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Papers by Jane Kim

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BACKGROUND Veterans Health Administration (VHA) issued policy for lung cancer screening; resource... more BACKGROUND Veterans Health Administration (VHA) issued policy for lung cancer screening; resources at eight Veterans Affairs medical centers (VAMCs) in a demonstration project (DP) from 2013 to 2015. RESEARCH QUESTION Do policies that provide resources increase lung cancer screening rates? STUDY DESIGN AND METHODS Data from 8 DP VAMCs (DP group) and 20 comparable VAMCs (comparison group) were divided into Pre-DP (January 2011-June 2013), DP (July 2013-June 2015) and Post-DP (July 2015-December 2018) time periods. Co-primary outcomes were unique Veterans screened per 1,000 eligible per month and those with 1-year (9-15 month) follow-up screening. Eligible Veterans were estimated using yearly counts and the percentage of those with eligible smoking histories. Controlled interrupted time series and difference-in-differences analyses were performed. RESULTS Of 27,746 Veterans screened, the median age was 66.5 and most were white (77.7%), male (95.6%) and urban dwelling (67.3%). During the DP, the average rate of unique Veterans screened at DP VAMCs was 17.7 per 1,000 eligible per month, compared to 0.3 at comparison VAMCs. Adjusted analyses found a higher rate increase at DP VAMCs by 0.93 screening per 1,000 eligible per month (95% confidence interval [CI] 0.25 - 1.61) during this time, with an average facility-level difference of 17.4 screenings per 1,000 eligible per month (95% CI 12.6 - 22.3). Veterans with 1-year follow-up screening also increased more rapidly at DP VAMCs during the DP, by 0.39 screening per 1,000 eligible per month (95% CI 0.18 - 0.60), for an average facility-level difference of 7.2 more screenings per 1,000 eligible per month (95% CI 5.2 - 9.2). Gains were not maintained post-DP. INTERPRETATION In this cohort, provision of resources for lung cancer screening implementation was associated with an increase in Veterans screened and those with 1-year follow-up screening. Screening gains associated with the DP were not maintained.

The FASEB Journal, 2014

Fractalkine (FKN) (CX3CL1) and its receptor CX3CR1 mediate cell-to-cell interactions in different... more Fractalkine (FKN) (CX3CL1) and its receptor CX3CR1 mediate cell-to-cell interactions in different tissues. Here, we demonstrate that the FKN/CX3CR1 system represents a novel regulatory mechanism for pancreatic islet beta cell function and insulin secretion. CX3CR1 KO mice exhibit glucose intolerance with normal insulin sensitivity, due to a marked beta cell defect in glucose and GLP1-stimulated insulin secretion. The defect in insulin secretion was also observed in vitro in isolated islets from CX3CR1 KO mice. In vivo administration of FKN improved glucose tolerance with an increase in insulin secretion. In vitro treatment of islets with FKN increased intracellular Ca2+ level and potentiated insulin secretion. The KO islets exhibited reduced expression of a set of genes which are necessary for the fully functional, differentiated beta cell state, whereas, treatment of WT islets with FKN leads to increased expression of these genes. Lastly, expression of FKN in islets was decreased by aging and HFD/obesity...

MCN: The American Journal of Maternal/Child Nursing, 2022

Abstract Purpose: The purpose of this study was to describe the experience of individuals with op... more Abstract Purpose: The purpose of this study was to describe the experience of individuals with opioid use disorder (OUD) during the perinatal period. Study Design and Methods: We convened focus groups of patients with OUD who had been pregnant and were parenting. Participants who were 18 and older, English-speaking, self-identified as pregnant or parenting, and actively using opioids or in recovery from OUD were recruited using snowball and convenience sampling in resident treatment facilities and outpatient settings. Data were recorded, transcribed, and analyzed for themes. Results: Twenty-four participants were recruited, 10 of whom were actively receiving residential recovery services. Most participants had been pregnant from 4 weeks to 2 years prior to our focus group session; none reported being currently pregnant. Nineteen participants had custody of some, or all, of their children. They identified four key themes related to their care: (1) disrespectful care, (2) fear of accessing services, (3) inconsistencies in care received, and (4) limited health and social services. Clinical Implications: Participants reported overall negative interactions across different health care settings and lack of social resources to promote ongoing recovery and successful parenting. Nurses should be aware of the lasting impressions they have on their patients. Recognition of their own biases, person-first language, and partnership building skills with patients can help attenuate OUD stigma, promote positive nurse–patient relationships, and support new parents in recovery and infant bonding. Encounters with health care professionals and the health care system can be stressful for pregnant women and parenting women with an opioid use disorder. In this study, patients who had experienced pregnancy and postpartum while they had an opioid use disorder share their interactions with nurses and other health care professionals and their fears of the system. Based on these reports, the authors offer suggestions for enhancing nursing care for this vulnerable population.

