Measures of Referral vs Receipt of Social Services Among Patients With Health-Related Social Needs.

This cohort study compares measures of referral vs receipt in evaluating social resource platform outcomes among patients with health-related social needs.

ParallelED-A novel screening and referral intervention using emergency department wait times to identify and address unmet social needs.

Background: People arriving at the emergency department (ED) often have unmet health-related social needs (HRSN). We implemented an intervention that used undergraduate student volunteers to screen patients in the ED waiting room (WR) for unmet social drivers of health and subsequently referred patients to community resources. Methods: This cross-sectional quality improvement study included patients who were approached to complete a HRSN screening questionnaire, subsequently referred to community resources, and followed up by phone from October 2021 to October 2022 in an ED WR of an academic medical center. Primary measures were the proportions of patients who had unmet HRSN and the proportions enrolled in a statewide database of social care resources-NCCARE360. Patient demographics and geospatial distribution were also assessed to better understand the population served. Results: Our intervention reached 3297 unique patients, with 398 patients (12%) agreeing to complete screening. Of those screened, 93% were positive for at least one social need and 95% of the aforementioned were interested in receiving assistance. A total of 60% of those who screened positive were enrolled into NCCARE360. Persons identifying as female or non-Hispanic Black were disproportionately represented at a higher rate among those who screened positive for at least one social need, with food and housing insecurity emerging as the most common referral categories. Conclusion: Our results demonstrate patients' willingness to be screened in the ED WR and a high identification of HRSN. Our findings show that idle time in the ED WR can be used to identify patients with unmet HRSN and refer them to resources.

OnabotulinumtoxinA effects on trigeminal nociceptors.

BACKGROUND: OnabotulinumtoxinA (onabotA) is approved globally for prevention of chronic migraine; however, the classical mechanism of action of onabotA in motor and autonomic neurons cannot fully explain the effectiveness of onabotulinumtoxinA in this sensory neurological disease. We sought to explore the direct effects of onabotulinumtoxinA on mouse trigeminal ganglion sensory neurons using an inflammatory soup-based model of sensitization. METHODS: Primary cultured trigeminal ganglion neurons were pre-treated with inflammatory soup, then treated with onabotulinumtoxinA (2.75 pM). Treated neurons were used to examine transient receptor potential vanilloid subtype 1 and transient receptor potential ankyrin 1 cell-surface expression, calcium influx, and neuropeptide release. RESULTS: We found that onabotulinumtoxinA cleaved synaptosomal-associated protein-25 kDa in cultured trigeminal ganglion neurons; synaptosomal-associated protein-25 kDa cleavage was enhanced by inflammatory soup pre-treatment, suggesting greater uptake of toxin under sensitized conditions. OnabotulinumtoxinA also prevented inflammatory soup-mediated increases in TRPV1 and TRPA1 cell-surface expression, without significantly altering TRPV1 or TRPA1 protein expression in unsensitized conditions. We observed similar inhibitory effects of onabotulinumtoxinA on TRP-mediated calcium influx and TRPV1- and TRPA1-mediated release of calcitonin gene-related peptide and prostaglandin 2 under sensitized, but not unsensitized control, conditions. CONCLUSIONS: Our data deepen the understanding of the sensory mechanism of action of onabotulinumtoxinA and support the notion that, once endocytosed, the cytosolic light chain of onabotulinumtoxinA cleaves synaptosomal-associated protein-25 kDa to prevent soluble N-ethylmaleimide-sensitive factor attachment protein receptor-mediated processes more generally in motor, autonomic, and sensory neurons.

Cooperation between ETS variant 2 and Jumonji domain­containing 2 histone demethylases.

The E26 transformation-specific (ETS) variant 2 (ETV2) protein, also designated as ETS-related 71, is a member of the ETS transcription factor family and is essential for blood and vascular development in the embryo. The role of ETV2 in cancer has not yet been investigated. In the present study, the expression of ETV2 mRNA was identified in a variety of tumor types, including prostate carcinoma. In addition, ETV2 gene amplification was identified in several types of cancer, suggesting that ETV2 plays an oncogenic role in tumorigenesis. It was demonstrated that ETV2 forms complexes with two histone demethylases: Jumonji domain­containing (JMJD)2A and JMJD2D; JMJD2A has been previously reported as a driver of prostate cancer development. In the present study, it was reported that ETV2 exhibited the potential to stimulate the promoters of matrix metalloproteinases (MMPs), including MMP1 and MMP7, within LNCaP prostate cancer cells. JMJD2A and JMJD2D could synergize with ETV2 to activate the MMP1 promoter, whereas only JMJD2A stimulated the MMP7 promoter in cooperation with ETV2. Furthermore, ETV2 expression was positively associated with JMJD2A and JMJD2D mRNA levels in neuroendocrine prostate tumors, in which an ETV2 gene amplification rate of 17.8% was identified. Collectively, the results of the present study indicated that ETV2, JMJD2A and JMJD2D may jointly promote tumorigenesis, particularly neuroendocrine prostate tumors. In addition, the interaction with the JMJD2A and JMJD2D epigenetic regulators may be important in the ability of ETV2 to reprogram cells, modulate normal and cancer stem cells, and affect spermatogenesis.