Recent Submissions

  • Toxic metals and pediatric clinical immune dysfunction: A systematic review of the epidemiological evidence

    Oktapodas Feiler, Marina; Kulick, Erin; Sinclair, Krystin Sinclair; Spiegel, Nitzana; Habel, Sonia; Given Castello, Olivia; Oktapodas Feiler|0000-0002-2315-9589; Given Castello|0000-0002-2721-9809; Kulick|0000-0001-8650-5357 (2024-04-11)
    Background: Children are at high risk for exposure to toxic metals and are vulnerable to their effects. Significant research has been conducted evaluating the role of these metals on immune dysfunction, characterized by biologic and clinical outcomes. However, there are inconsistencies in these studies. The objective of the present review is to critically evaluate the existing literature on the association between toxic metals (lead, mercury, arsenic, and cadmium) and pediatric immune dysfunction. Methods: Seven databases (PubMed (NLM), Embase (Elsevier), CINAHL (Ebsco), Web of Science (Clarivate Analytics), ProQuest Public Health Database, and ProQuest Environmental Science Collection) were searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in February 2024. Rayaan software identified duplicates and screened by title and abstract in a blinded and independent review process. The remaining full texts were reviewed for content and summarized. Exclusions during the title, abstract, and full-text reviews included: 1) not original research, 2) not epidemiology, 3) did not include toxic metals, 4) did not examine an immune health outcome, or 5) not pediatric (>18 years). This systematic review protocol followed the PRISMA guidelines. Rayaan was used to screen records using title and abstract by two blinded and independent reviewers. This process was repeated for full-text article screening selection. Results: The search criteria produced 7906 search results; 2456 duplicate articles were removed across search engines. In the final review, 79 studies were included which evaluated the association between toxic metals and outcomes indicative of pediatric immune dysregulation. Conclusions: The existing literature suggests an association between toxic metals and pediatric immune dysregulation. Given the imminent threat of infectious diseases demonstrated by the recent COVID-19 epidemic in addition to increases in allergic disease, understanding how ubiquitous exposure to these metals in early life can impact immune response, infection risk, and vaccine response is imperative.
  • Tweeting Conventions: Political journalists' use of Twitter to cover the 2012 presidential campaign

    Lawrence, Regina G.; Molyneux, Logan; Coddington, Mark; Holton, Avery; Molyneux|0000-0001-7382-3065 (2013-09-20)
    This study explores the use of Twitter by political reporters and commentators—an understudied population within the rapidly growing literature on digital journalism—covering the 2012 Republican and Democratic conventions. In particular, we want to know if and how the “affordances” of Twitter are shaping the traditional norms and routines of US campaign reporting surrounding objectivity, transparency, gatekeeping, and horse race coverage, and whether Twitter is bursting the “bubble” of insider talk among reporters and the campaigns they cover. A sample derived from all tweets by over 400 political journalists reveals a significant amount of opinion expression in reporters' tweets, but little use of Twitter in ways that improve transparency or disrupt journalists' (and campaigns') role as gatekeepers of campaign news. Overall, particularly when looking at what political journalists retweet and what they link to via Twitter, the campaign “bubble” seems at the moment to have remained largely intact.
  • US Political Journalists' Use of Twitter Lessons from 2012 and a Look Ahead

    Molyneux, Logan; Mourão, Rachel R.; Coddington, Mark; Molyneux|0000-0001-7382-3065 (2016-09-15)
  • Making Sources Visible: Representation of Evidence in News Texts, 2007–2019