<b>Copyright information:</b>Taken from "Development and initial testing of a co... more <b>Copyright information:</b>Taken from "Development and initial testing of a computer-based patient decision aid to promote colorectal cancer screening for primary care practice"BMC Medical Informatics and Decision Making 2005;5():36-36.Published online 28 Nov 2005PMCID:PMC1318488.Copyright © 2005 Kim et al; licensee BioMed Central Ltd.

Journal of Midwifery & Women's Health, 2021

INTRODUCTION The motivation to seek treatment for opioid use disorder (OUD) can increase during t... more INTRODUCTION The motivation to seek treatment for opioid use disorder (OUD) can increase during the perinatal period. However, several identified barriers, such as poor access to services, lack of trained providers, stigma, and legal ramifications of OUD, limit the ability for individuals with OUD to receive safe and supportive care during pregnancy and birth. During the birth hospital stay in particular, nurses provide the majority of care for pregnant and birthing families. We aimed to engage nurses, with experience caring for pregnant and postpartum individuals with OUD, in priority setting as a way to identify areas of need in the current health care systems. METHODS Using community-engaged priority setting methods, we recruited a sample of 47 nurses (phase 1) and 20 nurses (phase 2), including nurse-midwives and other advanced practice nurses, at a statewide nursing conference, who reported regularly providing care for pregnant and postpartum individuals with OUD. We invited participants to submit questions and concerns regarding the provision of care for individuals with OUD (phase 1). A selection of those who submitted questions attended a focus group to rank and prioritize submitted questions into a set of priorities for research, policy, and care improvement (phase 2). RESULTS In phase 1, participants submitted a total of 165 questions and concerns. In phase 2, participants prioritized the following: funding to support improvements in OUD care in the perinatal period, increased access to services, supportive housing for individuals in recovery, standardization of care for individuals with OUD, and efforts to destigmatize care. DISCUSSION Nurses who work with pregnant and postpartum individuals with OUD have a unique insight as to how health care providers, including midwives, can better support this community and should be engaged setting priorities for research, changes to policy, and improvement in care.

AEM Education and Training, 2021

Background: The COVID-19 pandemic posed significant challenges to traditional simulation educatio... more Background: The COVID-19 pandemic posed significant challenges to traditional simulation education. Because simulation is considered best practice for competencybased education, emergency medicine (EM) residencies adapted and innovated to accommodate to the new pandemic normal. Our objectives were to identify the impact of the pandemic on EM residency simulation training, to identify unique simulation adaptations and innovations implemented during the pandemic, and to analyze successes and failures through existing educational frameworks to offer guidance on the use of simulation in the COVID-19 era. Methods: The Society for Academic Emergency Medicine (SAEM)'s Simulation Academy formed the SimCOVID task force to examine the impact of COVID-19 on simulation didactics. A mixed-methods approach was employed. A literature search was conducted on the subject and used to develop an exploratory survey that was distributed on the Simulation Academy Listserv. The results were subjected to thematic analysis and examined through existing educational frameworks to better understand successes and failures and then used to generate suggestions on the use of simulation in the COVID-19 era. Results: Thirty programs responded to the survey. Strategies reported included adaptations to virtual teleconferencing and small-group in situ training with a focus on procedural training and COVID-19 preparedness. Successful continuation or relaunching of simulation programs was predicated on several factors including willingness for curricular pivots through rapid iterative prototyping, embracing teleconferencing software, technical know-how, and organizational and human capacity. In specific instances the use of in situ simulation for COVID-19 preparedness established the view of simulation as a "value add" to the organization. Conclusions: Whereas simulation educator's responses to the COVID-19 pandemic can be better appreciated through the lens of iterative curricular prototyping, their successes and failures depended on existing expertise in technological, pedagogical,

PLOS ONE, 2020

The incidence of type 2 diabetes is increasing more rapidly in adolescents than in any other age ... more The incidence of type 2 diabetes is increasing more rapidly in adolescents than in any other age group. We identified and compared metabolite signatures in obese children with type 2 diabetes (T2D), obese children without diabetes (OB), and healthy, age-and gendermatched normal weight controls (NW) by measuring 273 analytes in fasting plasma and 24hour urine samples from 90 subjects by targeted LC-MS/MS. Diabetic subjects were within 2 years of diagnosis in an attempt to capture early-stage disease prior to declining renal function. We found 22 urine metabolites that were uniquely associated with T2D when compared to OB and NW groups. The metabolites most significantly elevated in T2D youth included members of the betaine pathway, nucleic acid metabolism, and branched-chain amino acids (BCAAs) and their catabolites. Notably, the metabolite pattern in OB and T2D groups differed between urine and plasma, suggesting that urinary BCAAs and their intermediates behaved as a more specific biomarker for T2D, while plasma BCAAs associated with the obese, insulin resistant state independent of diabetes status. Correlative analysis of metabolites in the T2D signature indicated that betaine metabolites, BCAAs, and aromatic amino acids were associated with hyperglycemia, but BCAA acylglycine derivatives and nucleic acid metabolites were linked to insulin resistance. Of major interest, we found that urine levels of succinylaminoimidazole carboxamide riboside (SAICA-riboside) were increased in diabetic youth, identifying urine SAICA-riboside as a potential biomarker for T2D.

