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Bond J, Julion WA, Shattell M, Healey W, Reed M. The Lived Experiences of Racial Microaggressions for Black Individuals While Seeking Orthopedic-Related Care: A Qualitative Study. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02063-4. [PMID: 39192057 DOI: 10.1007/s40615-024-02063-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 08/29/2024]
Abstract
Race-based health disparities for racially and ethnically diverse people with orthopedic-related conditions are well documented and their experiences when seeking care deserve more attention. The purpose of this study was to understand the lived experiences of racial microaggressions occurring when racially and ethnically diverse people seek health care services for orthopedic-related conditions. We used transcendental phenomenology to understand their lived experiences of racial microaggressions while receiving orthopedic-related health care services. All participants self-identified as Black, none as Hispanic. Nineteen final codes were organized into five patterns and then into five themes-two background and three figural themes. Background themes: discrimination can occur across a lifetime, and poor treatment of poor people fuels health inequity. Figural themes: racial discrimination can come at any time and in various forms; resistance is necessary in the face of racial discrimination; and despite discriminatory encounters, health care goals are achievable. Participants shared their lived experiences of racial microaggressions while seeking care for their orthopedic-related conditions (figural) through a lens shaped by their other past experiences with varied discrimination (background). Black individuals have a longstanding relationship with racial discrimination that has a negative impact on many aspects of their lives, including their health. The results highlight ways to promote equity by capitalizing on Black individuls' goals to actively pursue health.
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Affiliation(s)
- Jerenda Bond
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA.
| | | | - Mona Shattell
- College of Nursing, University of Central Florida, Orlando, FL, USA
| | - William Healey
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Monique Reed
- College of Nursing, Rush University, Chicago, IL, USA
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Binvignat M, Miao BY, Wibrand C, Yang MM, Rychkov D, Flynn E, Nititham J, Tamaki W, Khan U, Carvidi A, Krueger M, Niemi E, Sun Y, Fragiadakis GK, Sellam J, Mariotti-Ferrandiz E, Klatzmann D, Gross AJ, Ye CJ, Butte AJ, Criswell LA, Nakamura MC, Sirota M. Single-cell RNA-Seq analysis reveals cell subsets and gene signatures associated with rheumatoid arthritis disease activity. JCI Insight 2024; 9:e178499. [PMID: 38954480 PMCID: PMC11343607 DOI: 10.1172/jci.insight.178499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open
Abstract
Rheumatoid arthritis (RA) management leans toward achieving remission or low disease activity. In this study, we conducted single-cell RNA sequencing (scRNA-Seq) of peripheral blood mononuclear cells (PBMCs) from 36 individuals (18 patients with RA and 18 matched controls, accounting for age, sex, race, and ethnicity), to identify disease-relevant cell subsets and cell type-specific signatures associated with disease activity. Our analysis revealed 18 distinct PBMC subsets, including an IFN-induced transmembrane 3-overexpressing (IFITM3-overexpressing) IFN-activated monocyte subset. We observed an increase in CD4+ T effector memory cells in patients with moderate-high disease activity (DAS28-CRP ≥ 3.2) and a decrease in nonclassical monocytes in patients with low disease activity or remission (DAS28-CRP < 3.2). Pseudobulk analysis by cell type identified 168 differentially expressed genes between RA and matched controls, with a downregulation of proinflammatory genes in the γδ T cell subset, alteration of genes associated with RA predisposition in the IFN-activated subset, and nonclassical monocytes. Additionally, we identified a gene signature associated with moderate-high disease activity, characterized by upregulation of proinflammatory genes such as TNF, JUN, EGR1, IFIT2, MAFB, and G0S2 and downregulation of genes including HLA-DQB1, HLA-DRB5, and TNFSF13B. Notably, cell-cell communication analysis revealed an upregulation of signaling pathways, including VISTA, in both moderate-high and remission-low disease activity contexts. Our findings provide valuable insights into the systemic cellular and molecular mechanisms underlying RA disease activity.