    Coddington, Mark; Molyneux, Logan; Molyneux|0000-0001-7382-3065 (2021-07-05)
    Journalistic work is shifting toward more aggregative and intertextual forms, using published sources more often within their news routines and stories. This study examines that shift through the lens of evidence. It applies the concepts of evidentiary distance and ancillary evidence — that is, evidence about evidence — to news texts to explore their originality and transparency, and it approaches those texts as central sites in which journalists outline the basis for their knowledge claims and make the case for their epistemic authority. A content analysis of news texts from newspapers and digital newsrooms in 2007, 2013, and 2019 shows firsthand evidence is rarely presented. Non-mediated attributed speech is by far the evidence most often presented, but it has become less common over time, with corresponding increases in mediated speech and thirdhand evidence. Ancillary evidence describing evidentiary sources or evidence-gathering processes is also fairly rare. Results suggest that evidence in news stories is becoming intertextual but remains rather opaque, with digital and legacy news organizations becoming more similar over time.
  • “Let’s Not Tank the Reputation of This Organization.” How Newsroom Social Media Policies Exacerbate Journalism’s Labor Crisis

    Molyneux, Logan; Nelson, Jacob L.; Molyneux|0000-0001-7382-3065 (2023-09-27)
    This study explores the tension between journalists’ personal social media accounts and newsroom social media policies to understand how newsroom managers exacerbate journalism’s labor crisis by de-professionalizing the field through restrictive policies. To analyze this tension, we conduct a critical discourse analysis of (1) managerial discourses collected from newsroom social media policies and scholarly literature and (2) journalistic discourses collected from in-depth interviews with 37 U.S. journalists. We find that newsroom social media policies require journalists to make four sacrifices in service of their organization’s reputation: individuality, opinion, voice, and privacy. This leaves journalists feeling frustrated by their lack of agency when it comes to engaging with the public and pursuing social media success. We conclude that this conflict contributes to journalism’s human resources crisis by limiting journalistic professionalism and autonomy, both of which are crucial for job satisfaction and journalism’s democratic mission.
  • When Sources Contradict: The Epistemological Functions of Contradiction in News Texts

    Coddington, Mark; Molyneux, Logan; Molyneux|0000-0001-7382-3065 (2023-05-17)
    Contradiction is a defining characteristic of contemporary journalism, despite the risks it carries of raising uncertainty among audiences. Scholars and observers alike have called for journalists to embrace an epistemological stance rooted in adjudication of competing claims, but studies suggest journalists can only rarely perform this service. What, then, is the epistemological role of contradictions in journalism? This study employs quantitative and qualitative analysis of news texts over a 12-year span to explore tensions in journalistic norms that shape the presentation of contradictions. Findings suggest contradictions are infrequently presented in news texts and are usually between sources on equal footing. In the rare cases journalists themselves contradict their sources, these contradictions are neither explicit nor forceful. Many contradictions revolve around questions of interpretation.
  • How Newsroom Social Media Policies Can Improve Journalists' Well-Being

    Molyneux, Logan; Nelson, Jacob L.; Molyneux|0000-0001-7382-3065 (2023-11-13)
    This chapter draws on a discourse analysis of newsroom social media policies, and in-depth interviews with journalists focused on their reactions to the social media policies within the newsrooms in which they have worked, and their recommendations for how those policies should be improved.
  • From Thinking to Doing: Effects of Different Social Norms on Ethical Behavior in Journalism

    Lee, Angela M.; Coleman, Renita; Molyneux, Logan; Molyneux|0000-0001-7382-3065 (2016-05-02)
    Journalists have been shown to be highly capable of making good moral decisions, but they do not always act as ethically as studies show them to be able. Using the Reasoned Action Model, this study explores the gap between moral motivation and moral behavior and tests the proposition that different social norms can help predict how journalists behave across three ethical and three unethical behaviors (N=374). The study found that descriptive norms predicted ethical behaviors and that injunctive norms predicted unethical behaviors. Descriptive norms also accounted for more variance in journalists’ ethical behavior (48%) than injunctive norms did on unethical behavior (28%). The findings advance the Four-Component Model in significantly improving moral behavior predictability and offer a new way to assess journalists’ moral reasoning.
  • Legitimating a platform: evidence of journalists’ role in transferring authority to Twitter

