. Cerebrovascular injury specific to SCD includes inflammation caused by underlying conditions of chronic hemolysis and reduced cerebrovascular perfusion. The objectives of this study were to investigate whether expression of neuregulin-1β (NRG-1), an endogenous neuroprotective polypeptide, is increased in SCD or experimental conditions mimicking the hemolysis and ischemic conditions of SCD, and to determine if treatment with exogenous NRG-1 reduces markers of cerebrovascular inflammation. Materials and methods: Plasma and brain-specific NRG-1 levels were measured in transgenic SCD mice. Endogenous NRG-1 levels and response to experimental conditions of excess heme and ischemia were measured in cultured human brain microvascular cells and astrocytes. Pre-treatment with NRG-1 was used to determine NRG-1's ability to ameliorate resultant cerebrovascular inflammation. Results: Plasma and brain-specific NRG-1 were elevated in transgenic SCD mice compared to healthy controls. Neuregulin-1 expression was significantly increased in cultured human microvascular cells and astrocytes exposed to excess heme and ischemia. Pre-treatment with NRG-1 reduced inflammatory chemokine (CXCL-1 and CXCL-10) and adhesion molecule (ICAM-1 and VCAM-1) expression and increased pro-angiogenic factors (VEGF-A) in microvascular cells and astrocytes exposed to excess heme and ischemia. Conclusions: Elevated NRG-1 in SCD is likely a protective endogenous response to ongoing cerebrovascular insults caused by chronic hemolysis and reduced cerebrovascular perfusion. Administration of NRG-1 to reduce cerebrovascular inflammation may be therapeutically beneficial in SCD and warrants continued investigation.
MeSH term(s)	Animals ; Humans ; Mice ; Anemia, Sickle Cell/complications ; Anemia, Sickle Cell/metabolism ; Anemia, Sickle Cell/pathology ; Heme ; Hemolysis/genetics ; Inflammation ; Ischemia ; Mice, Transgenic ; Neuregulin-1/metabolism
Chemical Substances	Heme (42VZT0U6YR) ; Neuregulin-1
Language	English
Publishing date	2022-12-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2022.106912
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Article ; Online: Modulation of Heme-Induced Inflammation Using MicroRNA-Loaded Liposomes: Implications for Hemolytic Disorders Such as Malaria and Sickle Cell Disease.

Bashi, Alaijah / Lekpor, Cecilia / Hood, Joshua L / Thompson, Winston E / Stiles, Jonathan K / Driss, Adel

International journal of molecular sciences

2023 Volume 24, Issue 23

Abstract: Hemolytic disorders, like malaria and sickle cell disease (SCD), are responsible for significant mortality and morbidity rates globally, specifically in the Americas and Africa. In both malaria and SCD, red blood cell hemolysis leads to the release of a ... ...

Abstract	Hemolytic disorders, like malaria and sickle cell disease (SCD), are responsible for significant mortality and morbidity rates globally, specifically in the Americas and Africa. In both malaria and SCD, red blood cell hemolysis leads to the release of a cytotoxic heme that triggers the expression of unique inflammatory profiles, which mediate the tissue damage and pathogenesis of both diseases. MicroRNAs (miRNAs), such as miR-451a and let-7i-5p, contribute to a reduction in the pro-inflammatory responses induced by circulating free hemes. MiR-451a targets both
MeSH term(s)	Humans ; MicroRNAs/metabolism ; Hemolysis ; Liposomes/metabolism ; Heme/metabolism ; Endothelial Cells/metabolism ; Hemopexin/metabolism ; Toll-Like Receptor 4/genetics ; Toll-Like Receptor 4/metabolism ; 14-3-3 Proteins/metabolism ; Anemia, Sickle Cell/genetics ; Anemia, Sickle Cell/metabolism ; Inflammation/genetics ; Inflammation/metabolism ; Anti-Inflammatory Agents/metabolism ; Malaria/metabolism
Chemical Substances	MicroRNAs ; Liposomes ; Heme (42VZT0U6YR) ; Hemopexin (9013-71-2) ; Toll-Like Receptor 4 ; 14-3-3 Proteins ; Anti-Inflammatory Agents
Language	English
Publishing date	2023-11-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms242316934
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Article ; Online: Neuregulin-1/ErbB4 signaling modulates

Harbuzariu, Adriana / Nti, Annette / Harp, Keri Oxendine / Cespedes, Juan C / Driss, Adel / Stiles, Jonathan K

iScience

2022 Volume 25, Issue 6, Page(s) 104407

Abstract: Human cerebral malaria (HCM) is a severe complication ... ...

