MHRT Poster Session 2021

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    Minority Health and Health Disparities Research Training (MHRT) Program at the University of Hawaii
    ( 2022-04-01) Nerurkar, Vivek R. ; Sy, Angela ; Kaholokula, Joseph K. ; Salomon, Renn ; Corpuz, Aira Mae ; Nerurkar, Vivek R.
    The objective of the Minority Health Research Training (MHRT) program at the University of Hawaii at Manoa (UHM) is to encourage students from underrepresented (including minority) backgrounds to pursue careers in science; and expose students to biomedical, clinical, and behavioral health research and global health issues that relate to health disparities. The program also aims to enable collaborations between colleges/universities and out-of-state research programs. Funded by the National Institute of Minority Health and Health Disparities (NIMHD), National Institutes of Health (NIH), the UHM MHRT program is in its ninth year. The MHRT program is a short-term research training opportunity offered to undergraduate, post-baccalaureate, and pre-doctoral students from under-represented backgrounds. MHRT students are from various academic disciplines at UH and have diverse ethnic backgrounds. To date, the MHRT program has trained eight (8) cohorts of students totaling 85 students. Selected students learn to conduct research during the spring semester and spend 8-9 weeks during the summer at their international training sites under the guidance of their assigned in-country mentor and their UH mentor. In addition to life-changing research and cultural experiences, program benefits include up to10 credits of directed research courses in the spring and summer semesters, and while abroad students are provided with a stipend, travel, and living expenses.
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    MHRT 2021 Abstract Book
    ( 2021-09-13) Nerurkar, Vivek ; Sy, Angela ; Salomon, Renn Silve
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    SARS-CoV-2 Vaccine Elicited IgG in Human Milk
    ( 2021-08-13) Williams, Caitlin ; Lehrer, Axel ; Nerurkar, Vivek ; Sy, Angela
    Background: Human milk is the main source of nutrition for most neonates as well as a source of components important for neonatal immunity. Neonates have a delay in development of robust immune responses and their immune system is supplemented via milk while the neonatal immune system continues to develop. Eventually, the neonatal immune system begins to function independently of mothers milk and placentally transferred IgG. Aside from missing nutritional benefits, infants who are not breastfed are at a higher risk of developing necrotizing enterocolitis (NEC), pneumonia, and sudden infant death syndrome. While the benefits of human milk in regard to neonatal health are established, the current pandemic brings to question whether or not breastfeeding can prevent disease acquisition in nursing infants. SARS-CoV-2 virus has been detected in human milk however vertical transmission of SARS-CoV-2 appears to be uncommon. Determination of the binding potential of maternal antibodies in the human milk can help us understand how milk can function to protect neonates from SARS-CoV-2 infection. Objectives: To profile the SARS-CoV-2 binding breadth of IgG in milk from vaccinated women on the island of Oahu, Hawaii. Materials and Methods An Institutional Review Board application was submitted and approved by the University of Hawaii Human Studies Program (Protocol number 2021-00090). Participants were given a survey and a human milk collection kit. Fat was removed from milk samples and the skim milk was assessed for IgG composition. Binding towards SARS-CoV-2, SARS-CoV, SARS-CoV-2 variants, and non-pandemic coronavirus antigens was assessed via multiplexed immunoassay. Conclusion Using multiplexed immunoassays, we detect antibodies capable of binding to SARS-CoV-2 Spike of prototype virus as well as novel virus variants which arose through dissemination of wild type SARS-CoV-2 in various geographical spaces during the course of the pandemic. Here we demonstrate that immunization with an emergency use authorization (EUA) SARS-CoV-2 vaccine yields antigen specific and cross-reactive antibody titers within the human milk which may be passed on to nursing infants.