    Molyneux, Logan; McGregor, Shannon C.; Molyneux|0000-0001-7382-3065 (2021-01-31)
    Studies suggest a growing interdependence between journalists and Twitter. What is behind this interdependence, and how does it manifest in news texts? We argue that social media platforms (and Twitter in particular) have situated themselves as purveyors of legitimated content, a projection that journalists have not fully challenged and at times abetted. Instead, journalists rely on these platforms both for access to powerful users and as conduits to surface the words of ‘ordinary people.’ This practice treats tweets more like content, an interchangeable building block of news, than like sources, whose ideas and messages must be verified. Using a corpus of U.S. news stories with tweets in them, we provide empirical evidence for our argument of the power of platforms to legitimate speech and shape journalism. This study illuminates journalists’ role in transferring some of the press’s authority to Twitter, thereby shaping the participants in and content of public deliberation.
  • Café Del Cerro: Miles de voces dirán que no fue en vano

    Morris, Nancy; Morris|0000-0001-5106-9268 (2022-12-30)
  • Cardiac strain is lower among women with HIV in relation to monocyte activation

    Center for Neurovirology and Gene Editing (Temple University) (2022-12-30)
    Background: Women with HIV (WWH) face heightened risks of heart failure; however, insights on immune/inflammatory pathways potentially contributing to left ventricular (LV) systolic dysfunction among WWH remain limited. Setting: Massachusetts General Hospital, Boston, Massachusetts. Methods: Global longitudinal strain (GLS) is a sensitive measure of LV systolic function, with lower cardiac strain predicting incident heart failure and adverse heart failure outcomes. We analyzed relationships between GLS (cardiovascular magnetic resonance imaging) and monocyte activation (flow cytometry) among 20 WWH and 14 women without HIV. Results: WWH had lower GLS compared to women without HIV (WWH vs. women without HIV: 19.4±3.0 vs. 23.1±1.9%, P<0.0001). Among the whole group, HIV status was an independent predictor of lower GLS. Among WWH (but not among women without HIV), lower GLS related to a higher density of expression of HLA-DR on the surface of CD14+CD16+ monocytes (ρ = -0.45, P = 0.0475). Further, among WWH, inflammatory monocyte activation predicted lower GLS, even after controlling for CD4+ T-cell count and HIV viral load. Conclusions: Additional studies among WWH are needed to examine the role of inflammatory monocyte activation in the pathogenesis of lower GLS and to determine whether targeting this immune pathway may mitigate risks of heart failure and/or adverse heart failure outcomes. Trial registration: Clinical trials.gov registration: NCT02874703.
  • Development of a Web-Based Diabetes Prevention Program (DPP) for Chinese Americans: A Formative Evaluation Approach

    Center for Asian Health (Temple University) (2022-12-29)
    Increasing evidence demonstrates that an online Diabetes Prevention Program (DPP) can delay the onset of type 2 diabetes. However, little has been done for Chinese Americans. This study, using Community-Based Participatory Research and Intervention Mapping approaches, describes a formative research process in the development of a culturally and linguistically tailored online DPP program among Chinese Americans with prediabetes living in New York City. Using a triangulation approach, data were collected to inform the development of an online DPP curriculum through (1) a literature review, (2) three focus groups (n = 24), and (3) a community advisory board meeting among 10 key informants knowledgeable in community needs, diabetes care, and lifestyle interventions. Participants indicated online DPPs would be very useful and easily accessible. However, key barriers including low computer skills/literacy and technology self-efficacy were identified. In addition, taking meal photos and tracking pedometer steps daily were found to be acceptable self-motoring tools for sustaining a healthy lifestyle. Furthermore, the integration of features such as text message reminders and the creation of social support groups into the online DPP curriculum was proposed to minimize attrition. This theory-based formative research to develop a culturally and linguistically appropriate web-based DPP curriculum was well-received by Chinese Americans and warrants testing in future intervention studies.
  • The company we keep. Using hemodialysis social network data to classify patients’ kidney transplant attitudes with machine learning algorithms

