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 Metadata only National Trends in Lung Cancer Stage, Treatment, and Time to Treatment Initiation After a Major Healthcare Disruption (NCDB 2014-2022)(2026-02-26)INTRODUCTION: Healthcare system (HCS) disruptions during COVID-19 have significantly impacted cancer diagnostics and treatment management. This study examined the effects of the COVID-19 pandemic on the staging at diagnosis, initial treatment patterns, and time to treatment initiation (TTI) for non-small cell lung cancer (NSCLC), focusing on disparities across healthcare settings and demographics. METHODS: We conducted a retrospective cohort analysis of NSCLC cases in the US National Cancer Database (2014-2022), excluding records with missing TTI or clinical stage data. Outcomes were compared before (2014-2019) and after (2021-2022) the healthcare system disruption using chi-square tests, t-tests, and interrupted time series analysis. RESULTS: A total of 865,808 individuals were included (mean age 69; 50% female; 82% White; 73% Medicare/Medicaid). Early-stage diagnoses increased from 44% to 46% (p<0.01). Minor differences were observed in initial treatment patterns. Mean TTI increased by approximately 9 days (p<0.01), with community cancer programs showing the greatest increase (+10 days) compared to other facilities. Regional differences were also noted, with New England experiencing the highest TTI increase (+12 days). Black individuals faced longer TTIs (56 vs 51 days for White patients), though White patients experienced the greatest increased (+9 days). CONCLUSIONS: Healthcare system disruptions due to COVID-19 were associated with delayed NSCLC diagnoses, longer treatment initiation, and persistent disparities in access to timely care. While short-term survival differences were modest, earlier treatment initiation remained associated with improved outcomes. Further research is needed to evaluate whether these delays persist and to explore their long-term consequences on patient outcomes. POLICY SUMMARY: This evidence calls for resilience-focused oncology policies, supporting continuity plans, real-time delay monitoring, and targeted resource allocation to underserved and outpatient settings.Publication Open Access The Use of Artificial Intelligence in Suicide Prevention and Mental Health Support(University of Massachusetts Chan Medical School, 2026-02-26)These are questions and guidance for researchers developing or applying for funding related to artificial intelligence for use in mental health and suicide prevention. Persons with a range of lived experiences—from acute to chronic suicidal despair—should be meaningfully included in the design and development of AI tools, to ensure the content is grounded in real world perspectives.Publication Open Access Transposable element-gene chimera cartography, origination and role in enhancing transcriptome plasticity(2026-02-25)Transposable elements (TEs) in the human genome are the heritage of ancient parasitic infections. While most of human DNA comprises TEs and TE-derived elements, their repetitive nature poses technical challenges; thus, little is known about their positional identity and regulatory roles. Here, by integrating long-read and multidimensional transcriptional analyses, we investigate when, where and how TEs become part of a gene. We characterize how TE-derived isoforms change across mouse-human variation and how they are linked to gene regulatory networks controlling cell states during differentiation, organogenesis and health (aging and pathological states). Mechanistically, we identify an RNA degradation-dependent and splicing-dependent quality control mechanism that operates independently of conventional mechanisms of TE suppression, such as DNA methylation and heterochromatinization, and prevents TE-chimera expression and TE-induced cell differentiation. Overall, our findings unveil mechanisms by which viral-derived elements enhance transcriptome plasticity.Publication Open Access "QuickStainer": a rapid negative staining device for improved preservation of molecular structure(2026-02-21)Negative staining is a widely used technique for observing macromolecules and their assemblies by transmission electron microscopy. It is commonly employed to optimize specimens for cryo-EM. The stain, typically a uranyl salt, surrounds the structure, providing an outline view at about 20 Å resolution. Many macromolecules are relatively stable and rigid, and negative stain images provide a good representation of their structure. However, some are labile or flexible and their structure or assembly state is altered by binding to the carbon substrate on the grid before specimen staining. In these cases, the negatively stained appearance does not faithfully represent the structure in solution. This problem is reduced when samples are incubated on the carbon surface for short times (5 s) rather than typical times (30-60 s) before staining. To reduce disruption to a minimum, we have developed a rapid negative staining device (QuickStainer) using 3D-printed components, a stepper motor for precisely timed movements, and an Arduino-controlled interface to execute commands. QuickStainer produces consistent sample incubation times as low as 10 ms before staining. Tests show rapid adherence of molecules to the grid and greatly improved structural preservation of labile specimens compared with standard preparation protocols. The design of QuickStainer can accommodate inclusion of additional steps, such as timed incubation with enzyme substrate, before staining.Publication Metadata only Development, image interpretation, clinical experience, and applications of optical coherence tomography in neurointerventional surgery(2026-02-20)Angiography remains the standard imaging modality for evaluating vascular disease and guiding endovascular interventions; however, its limited spatial resolution restricts visualization of vessel wall pathology and therapeutic devices. Over the past decade, intravascular optical coherence tomography (OCT) has emerged as a transformative tool in coronary artery disease. OCT provides three-dimensional, high-resolution imaging of coronary arteries, enabling assessment of vessel wall microstructure, plaque composition, lumen geometry, and stent deployment. This level of detail has advanced the understanding of coronary pathology and contributed to improved outcomes in percutaneous coronary interventions. Major cardiology societies now recommend the use of intravascular imaging, including OCT, for complex coronary interventions with level 1A evidence.OCT is now expanding beyond the coronary vasculature, with growing interest in its potential role in neurointerventional surgery. While limited use of OCT has been reported in the neurovasculature, the characteristics of a coronary OCT device prevent routine use in intracranial arteries. A new generation of intravascular OCT technology has been developed for the tortuous and complex anatomy of cerebral vessels. Early clinical experience has investigated its safety, feasibility, and utility for intracranial vascular imaging. Neuro-dedicated OCT technology could represent a significant advancement in cerebrovascular imaging, offering insights beyond the capabilities of current modalities, with the potential to improve current understanding of neurovascular pathology and refine diagnostic and therapeutic strategies. Successful translation of OCT into neurointervention, however, also requires establishing principles for image interpretation to assess neurovascular disease and therapeutic devices. This article aims to provide guidance for interpreting OCT imaging of intracranial arteries. In addition, it reviews applications of OCT in neurointervention and describes the development of neuro-specific OCT technology.