Abstract	Human cerebral malaria (HCM) is a severe complication of
Language	English
Publishing date	2022-05-14
Publishing country	United States
Document type	Journal Article
ISSN	2589-0042
ISSN (online)	2589-0042
DOI	10.1016/j.isci.2022.104407
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Article ; Online: Angiogenic and angiostatic factors present in the saliva of malaria patients.

Lekpor, Cecilia Elorm / Botchway, Felix / Kusi, Kwadwo Asamoah / Adjei, Andrew A / Wilson, Michael D / Stiles, Jonathan K / Wilson, Nana O

Malaria journal

2022 Volume 21, Issue 1, Page(s) 220

Abstract: Background: Malaria related mortality is associated with significant deregulation of host inflammatory factors such as interferon-inducible protein 10, a member of the CXC or α-subfamily (CXCL10), and host angiogenic factors such as angiopoietin 1 (Ang- ... ...

Abstract	Background: Malaria related mortality is associated with significant deregulation of host inflammatory factors such as interferon-inducible protein 10, a member of the CXC or α-subfamily (CXCL10), and host angiogenic factors such as angiopoietin 1 (Ang-1) and angiopoietin 2 (Ang-2). However, detection of these factors in malaria patients requires the drawing of blood, which is invasive and increases the risk of accidental blood-borne infections. There has been an increased interest in the use of saliva as the body fluid of choice for the diagnosis of many infectious diseases including malaria. Here, saliva levels of CXCL10, Ang-1, and Ang-2 previously shown to be predictive of severe malaria in malaria patients in Ghana were assessed in malaria patients. Methods: This study was conducted in the Shai-Osudoku District Hospital in Dodowa, Accra, Ghana and the study population comprised 119 malaria patients and 94 non-malaria subjects. The non-malaria subjects are healthy community participants with no malaria infection. Plasma and saliva levels of CXCL10, Ang-1 and Ang-2 of the study participants were measured using an enzyme-linked immunoassay. Complete blood counts of each participant were measured with a haematology autoanalyzer. Pearson correlation was used to evaluate the correlation between plasma and saliva levels of each biomarker in malaria patients. A p-value of < 0.05 was considered significant. Box plots of median biomarker concentrations were plotted. SPSS version 14.2 software was used for statistical analysis. Results: The non-malaria subjects had a median age of 29 years compared to 23 years for malaria patients (p = 0.001). Among the malaria patients, there was a strong significant relationship between CXCL10 (R Conclusions: This study provides the first evidence of elevated levels of CXCL10 and Ang-2 in the saliva of malaria patients. Detection of CXCL10, Ang-1 and Ang-2 in saliva may have a potential application for non-invasive malaria diagnosis.
MeSH term(s)	Adult ; Angiopoietin-1 ; Angiopoietin-2 ; Biomarkers ; Ghana ; Humans ; Malaria/diagnosis ; Saliva
Chemical Substances	Angiopoietin-1 ; Angiopoietin-2 ; Biomarkers
Language	English
Publishing date	2022-07-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2091229-8
ISSN	1475-2875 ; 1475-2875
ISSN (online)	1475-2875
ISSN	1475-2875
DOI	10.1186/s12936-022-04221-7
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Article ; Online: The Role of Mock Reviewing Sessions in the National Research Mentoring Network Strategic Empowerment Tailored for Health Equity Investigators: A Randomized Controlled Study.

Mubasher, Mohamed / Pearson, Thomas / Idris, Muhammed Y / Lawson, Kimberly / Holmes, Jada / Pemu, Priscilla / Baez, Adriana / Stiles, Jonathan K / Salazar, Maritza S / Thompson, Winston E / Quarshie, Alexander / Caplan, Lee S / Strekalova, Yulia / Ofili, Elizabeth

International journal of environmental research and public health

2023 Volume 20, Issue 9

Abstract: The National Research Mentoring Network (NRMN) Strategic Empowerment Tailored for Health Equity Investigators (SETH) study evaluates the value of adding Developmental Network to Coaching in the career advancement of diverse Early-Stage Investigators ( ... ...