    Center for Data Analytics and Biomedical Informatics (Temple University) (2022-12-29)
    Background: Hemodialysis clinic patient social networks may reinforce positive and negative attitudes towards kidney transplantation. We examined whether a patient’s position within the hemodialysis clinic social network could improve machine learning classification of the patient’s positive or negative attitude towards kidney transplantation when compared to sociodemographic and clinical variables. Methods: We conducted a cross-sectional social network survey of hemodialysis patients in two geographically and demographically different hemodialysis clinics. We evaluated whether machine learning logistic regression models using sociodemographic or network data best predicted the participant’s transplant attitude. Models were evaluated for accuracy, precision, recall, and F1-score. Results: The 110 surveyed participants’ mean age was 60 ± 13 years old. Half (55%) identified as male, and 74% identified as Black. At facility 1, 69% of participants had a positive attitude towards transplantation whereas at facility 2, 45% of participants had a positive attitude. The machine learning logistic regression model using network data alone obtained a higher accuracy and F1 score than the sociodemographic and clinical data model (accuracy 65% ± 5% vs. 61% ± 7%, F1 score 76% ± 2% vs. 70% ± 7%). A model with a combination of both sociodemographic and network data had a higher accuracy of 74% ± 3%, and an F1-score of 81% ± 2%. Conclusion: Social network data improved the machine learning algorithm’s ability to classify attitudes towards kidney transplantation, further emphasizing the importance of hemodialysis clinic social networks on attitudes towards transplant.
  • S-Nitrosoglutathione Reduces the Density of Staphylococcus aureus Biofilms Established on Human Airway Epithelial Cells

    Center of Inflammation and Lung Research (Temple University) (2022-12-28)
    Patients with chronic rhinosinusitis (CRS) often show persistent colonization by bacteria in the form of biofilms which are resistant to antibiotic treatment. One of the most commonly isolated bacteria in CRS is Staphylococcus aureus (S. aureus). Nitric oxide (NO) is a potent antimicrobial agent and disperses biofilms efficiently. We hypothesized that S-nitrosoglutathione (GSNO), an endogenous NO carrier/donor, synergizes with gentamicin to disperse and reduce the bacterial biofilm density. We prepared GSNO formulations which are stable up to 12 months at room temperature and show the maximum amount of NO release within 1 h. We examined the effects of this GSNO formulation on the S. aureus biofilm established on the apical surface of the mucociliary-differentiated airway epithelial cell cultures regenerated from airway basal (stem) cells from cystic fibrosis (CF) and CRS patients. We demonstrate that for CF cells, which are defective in producing NO, treatment with GSNO at 100 μM increased the NO levels on the apical surface and reduced the biofilm bacterial density by 2 log units without stimulating pro-inflammatory effects or inducing epithelial cell death. In combination with gentamicin, GSNO further enhanced the killing of biofilm bacteria. Compared to placebo, GSNO significantly increased the ciliary beat frequency (CBF) in both infected and uninfected CF cell cultures. The combination of GSNO and gentamicin also reduced the bacterial density of biofilms grown on sinonasal epithelial cells from CRS patients and improved the CBF. These findings demonstrate that GSNO in combination with gentamicin may effectively reduce the density of biofilm bacteria in CRS patients. GSNO treatment may also enhance the mucociliary clearance by improving the CBF.
  • Lack of Mitogen-activated Kinase Phosphatase-5 in Macrophages Protects Ldlr-null Mice against Atherogenesis

