Featured Publications
Outcomes and Care Quality Metrics for Women of Reproductive Age Living With Rheumatic Heart Disease in Uganda
Chang A, Nabbaale J, Okello E, Ssinabulya I, Barry M, Beaton A, Webel A, Longenecker C. Outcomes and Care Quality Metrics for Women of Reproductive Age Living With Rheumatic Heart Disease in Uganda. Journal Of The American Heart Association 2020, 9: e015562. PMID: 32295465, PMCID: PMC7428530, DOI: 10.1161/jaha.119.015562.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsAnticoagulantsComorbidityFemaleHealthcare DisparitiesHumansMaleMedication AdherenceOutcome and Process Assessment, Health CareQuality Indicators, Health CareRegistriesReproductive HealthRetention in CareRetrospective StudiesRheumatic Heart DiseaseRisk AssessmentRisk FactorsSex FactorsTime FactorsTreatment OutcomeUgandaWomen's HealthYoung AdultConceptsRheumatic heart diseaseWomen of reproductive ageHeart diseaseReproductive ageClinical rheumatic heart diseaseRheumatic Heart Disease RegistryAdherence to guideline-based therapyNew York Heart Association class III-IV heart failurePrescription of warfarinRisk of cardiovascular complicationsCox proportional hazards modelsProportional hazards modelRetrospective cohort studyGuideline-based therapyAdherence ratesDisease RegistryCohort studyAnticoagulant prescriptionSub-Saharan AfricaAnticoagulant useCardiovascular complicationsClinical outcomesCompare comorbiditiesHazards modelHeart failureMotivations of women in Uganda living with rheumatic heart disease: A mixed methods study of experiences in stigma, childbearing, anticoagulation, and contraception
Chang A, Nabbaale J, Nalubwama H, Okello E, Ssinabulya I, Longenecker C, Webel A. Motivations of women in Uganda living with rheumatic heart disease: A mixed methods study of experiences in stigma, childbearing, anticoagulation, and contraception. PLOS ONE 2018, 13: e0194030. PMID: 29590159, PMCID: PMC5874006, DOI: 10.1371/journal.pone.0194030.Peer-Reviewed Original ResearchConceptsWomen of childbearing ageRheumatic heart diseaseFocus groupsLack of health system resourcesLimited health literacyQualitative descriptive methodologyHealth system resourcesHeart diseaseMixed methods studyMiddle-income countriesMale partnersChildbearing ageHealth literacyPatient empowermentWomen of reproductive ageAbandonment of patientsHealth programsPremature mortalitySide effects of contraceptivesDescriptive methodologyConsiderable stigmaIncreased risk of cardiovascular complicationsQualitative studyRisk of cardiovascular complicationsLMICs
2023
Effectiveness of a community health worker-led low-sodium salt intervention to reduce blood pressure in rural Bangladesh: protocol for a cluster randomized controlled trial
Chang A, Rahman M, Talukder A, Shah H, Mridha M, Hasan M, Sarker M, Geldsetzer P. Effectiveness of a community health worker-led low-sodium salt intervention to reduce blood pressure in rural Bangladesh: protocol for a cluster randomized controlled trial. Trials 2023, 24: 480. PMID: 37501102, PMCID: PMC10375753, DOI: 10.1186/s13063-023-07518-3.Peer-Reviewed Original ResearchConceptsLow-sodium salt substituteCommunity health workersCluster randomized controlled trialHealth workersRural BangladeshImplementing health interventionsBackgroundHigh blood pressureMonths post-interventionBlood pressureExcessive salt consumptionMiddle-income countriesRandomized controlled trialsBlood pressure improvementPublic health problemHigh blood pressureLow-sodium saltPost-interventionCommunity healthHealth interventionsMortality reductionSalt consumptionHealth consequencesHealth problemsBlood pressure-lowering interventionsControlled trialsImpact of a Multidisciplinary Curriculum Training Students and Residents in Tobacco Cessation Strategies for Adult Caregivers of Children
Gribben V, Chang A, Ling P, Rasmussen J, Tebb K, Fuentes-Afflick E, Marbin J. Impact of a Multidisciplinary Curriculum Training Students and Residents in Tobacco Cessation Strategies for Adult Caregivers of Children. MedEdPORTAL 2023, 19: 11313. PMID: 37228253, PMCID: PMC10203095, DOI: 10.15766/mep_2374-8265.11313.Peer-Reviewed Original ResearchConceptsClinical Effort Against Secondhand Smoke ExposureNicotine replacement therapyAdult caregiversCeased trainingPrescription of nicotine replacement therapyChildren's exposure to secondhand smokePediatric residentsAdult caregivers of childrenExposure to secondhand smokeGroup of pediatric residentsCaregivers of ChildrenSmoking cessation skillsTrained pediatric providersNurse practitioner studentsSecondhand smoke exposureHealth professions studentsSmoking cessation techniquesFamily medicine residentsSurveys measuring changesSelf-perceived knowledgeTobacco cessation strategiesUrban academic centerPhysician championsState quitlinesPractitioner students
2022
Impacts of a Multicenter Medical Education Curriculum for Training Pediatric Residents on Tobacco Cessation for Adult Caregivers of Pediatric Patients