Abstract	The National Research Mentoring Network (NRMN) Strategic Empowerment Tailored for Health Equity Investigators (SETH) study evaluates the value of adding Developmental Network to Coaching in the career advancement of diverse Early-Stage Investigators (ESIs). Focused NIH-formatted Mock Reviewing Sessions (MRS) prior to the submission of grants can significantly enhance the scientific merits of an ESI's grant application. We evaluated the most prevalent design, analysis-related factors, and the likelihood of grant submissions and awards associated with going through MRS, using descriptive statistics, Chi-square, and logistic regression methods. A total of 62 out of 234 applications went through the MRS. There were 69.4% that pursued R grants, 22.6% career development (K) awards, and 8.0% other grant mechanisms. Comparing applications that underwent MRS versus those that did not (N = 172), 67.7% vs. 38.4% were submitted for funding (i.e., unadjusted difference of 29.3%; OR = 4.8, 95% CI = (2.4, 9.8),
MeSH term(s)	Humans ; United States ; Mentoring ; Health Equity ; Biomedical Research ; COVID-19/epidemiology ; Mentors
Language	English
Publishing date	2023-05-08
Publishing country	Switzerland
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20095738
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Article ; Online: Heme-mediated apoptosis and fusion damage in BeWo trophoblast cells.

Liu, Mingli / Hassana, Salifu / Stiles, Jonathan K

Scientific reports

2016 Volume 6, Page(s) 36193

Abstract: Placental malaria (PM) is a complication associated with malaria infection during pregnancy that often leads to abortion, premature delivery, intrauterine growth restriction and low birth weight. Increased levels of circulating free heme, a by-product of ...

Abstract	Placental malaria (PM) is a complication associated with malaria infection during pregnancy that often leads to abortion, premature delivery, intrauterine growth restriction and low birth weight. Increased levels of circulating free heme, a by-product of Plasmodium-damaged erythrocytes, is a major contributor to inflammation, tissue damage and loss of blood brain barrier integrity associated with fatal experimental cerebral malaria. However, the role of heme in PM remains unknown. Proliferation and apoptosis of trophoblasts and fusion of the mononucleated state to the syncytial state are of major importance to a successful pregnancy. In the present study, we examined the effects of heme on the viability and fusion of a trophoblast-derived cell line (BeWo). Results indicate that heme induces apoptosis in BeWo cells by activation of the STAT3/caspase-3/PARP signaling pathway. In the presence of forskolin, which triggers trophoblast fusion, heme inhibits BeWo cell fusion through activation of STAT3. Understanding the effects of free plasma heme in pregnant women either due to malaria, sickle cell disease or other hemolytic diseases, will enable identification of high-risk women and may lead to discovery of new drug targets against associated adverse pregnancy outcome.
MeSH term(s)	Apoptosis/drug effects ; Blood Proteins ; Caspase 3/metabolism ; Cell Differentiation/drug effects ; Cell Fusion ; Cell Line ; Colforsin/pharmacology ; Female ; Galectin 3/genetics ; Galectin 3/metabolism ; Galectins ; Gene Expression/drug effects ; Heme/toxicity ; Hemeproteins/pharmacology ; Humans ; Malaria/metabolism ; Malaria/parasitology ; Malaria/pathology ; Placenta/metabolism ; Placenta/parasitology ; Poly(ADP-ribose) Polymerases/metabolism ; Pregnancy ; Pregnancy Proteins/genetics ; Pregnancy Proteins/metabolism ; STAT3 Transcription Factor/metabolism ; Signal Transduction/drug effects ; Trophoblasts/cytology ; Trophoblasts/drug effects ; Trophoblasts/metabolism
Chemical Substances	Blood Proteins ; ERVFRD-1 protein, human ; Galectin 3 ; Galectins ; Hemeproteins ; LGALS3 protein, human ; Pregnancy Proteins ; STAT3 Transcription Factor ; Colforsin (1F7A44V6OU) ; hemozoin (39404-00-7) ; Heme (42VZT0U6YR) ; Poly(ADP-ribose) Polymerases (EC 2.4.2.30) ; Caspase 3 (EC 3.4.22.-)
Language	English
Publishing date	2016-10-31
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/srep36193
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Article ; Online: Cardiovascular risk factors among Ghanaian patients with HIV: A cross-sectional study.

Appiah, Lambert T / Sarfo, Fred S / Huffman, Mark D / Nguah, Samuel B / Stiles, Jonathan K

Clinical cardiology

2019 Volume 42, Issue 12, Page(s) 1195–1201

Abstract: Background: Cardiovascular disease (CVD) poses a significant cause of morbidity and mortality among people living with human immunodeficiency virus (HIV). However, data are limited on CVD risk burden among HIV patients in Ghana. We describe the age- and ...