    Zhang, Xinbo; Zhao, Zhiqiang; Baldini, Margaret; Zhang, Cheng; Tao, Bo; Zhang, Lei; Bennett, Anton M.; Yu, Jun; Zhang|0000-0001-8932-0585; Yu|0000-0003-4530-2179 (2022-12-29)
    Background: Mitogen-activated protein kinases, including JNK, ERK, and p38 mitogen-activated protein kinase, are critical in regulating the expression of various proinflammatory and anti-inflammatory cytokines and chemokines. Previous work has suggested that the absence of MAP kinase phosphatase-5 (MKP-5) inhibits oxidized low-density lipoprotein (oxLDL)-induced macrophage foam cell formation without influencing the MAKP activation. The current study is to determine the role of macrophage MKP-5 in the pathogenesis of atherosclerosis and underlying mechanisms. Methods: Nine-week-old male congenic MKP-5 deficient (MKP-5–/–) and C57Bl/6J control (WT) mice on an low-density lipoprotein (LDL) receptor knock-out (LDLR–/–) background were fed with a high-fat diet containing 1.25% cholesterol for 14 weeks. Global deficiency of MKP-5 attenuated atherosclerotic plaque formation without altering the lipid profile in vivo. To further elucidate the macrophage-specific effect of MKP-5 in atherogenesis, lethally irradiated LDLR–/– mice were transplanted with wild-type or MKP-5–/– bone marrow and subjected to high-fat feeding. Results: Mice transplanted with MKP-5–/– bone marrow developed smaller atherosclerotic lesions accompanied by decreased lipid deposition and macrophage content compared with wild type. Lack of MKP-5 in macrophages reduced plasma levels of interleukin-1α (IL-1α) and IL-7, elevated anti-inflammatory cytokines IL-1 receptor antagonist (IL-1rn), and IL-4. Mechanistically, lack of MKP-5 in macrophages inhibited ox-LDL-induced foam cell formation through enhanced cholesterol efflux mediated by increased expression of ATP-binding cassette transporters ABCA1 and ABCG1. Conclusions: These data suggest that the myeloid MKP-5 deficiency reduces atherosclerosis progression and foam cell formation by ameliorating cholesterol efflux and inhibiting inflammation.
  • Case report: diagnosis of chronic Chagas cardiomyopathy using a multimodality imaging approach

    Li, Shannon X.; Soles, Estefania Oliveros; Sharma, Parikshit S.; Rao, Anupama K. (2023-01-06)
    Background: In the USA, ∼300 000 people are affected by Chagas heart disease, a growing, but commonly overlooked, public health issue. Chagas as a potential aetiology of dilated cardiomyopathy remains under-recognized. We present a case where multimodality imaging was essential in the diagnosis and management of Chagas heart disease. Case summary: A 54-year-old man, originally from Mexico, presented to the emergency department with chest pain and recurrent syncopal episodes, found to be in haemodynamically unstable ventricular tachycardia (VT) requiring urgent cardioversion. Urgent coronary angiography revealed no obstructive disease. A transthoracic echocardiogram revealed moderately reduced left ventricular systolic function (left ventricular ejection fraction 35–40%) with apical akinesis and an aneurysm of the apical septum. Cardiac magnetic resonance (CMR) confirmed a prominent apical aneurysm with dyskinesis of the apical septum, with the evidence of transmural myocardial late gadolinium enhancement of the entire left ventricular apex and a small apical thrombus. Serologic testing was positive for Trypanosoma cruzi IgG antibody, which was confirmed on repeat testing at the Centers for Disease Control and Prevention. Patient underwent VT ablation and was discharged on guideline-directed medical therapy including a regimen of anticoagulation, beta-blocker, and angiotensin-converting enzyme inhibitor therapies. He has had no subsequent syncope or VT. Discussion: Chagas heart disease remains under-recognized and under-diagnosed despite the growing burden of T. cruzi infection in the USA. Suspicion for Chagas heart disease should be considered in patients presenting with heart failure symptoms and ventricular arrhythmias with the right corresponding history and imaging findings on echocardiogram and CMR.
  • Integrating community-based HIV and non-communicable disease care with microfinance groups: a feasibility study in Western Kenya