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    The Sharing of Needles and/or Drug Injection Preparatory Equipment Among People Who Inject Drugs: A Systematic Review, United States, 1988-2019 (Preliminary Report)
    ( 2021-08-13) Salek, Thomas ; Katz, Alan ; Nerurkar, Vivek ; Sy, Angela
    Background: Documenting the characteristics associated with the sharing of needles and drug injection equipment among people who inject drugs has important implications for monitoring drug-related trends. Since the inception of needle exchange programs in the U.S. in 1988, previous reviews on sharing and injection risk behaviors have been restrictive in either scope, population, interest, and/or context (PICo). Objective: To document and aggregate existing literature on reports of needle and/or drug injection equipment sharing behaviors, as well as other injection-related HIV/HCV risk behavior in the U.S. in the era of needle exchange programs (i.e.,1988 to 2019). Methods: To be included in the review, eligible sources must have been published between January 1988 and December 2019, written in English, limited geographically to the United States, and included people aged 18 years or older. Eligible sources were collected from online databases and must have also reported one or more of the prespecified 10 data items and outcomes. Additionally, an online survey of syringe exchange programs participating in the North American Syringe Exchange Network (NASEN) was included. Results: Of 9,925 identified sources, 2,486 were eligible for full review. Of these, n=354 unique research studies from 39 U.S. states were eligible for inclusion. For the 10 data items and outcomes, preliminary findings have tallied: 1) syringe sharing (n=289); 2) non-syringe drug injection equipment sharing (n=146); 3) syringe cleaning practices (n=84); 4) syringe-mediated drug sharing (n=69); 5) speedball and/or goofball injection (n=136); 6) sharing partner (n=35); 7) injection partner (n=41); 8) shooting gallery attendance (n=104); 9) HIV/HCV serosorting (n=8); and 10) syringe reuse (n=30). These findings represent 29.3% of the total data screening and extraction processes to be done. Conclusions: Researchers, health-policy leaders, and health services providers may utilize this summarization of syringe sharing and other HIV/HCV injection risk behavior to enhance the understanding of injection-related behaviors with the goal of optimizing the provision of harm reduction services to persons who inject drugs.
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    Social Determinants of Access to Healthcare Services in the Tri-County Charleston Metropolitan Area, South Carolina, by Race and Ethnicity
    ( 2021-08-13) Low, Jonathan ; Kaholokula, Joseph ; Maness, Sarah ; Nerurkar, Vivek ; Sy, Angela
    Background: Despite an overall increase in insurance coverage in the Tri-County Charleston Metropolitan Area (Tri-County Area) in South Carolina, the number of premature deaths increased between the years of 2015 to 2020. In addition, racial and ethnic disparities in health outcomes and deaths persist. Objective: Employ the 2019 Community Health Needs Assessment Report conducted by Trident United Way in conjunction with the Medical University of South Carolina and Roper St. Francis Hospital to assess differences in access to healthcare and self-reported reasons for limited healthcare access by race and ethnicity. Methods: Reasons for limited healthcare access included cultural/religious beliefs, not knowing how to access services, not knowing when to see a doctor, fear, lack of trust, lack of available services, no insurance, cost, not knowing how to sign up for insurance, lack of transportation, work schedule, distance or safety to access health services, lack of knowledge, or other. Race and ethnicity was categorized as White, Hispanic, Black and Other. Rao-Scott Chi Square tests were used in Excel to conduct all analyses. Results: Statistically significant differences between race and ethnicity were found for all but four reasons for limited healthcare access. Significant results indicated a difference by race and ethnicity for the following reasons for limited healthcare access: “Cultural/religious beliefs” (p=<.0001); “I don’t know how to access healthcare services (p=.034); “I do not know when I need to see a doctor” (p=.006); “Fear” (p=.010); “I do not trust doctors'' (p=.003), “I do not have insurance and cannot pay for services (<.001); “I have insurance, but I cannot afford the co-pay or deductibles” (p<.001); “I do not know how to sign up for health insurance” (p<.001); “Lack of transportation” (p<.001); and “Lack of knowledge” (p<.001). No significant difference was found for lack of available healthcare services or distance to healthcare services. Conclusions: Findings indicate that many disparities exist by race and ethnicity in reasons for limited healthcare access in the Charleston Tri-County area. It is interesting that no differences were found in terms of availability of services or distance to services, indicating that other strategies are needed to increase access to care. Further research with a community-based collaborative approach is needed to address these barriers to care.