Abstract	Background: Cardiovascular disease (CVD) poses a significant cause of morbidity and mortality among people living with human immunodeficiency virus (HIV). However, data are limited on CVD risk burden among HIV patients in Ghana. We describe the age- and sex-adjusted prevalence of CVD risk factors among HIV patients in Ghana. Methods: From January 2013 to May 2014, we identified eligible HIV patients 18 years and older, as well as uninfected adult blood donors presenting to the Komfo Anokye Teaching Hospital as controls. Using a standardized protocol, we collected demographic, clinical, laboratory, and electrocardiographic data. We created multivariable logistic regression models to compare the prevalence of abnormal risk factors between the two groups. Results: We recruited 345 patients with HIV (n = 173 on HAART, n = 172 not on HAART) and 161 uninfected adult blood donors. Patients with HIV were older (mean [SD] age: 41 [11] vs 32 [11] years) and were more likely to be female (72% vs 28%) than blood donors. Among patients on HAART, median (interquartile range) treatment duration was 17 (4-52) months. The prevalence of hypertension, hypercholesterolemia, and diabetes mellitus among HIV patients was 9%, 29%, and 5%, respectively, compared with 5%, 15%, and 0.6% among uninfected blood donors. Smoking was the least prevalent CVD risk factor (1%-2%). After adjustment for age, sex, and body mass index, HIV patients had a 10-fold higher odds of prevalent diabetes compared with controls, (adjusted OR = 10.3 [95% CI: 1.2, 86.7]). Conclusion: CVD risk factors are common among HIV patients in Ghana, demonstrating the urgent need for creation and implementation of strategic CVD interventions.
MeSH term(s)	Adult ; Antiretroviral Therapy, Highly Active ; Cardiovascular Diseases/epidemiology ; Cross-Sectional Studies ; Female ; Ghana ; HIV Infections/complications ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Young Adult
Language	English
Publishing date	2019-09-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	391935-3
ISSN	1932-8737 ; 0160-9289
ISSN (online)	1932-8737
ISSN	0160-9289
DOI	10.1002/clc.23273
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Article ; Online: Sickle Cell Hemoglobin Genotypes Affect Malaria Parasite Growth and Correlate with Exosomal miR-451a and let-7i-5p Levels.

Oxendine Harp, Keri / Bashi, Alaijah / Botchway, Felix / Addo-Gyan, Daniel / Tetteh-Tsifoanya, Mark / Lamptey, Amanda / Djameh, Georgina / Iqbal, Shareen A / Lekpor, Cecilia / Banerjee, Saswati / Wilson, Michael D / Dei-Adomakoh, Yvonne / Adjei, Andrew A / Stiles, Jonathan K / Driss, Adel

International journal of molecular sciences

2023 Volume 24, Issue 8

Abstract: Malaria affects a significant portion of the global population, with 247 million cases in 2021, primarily in Africa. However, certain hemoglobinopathies, such as sickle cell trait (SCT), have been linked to lower mortality rates in malaria patients. ... ...

Abstract	Malaria affects a significant portion of the global population, with 247 million cases in 2021, primarily in Africa. However, certain hemoglobinopathies, such as sickle cell trait (SCT), have been linked to lower mortality rates in malaria patients. Hemoglobin (Hb) mutations, including HbS and HbC, can cause sickle cell disease (SCD) when both alleles are inherited (HbSS and HbSC). In SCT, one allele is inherited and paired with a normal allele (HbAS, HbAC). The high prevalence of these alleles in Africa may be attributed to their protective effect against malaria. Biomarkers are crucial for SCD and malaria diagnosis and prognosis. Studies indicate that miRNAs, specifically miR-451a and let-7i-5p, are differentially expressed in HbSS and HbAS compared to controls. Our research examined the levels of exosomal miR-451a and let-7i-5p in red blood cells (RBCs) and infected red blood cells (iRBCs) from multiple sickle Hb genotypes and their impact on parasite growth. We assessed exosomal miR-451a and let-7i-5p levels in vitro in RBC and iRBC supernatants. Exosomal miRNAs exhibited distinct expression patterns in iRBCs from individuals with different sickle Hb genotypes. Additionally, we discovered a correlation between let-7i-5p levels and trophozoite count. Exosomal miR-451a and let-7i-5p could modulate SCD and malaria severity and serve as potential biomarkers for malaria vaccines and therapies.
MeSH term(s)	Animals ; Humans ; Parasites/metabolism ; Hemoglobins/metabolism ; Hemoglobin, Sickle/genetics ; Hemoglobin, Sickle/metabolism ; MicroRNAs/genetics ; Genotype ; Anemia, Sickle Cell/genetics ; Sickle Cell Trait/genetics ; Biomarkers ; Hemoglobin A/genetics ; Malaria/genetics
Chemical Substances	Hemoglobins ; Hemoglobin, Sickle ; MicroRNAs ; Biomarkers ; Hemoglobin A (9034-51-9)
Language	English
Publishing date	2023-04-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms24087546
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Article ; Online: Impact of COVID-19 on the Research Career Advancement of Health Equity Scholars from Diverse Backgrounds.