    Kafu, Catherine; Wachira, Juddy; Omodi, Victor; Said, Jamil; Pastakia, Sonak D.; Tran, Dan; Onyango, Jael Adongo; Aburi, Dan; Wilson-Barthes, Marta; Galárraga, Omar; Genberg, Becky Lynn; Tran|0000-0002-8332-8196 (2022-12-28)
    Background: The Harambee study is a cluster randomized trial in Western Kenya that tests the effect, mechanisms, and cost-effectiveness of integrating community-based HIV and non-communicable disease care within microfinance groups on chronic disease treatment outcomes. This paper documents the stages of our feasibility study conducted in preparation for the Harambee trial, which include (1) characterizing the target population and gauging recruitment capacity, (2) determining community acceptability of the integrated intervention and study procedures, and (3) identifying key implementation considerations prior to study start. Methods: Feasibility research took place between November 2019 and February 2020 in Western Kenya. Mixed methods data collection included surveys administered to 115 leaders of 105 community-based microfinance groups, 7 in-person meetings and two workshops with stakeholders from multiple sectors of the health system, and ascertainment of field notes and geographic coordinates for group meeting locations and HIV healthcare facilities. Quantitative survey data were analyzed using STATA IC/13. Longitude and latitude coordinates were mapped to county boundaries using Esri ArcMap. Qualitative data obtained from stakeholder meetings and field notes were analyzed thematically. Results: Of the 105 surveyed microfinance groups, 77 met eligibility criteria. Eligible groups had been in existence from 6 months to 18 years and had an average of 22 members. The majority (64%) of groups had at least one member who owned a smartphone. The definition of “active” membership and model of saving and lending differed across groups. Stakeholders perceived the community-based intervention and trial procedures to be acceptable given the minimal risks to participants and the potential to improve HIV treatment outcomes while facilitating care integration. Potential challenges identified by stakeholders included possible conflicts between the trial and existing community-based interventions, fear of group disintegration prior to trial end, clinicians’ inability to draw blood for viral load testing in the community, and deviations from standard care protocols. Conclusions: This study revealed that it was feasible to recruit the number of microfinance groups necessary to ensure that our clinical trial was sufficient powered. Elicitation of stakeholder feedback confirmed that the planned intervention was largely acceptable and was critical to identifying challenges prior to implementation. Trial registration: The original trial was prospectively registered with ClinicalTrials.gov (NCT04417127) on 4 June 2020.
  • ApoJ/Clusterin concentrations are determinants of cerebrospinal fluid cholesterol efflux capacity and reduced levels are associated with Alzheimer’s disease

    Alzheimer’s Center (Temple University) (2022-12-26)
    Background: Alzheimer’s disease (AD) shares risk factors with cardiovascular disease (CVD) and dysregulated cholesterol metabolism is a mechanism common to both diseases. Cholesterol efflux capacity (CEC) is an ex vivo metric of plasma high-density lipoprotein (HDL) function and inversely predicts incident CVD independently of other risk factors. Cholesterol pools in the central nervous system (CNS) are largely separate from those in blood, and CNS cholesterol excess may promote neurodegeneration. CEC of cerebrospinal fluid (CSF) may be a useful measure of CNS cholesterol trafficking. We hypothesized that subjects with AD and mild cognitive impairment (MCI) would have reduced CSF CEC compared with Cognitively Normal (CN) and that CSF apolipoproteins apoA-I, apoJ, and apoE might have associations with CSF CEC. Methods: We retrieved CSF and same-day ethylenediaminetetraacetic acid (EDTA) plasma from 108 subjects (40 AD; 18 MCI; and 50 CN) from the Center for Neurodegenerative Disease Research biobank at the Perelman School of Medicine, University of Pennsylvania. For CSF CEC assays, we used N9 mouse microglial cells and SH-SY5Y human neuroblastoma cells, and the corresponding plasma assay used J774 cells. Cells were labeled with [3H]-cholesterol for 24 h, had ABCA1 expression upregulated for 6 h, were exposed to 33 μl of CSF, and then were incubated for 2.5 h. CEC was quantified as percent [3H]-cholesterol counts in medium of total counts medium+cells, normalized to a pool sample. ApoA-I, ApoJ, ApoE, and cholesterol were also measured in CSF. Results: We found that CSF CEC was significantly lower in MCI compared with controls and was poorly correlated with plasma CEC. CSF levels of ApoJ/Clusterin were also significantly lower in MCI and were significantly associated with CSF CEC. While CSF ApoA-I was also associated with CSF CEC, CSF ApoE had no association with CSF CEC. CSF CEC is significantly and positively associated with CSF Aβ. Taken together, ApoJ/Clusterin may be an important determinant of CSF CEC, which in turn could mitigate risk of MCI and AD risk by promoting cellular efflux of cholesterol or other lipids. In contrast, CSF ApoE does not appear to play a role in determining CSF CEC.

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