Gribben V, Kosack A, Garell C, Shaikh U, Huang M, Chang A, Rasmussen J, Tebb K, Marbin J. Impacts of a Multicenter Medical Education Curriculum for Training Pediatric Residents on Tobacco Cessation for Adult Caregivers of Pediatric Patients. Clinical Pediatrics 2022, 62: 115-120. PMID: 35891607, DOI: 10.1177/00099228221113783.Peer-Reviewed Original ResearchConceptsClinical Effort Against Secondhand Smoke ExposureSecondhand smoke exposureAdult caregivers of pediatric patientsSmoking cessationPediatric residentsCaregivers of pediatric patientsPost-training knowledgeTraining pediatric residentsMedical education curriculumPediatric residents' attitudesSelf-efficacy itemsEvidence-based frameworkPhysician championsTobacco cessationPatients' caregiversEducation curriculumAdult caregiversLongitudinal curriculumProviders' abilityUntrained residentsSmokers' QuitlineAnonymous surveySmoke exposureDidactic trainingPediatric patients
2021
Clinical Outcomes, Echocardiographic Findings, and Care Quality Metrics for People Living With Human Immunodeficiency Virus (HIV) and Rheumatic Heart Disease in Uganda
Chang A, Rwebembera J, Bendavid E, Okello E, Barry M, Beaton A, Haeffele C, Webel A, Kityo C, Longenecker C. Clinical Outcomes, Echocardiographic Findings, and Care Quality Metrics for People Living With Human Immunodeficiency Virus (HIV) and Rheumatic Heart Disease in Uganda. Clinical Infectious Diseases 2021, 74: 1543-1548. PMID: 34382644, DOI: 10.1093/cid/ciab681.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusRheumatic heart diseaseEchocardiographic findingsImmunodeficiency virusHeart diseaseClinical outcomesDiagnosis of human immunodeficiency virusPrescription ratesAge- and sex-matched cohortMedication prescription ratesLongitudinal outcomes of patientsCare quality metricsOutcomes of patientsMiddle-income countriesEpidemiology of patientsSex-matched cohortAll-cause mortalityStroke/transient ischemic attackRate of strokeMedian ageClinical careCardiovascular complicationsClinical characteristicsMultivariable adjustmentConcurrent diagnosis
2020
Breast cancer induces systemic immune changes on cytokine signaling in peripheral blood monocytes and lymphocytes
Wang L, Simons D, Lu X, Tu T, Avalos C, Chang A, Dirbas F, Yim J, Waisman J, Lee P. Breast cancer induces systemic immune changes on cytokine signaling in peripheral blood monocytes and lymphocytes. EBioMedicine 2020, 52: 102631. PMID: 31981982, PMCID: PMC6992943, DOI: 10.1016/j.ebiom.2020.102631.Peer-Reviewed Original ResearchConceptsSystemic immune changesPeripheral blood monocytesBreast Cancer Research FoundationBreast Cancer Research ProgramBC patientsImmune changesBlood monocytesPeripheral bloodImmune cellsNon-metastatic BC patientsPeripheral blood immune cellsPeripheral blood T cellsCancer patients' peripheral bloodBlood immune cellsBreast cancer patientsOverall immune statusBlood T cellsPatients' peripheral bloodTumor-infiltrating macrophagesDefense Breast Cancer Research ProgramCancer Research ProgramCancer Research FoundationConcurrent cytokineLocalized diseaseImmune status
2017
IL6 Signaling in Peripheral Blood T Cells Predicts Clinical Outcome in Breast Cancer
Wang L, Miyahira A, Simons D, Lu X, Chang A, Wang C, Suni M, Maino V, Dirbas F, Yim J, Waisman J, Lee P. IL6 Signaling in Peripheral Blood T Cells Predicts Clinical Outcome in Breast Cancer. Cancer Research 2017, 77: 1119-1126. PMID: 27879265, PMCID: PMC5334262, DOI: 10.1158/0008-5472.can-16-1373.Peer-Reviewed Original ResearchConceptsPeripheral blood T cellsBreast cancer patientsBlood T cellsCancer patientsT cellsIL6 levelsWorse relapse-free survivalPlasma IL6 levelsCancer cellsRelapse-free survivalSerum IL6 levelsAnti-inflammatory propertiesHost immune responseInvolved downregulationClinical outcomesPredictive biomarkersImmune responsePleiotropic cytokinePatientsIL6Cancer ResCancer progressionSurvivalDiagnosisCells
2013
Spatial organization of dendritic cells within tumor draining lymph nodes impacts clinical outcome in breast cancer patients
Chang A, Bhattacharya N, Mu J, Setiadi A, Carcamo-Cavazos V, Lee G, Simons D, Yadegarynia S, Hemati K, Kapelner A, Ming Z, Krag D, Schwartz E, Chen D, Lee P. Spatial organization of dendritic cells within tumor draining lymph nodes impacts clinical outcome in breast cancer patients. Journal Of Translational Medicine 2013, 11: 242. PMID: 24088396, PMCID: PMC3852260, DOI: 10.1186/1479-5876-11-242.Peer-Reviewed Original ResearchConceptsBreast cancer patientsLymph nodesCancer patientsImmune cellsT cellsDendritic cellsIntra-mammary lymph nodesAnti-tumor immune responseDC cancer vaccinesKaplan-Maier analysisDisease-free survivalLog-rank testClinical outcome analysisT cell interactionsIntra-group comparisonInter-group comparisonMann-Whitney testDC clustersBackgroundDendritic cellsDC clusteringClinical outcomesCancer vaccinesSurvival outcomesDC functionNon-parametric Mann-Whitney test