eScholarship@UMassChan
eScholarship@UMassChan is a digital archive for UMass Chan Medical School's research and scholarship, including journal articles, theses, datasets and more. We welcome submissions from our faculty, staff, and students. eScholarship@UMassChan is a service of the Lamar Soutter Library, Worcester, MA, USA. See also our open access journal publishing services.
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Recent Publications
Publication Changes to Parental Consent Requirements for Abortion in Massachusetts and Impact on Timeliness of Care for Adolescents Aged 16 to 17 Years(2025-03)To measure the effect of the ROE Act on abortion timing for adolescents aged 16 to 17 years in Massachusetts. The primary outcome was gestational duration at abortion for individuals aged 16 to 19 years at Planned Parenthood League of Massachusetts from 2017 to 2022. Our control group included individuals aged 18 to 19 years undergoing abortions. In our primary analysis, we used a comparative interrupted time series with a linear model to capture temporal trends, seasonality, whether an abortion was undergone during the acute phase of the COVID-19 pandemic, previous abortion, and race/ethnicity categories. Minors aged 16 to 17 years underwent 749 abortions during the study. Individuals aged 18 to 19 years underwent 2773 abortions. The ROE Act resulted in a 5.46-day decrease in gestational duration at abortion among minors (95% confidence interval = -11.82, 0.91). Removal of the parental involvement requirement for adolescents aged 16 to 17 years in Massachusetts led to minors undergoing abortions at earlier gestational durations, highlighting the importance of potential impacts of similar legislation to decrease barriers to abortion access for minors. (. 2025;115(3):397-402. https://doi.org/10.2105/AJPH.2024.307918).Publication Prevalence and Co-Detection Rates of SARS-CoV-2, Influenza, and Respiratory Syncytial Virus: A Retrospective Analysis(2025-03)In late 2022, there was a significant increase in the prevalence of RSV in the northeastern United States. This surge occurred concurrently with the beginning of the traditional influenza season and the ongoing circulation of SARS-CoV-2. We retrospectively analyzed respiratory testing data at a regional reference laboratory from September 2022 to April 2024 to characterize the prevalence and incidence of co-detection of RSV, influenza A, influenza B, and SARS-CoV-2 in the northeastern United States. The positivity rates were found to be 16.68% for SARS-CoV-2, 11.66% for influenza A, 0.83% for influenza B, and 9.11% for RSV during the study period. Co-detections were observed in 0.49% of samples, with SARS-CoV-2/influenza A co-detection being the most common. Co-detections occurred less frequently than expected based on individual positivity rates. During the study period, influenza B positivity increased over 10-fold, SARS-CoV-2 positivity decreased by 60%, and co-detection was more prevalent in the pediatric population.Publication 4D marmoset brain map reveals MRI and molecular signatures for onset of multiple sclerosis-like lesions(2025-02-28)Inferring cellular and molecular dynamics of multiple sclerosis (MS) lesions from postmortem tissue collected decades after onset is challenging. Using magnetic resonance image (MRI)-guided spatiotemporal RNA profiling in marmoset experimental autoimmune encephalitis (EAE), we mapped lesion dynamics and modeled molecular perturbations relevant to MS. Five distinct lesion microenvironments emerged, involving neuroglial responses, tissue destruction and repair, and brain border regulation. Before demyelination, MRI identified a high ratio of proton density-weighted signal to relaxation time, capturing early hypercellularity, and elevated astrocytic and ependymal senescence signals marked perivascular and periventricular areas that later became demyelination hotspots. As lesions expanded, concentric glial barriers formed, initially dominated by proliferating and diversifying microglia and oligodendrocyte precursors, later replaced by monocytes and lymphocytes. We highlight SERPINE1 astrocytes as a signaling hub underlying lesion onset in both marmoset EAE and MS.Publication Nurse PATHIT: An Adapted Framework for Nurse Support for Patient Activation Through Health Information Technology(2025-02-28)Aims: This article presents an adapted framework that integrates the Patient Health Engagement (PHE) model with Orem's Nursing Systems theory. The framework highlights the nursing role in encouraging Health Information Technology (HIT) tools, such as secure messaging and patient portals, to enhance patient activation and support their self-care capabilities, particularly in chronic disease management aided by nursing actions. Background: Despite HIT's role in improving patient care and the increased government incentives for its adoption, utilisation remains low due to various sociodemographic factors and psychosocial factors. The nursing discipline addresses these factors in its practice and thus could facilitate the use of HIT-related tools for patients. We propose an adapted framework embedded in nursing priorities for building self-care agencies in patients centred around HIT use. Methods: We aligned Orem's nursing system model and PHE model to propose an adapted Nurse PATHIT framework that provides actions and considerations for nursing discipline to target the HIT tools for enhancement of patient activation in chronic care engagement based on patient's readiness. Results: The integration of the PHE model with Nursing System theory offers a framework for promoting HIT use as one of the tools for managing chronic diseases by building self-care agency in patients. Three of the four stages of the PHE model-blackout, arousal and adhesion-correspond to the wholly compensatory, partially compensatory and supportive approaches within Nursing Systems theory. Conclusion: Adapting the PHE model with Orem's Nursing System theory in the form of Nurse PATHIT creates a comprehensive framework for nurses to encourage the use of HIT tools in chronic disease management. Future research on patient-centred outcomes using HIT can test this framework by incorporating support and motivation for HIT use for patients as one of the tools to actively engage patients in nursing care planning to increase patients' self-care agency.Publication Long-term safety and efficacy of the FRED X flow diverter for intracranial aneurysms: a multicenter study of 154 patients(2025-02-28)Objective: The Flow-Redirection Endoluminal Device X (FRED X) is a newer generation flow diverter with surface modifications aimed at minimizing thrombogenicity. At present, data on its long-term efficacy are limited. This multicenter study presents the largest series within the United States describing the device's efficacy, safety, and long-term outcomes in treating cerebral aneurysms of varying morphology. Methods: Patients treated with the FRED X for a cerebral aneurysm between February 2022 and February 2024 at 6 high-volume centers across the United States were included. Data were collected regarding demographics, clinical presentation, and procedural efficacy. Angiographic and clinical follow-up outcomes were assessed at 6 and 12 months. Results: A total of 154 patients with 162 aneurysms were treated with 164 FRED X devices over the study period. Overall, 81.8% of the cohort was female with a mean age of 56.8 years. The authors observed satisfactory rates (≥ 99.3%) of device deployment and good wall apposition and neck coverage. One hundred forty-seven (95.5%) patients were functionally independent at discharge (modified Rankin Scale scores 0-2). Rates of adequate occlusion (Raymond-Roy Occlusion Scale score I or II) increased from 84.2% at 6 months to 83.5% at the 12-month follow-up, while rates of in-stent stenosis decreased. All patients (100%) who underwent follow-up were functionally independent at 6 months, and 95.9% were functionally independent at 12 months. Conclusions: This multicenter cohort study demonstrates the ease of FRED X deployment with an adequate safety profile, with low rates of procedural complications and favorable outcomes on follow-up. Rates of aneurysm occlusion increased over time, with a subsequent decrease in stent-associated complications.