Báez, Adriana / Idris, Muhammed Y / Lawson, Kimberly / Mubasher, Mohamed / Strekalova, Yulia / Green, Keith / Pemu, Priscilla / Stiles, Jonathan K / Salazar, Martiza / Quarshie, Alexander / Caplan, Lee S / Alema-Mensah, Ernest / Pearson, Thomas / Faupel-Badger, Jessica / Engler, Jeffrey A / Ofili, Elizabeth O

International journal of environmental research and public health

2023 Volume 20, Issue 6

Abstract: The COVID-19 pandemic has significantly taxed scientific research and seems to have exacerbated existing inequities within the research field, particularly for early-stage investigators (ESIs). This study examines the effects of the COVID-19 pandemic on ... ...

Abstract	The COVID-19 pandemic has significantly taxed scientific research and seems to have exacerbated existing inequities within the research field, particularly for early-stage investigators (ESIs). This study examines the effects of the COVID-19 pandemic on traditionally underrepresented ESIs enrolled in an NIH-supported study evaluating the effectiveness of developmental networks, grant writing coaching, and mentoring on research career advancement. The survey consisted of 24 closed-ended (quantitative) and 4 open-ended questions (qualitative) linked to a participant's ability to meet grant submission deadlines, research and professional development disruptions, stress level, career transition level, self-efficacy and management of scholarly tasks, and familial responsibilities. Results from 32 respondents (53%) suggest that COVID-19 adversely impacted the continuity of research (81%) and grant submissions (63%). On average, grant submissions were delayed by 6.69 months (i.e., greater than one grant cycle). We also conducted additional analyses characterizing nonresponse and found that there were no significant predictors of nonresponse, indicating a limited threat to the validity of our findings. The disruption caused by COVID-19 to the careers of ESIs from underrepresented groups in the biomedical workforce has been profound in the short term. The long-term consequences to the future success of these groups are unknown but is a worthwhile area of research and potential innovation.
MeSH term(s)	Humans ; Health Equity ; Pandemics ; COVID-19/epidemiology ; Mentoring/methods ; Mentors ; Biomedical Research
Language	English
Publishing date	2023-03-08
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20064750
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Article ; Online: Individual and Institutional Factors Contribute to Research Capacity Building for Early-Stage Investigators from Groups Underrepresented in Biomedical Research: A Qualitative Comparative Analysis.

Strekalova, Yulia A Levites / Kornetti, Diana L / Wang, Ruixuan / Báez, Adriana / Caplan, Lee S / Idris, Muhammed Y / Lawson, Kimberly / Holmes, Jada / Mubasher, Mohamed / Pemu, Priscilla / Stiles, Jonathan K / Campo, Maritza Salazar / Quarshie, Alexander / Pearson, Thomas / Ofili, Elizabeth O

International journal of environmental research and public health

2023 Volume 20, Issue 9

Abstract: Background: Enhancement of diversity within the U.S. research workforce is a recognized need and priority at a national level. Existing comprehensive programs, such as the National Research Mentoring Network (NRMN) and Research Centers in Minority ... ...

Abstract	Background: Enhancement of diversity within the U.S. research workforce is a recognized need and priority at a national level. Existing comprehensive programs, such as the National Research Mentoring Network (NRMN) and Research Centers in Minority Institutions (RCMI), have the dual focus of building institutional research capacity and promoting investigator self-efficacy through mentoring and training. Methods: A qualitative comparative analysis was used to identify the combination of factors that explain the success and failure to submit a grant proposal by investigators underrepresented in biomedical research from the RCMI and non-RCMI institutions. The records of 211 participants enrolled in the NRMN Strategic Empowerment Tailored for Health Equity Investigators (NRMN-SETH) program were reviewed, and data for 79 early-stage, underrepresented faculty investigators from RCMI (n = 23) and non-RCMI (n = 56) institutions were included. Results: Institutional membership (RCMI vs. non-RCMI) was used as a possible predictive factor and emerged as a contributing factor for all of the analyses. Access to local mentors was predictive of a successful grant submission for RCMI investigators, while underrepresented investigators at non-RCMI institutions who succeeded with submitting grants still lacked access to local mentors. Conclusion: Institutional contexts contribute to the grant writing experiences of investigators underrepresented in biomedical research.
MeSH term(s)	Humans ; Capacity Building ; Biomedical Research ; Minority Groups/education ; Mentoring ; Mentors
Language	English
Publishing date	2023-04-27
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20095662
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