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Affiliation(s)
- Marie Binvignat
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, California, USA
- Immunology Immunopathology Immunotherapy, Pitie Salpetriere Hospital UMRS 959, Sorbonne University, Paris, France
- Department of Rheumatology, Research Center Saint Antoine, UMRS 938, Sorbonne University, AP-HP, Saint-Antoine Hospital, Inserm UMRS 938, Paris, France
| | - Brenda Y. Miao
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, California, USA
| | - Camilla Wibrand
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, California, USA
- Aarhus University, Aarhus, Denmark
| | - Monica M. Yang
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Division of Rheumatology, Department of Medicine, and
| | - Dmitry Rychkov
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, California, USA
| | - Emily Flynn
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Division of Rheumatology, Department of Medicine, and
- CoLabs, UCSF, San Francisco, California, USA
| | - Joanne Nititham
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Division of Rheumatology, Department of Medicine, and
| | - Whitney Tamaki
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, California, USA
| | - Umair Khan
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, California, USA
| | - Alexander Carvidi
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Division of Rheumatology, Department of Medicine, and
| | - Melissa Krueger
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Erene Niemi
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Division of Rheumatology, Department of Medicine, and
| | - Yang Sun
- Department of Human Genetics and
| | - Gabriela K. Fragiadakis
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Division of Rheumatology, Department of Medicine, and
- CoLabs, UCSF, San Francisco, California, USA
| | - Jérémie Sellam
- Department of Rheumatology, Research Center Saint Antoine, UMRS 938, Sorbonne University, AP-HP, Saint-Antoine Hospital, Inserm UMRS 938, Paris, France
| | - Encarnita Mariotti-Ferrandiz
- Immunology Immunopathology Immunotherapy, Pitie Salpetriere Hospital UMRS 959, Sorbonne University, Paris, France
| | - David Klatzmann
- Immunology Immunopathology Immunotherapy, Pitie Salpetriere Hospital UMRS 959, Sorbonne University, Paris, France
| | - Andrew J. Gross
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Division of Rheumatology, Department of Medicine, and
| | | | - Atul J. Butte
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, California, USA
- Department of Pediatrics, UCSF, San Francisco, California, USA
| | - Lindsey A. Criswell
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Division of Rheumatology, Department of Medicine, and
- National Human Genome Research Institute (NHGRI), NIH, Bethesda, Maryland, USA
| | - Mary C. Nakamura
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Division of Rheumatology, Department of Medicine, and
- San Francisco VA Health Care System, San Francisco, California, USA
| | - Marina Sirota
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, California, USA
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Pourfridoni M, Farhadi Rad H, Mirzaee F, Abbasnia SM, Nikvarz M, Sharifi E, Shafiei S, Baghcheghi Y, Amiri Domari A, Askarpour H. Erythrocyte sedimentation rate and red blood cell indices association in pediatrics patients with fever and cough: A cross-sectional study. Health Sci Rep 2024; 7:e1843. [PMID: 38274138 PMCID: PMC10809022 DOI: 10.1002/hsr2.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/06/2023] [Accepted: 01/08/2024] [Indexed: 01/27/2024] Open
Abstract
Background and Aims The erythrocyte sedimentation rate (ESR) is an essential inflammatory marker in treating some patients, particularly children. The level of ESR can be affected by red blood cell (RBC) indices, and not considering this can complicate the interpretation of ESR and the treatment and follow-up of patients. The study aimed to assess the association between ESR and RBC indices in children hospitalized with fever and cough in the pediatric ward of Imam Khomeini Hospital, Jiroft, in 2023. Methods A cross-sectional study was conducted to measure the association between ESR and RBC indices in children hospitalized with fever and cough in the pediatric ward of Imam Khomeini Hospital, Jiroft, in 2023. A total of 156 patients participated in the study. SPSS software was used for statistical analysis. Results The mean age of participants was 27.26 ± 3.14 months. The results showed that there is a significant negative correlation between ESR and RBC, r = -0.282 (p < 0.001), and ESR and hematocrit (HCT), r = -0.215 (p = 0.007). Also, the results demonstrated that there is a significant positive correlation between ESR and mean corpuscular volume (MCV), r = 0.159 (p = 0.048), ESR and mean corpuscular hemoglobin (MCH), r = 0.214 (p = 0.007), and ESR and mean cell hemoglobin concentration (MCHC), r = 0.209 (p = 0.009). There was a negative correlation between ESR and hemoglobin (Hb), r = -0.98 (p = 0.225), but this correlation was insignificant. Conclusion This study showed an association between ESR and RBC indices in hospitalized children with complaints of fever and cough. So, it is necessary that physicians and treatment staff pay attention to the RBC indices while interpreting and following up the results of ESR to complete the treatment process of patients.
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Affiliation(s)
| | | | - Faezeh Mirzaee
- Student Research CommitteeJiroft University of Medical SciencesJiroftIran
| | | | - Mehran Nikvarz
- Department of PediatricsJiroft University of Medical SciencesJiroftIran
| | - Elham Sharifi
- Department of PediatricsJiroft University of Medical SciencesJiroftIran
| | | | - Yousef Baghcheghi
- Student Research CommitteeJiroft University of Medical SciencesJiroftIran
| | | | - Hedyeh Askarpour
- Clinical ResearchJiroft University of Medical SciencesJiroftIran
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