International Journal of Qualitative Methods, 2020

While community engagement can occur at all levels of research development, implementation, and d... more While community engagement can occur at all levels of research development, implementation, and dissemination, there is a great need for participation from those with lived experience in the development of research priorities to be used by stakeholders in research, funding, and policy. The Research Prioritization by Affected Communities (RPAC) protocol has successfully developed community-driven priorities for those at risk for preterm birth, but the 2-day focus group methodology may not be suitable for all vulnerable communities. For the purposes of a larger study supporting pregnant and parenting individuals with opioid use disorder (OUD) in research prioritization, we adapted the RPAC protocol to meet the needs of this highly stigmatized community. This adaptation made it possible for those who may not have been able to attend two separate sessions to successfully engage in this participatory process and produce a completed set of priorities by the end of 1 day. The objective of ...

Journal of Teaching in Social Work, 2020

ABSTRACT Based on CSWE’s 2015 EPAS, students in MSW programs are expected to have knowledge of re... more ABSTRACT Based on CSWE’s 2015 EPAS, students in MSW programs are expected to have knowledge of research methods. However, an understanding of how students perceive these courses as they pertain to their future careers as social work practitioners is less known. This qualitative study examined what MSW students learned about themselves as a result of taking a foundational research method course taught with a social justice lens. Five themes emerged from the thematic analysis including critical thinking, using research as a social worker, research and social justice, expanded ability to engage in research, and what students learned about themselves. Implications of including critical reflection and social justice in research courses for MSW students are discussed.

Physiological genomics, Jan 8, 2018

Highly inbred C57BL/6 mice show wide variation in their degree of insulin resistance in response ... more Highly inbred C57BL/6 mice show wide variation in their degree of insulin resistance in response to diet-induced obesity even though they are almost genetically identical. Here we employed transcriptional profiling by RNA sequencing (RNA-Seq) of visceral adipose tissue (VAT) and liver in young mice to determine how gene expression patterns correlate with the later development of high-fat diet (HFD)-induced insulin resistance in adulthood. To accomplish this goal, we partially removed and banked tissues from pubertal mice. Mice subsequently received HFD followed by metabolic phenotyping to identify two well-defined groups of mice with either severe or mild insulin resistance. The remaining tissues were collected at study termination. We then applied RNA-Seq to generate transcriptome profiles associated with worsened insulin resistance prior to and after the initiation of HFD. We found 244 up- and 109 downregulated genes in VAT of the most insulin resistant mice even prior to HFD expo...

Choice Reviews Online, 2003

BioEssays : news and reviews in molecular, cellular and developmental biology, 2017

In this review, we discuss how two evolutionarily conserved pathways at the interface of DNA repl... more In this review, we discuss how two evolutionarily conserved pathways at the interface of DNA replication and repair, template switching and break-induced replication, lead to the deleterious large-scale expansion of trinucleotide DNA repeats that cause numerous hereditary diseases. We highlight that these pathways, which originated in prokaryotes, may be subsequently hijacked to maintain long DNA microsatellites in eukaryotes. We suggest that the negative mutagenic outcomes of these pathways, exemplified by repeat expansion diseases, are likely outweighed by their positive role in maintaining functional repetitive regions of the genome such as telomeres and centromeres.

Nature communications, Jun 27, 2017

DNA replication and repair enzyme Flap Endonuclease 1 (FEN1) is vital for genome integrity, and F... more DNA replication and repair enzyme Flap Endonuclease 1 (FEN1) is vital for genome integrity, and FEN1 mutations arise in multiple cancers. FEN1 precisely cleaves single-stranded (ss) 5'-flaps one nucleotide into duplex (ds) DNA. Yet, how FEN1 selects for but does not incise the ss 5'-flap was enigmatic. Here we combine crystallographic, biochemical and genetic analyses to show that two dsDNA binding sites set the 5'polarity and to reveal unexpected control of the DNA phosphodiester backbone by electrostatic interactions. Via 'phosphate steering', basic residues energetically steer an inverted ss 5'-flap through a gateway over FEN1's active site and shift dsDNA for catalysis. Mutations of these residues cause an 18,000-fold reduction in catalytic rate in vitro and large-scale trinucleotide (GAA)n repeat expansions in vivo, implying failed phosphate-steering promotes an unanticipated lagging-strand template-switch mechanism during replication. Thus, phosphat...

JAMA internal medicine, Jan 30, 2017

The US Preventive Services Task Force recommends annual lung cancer screening (LCS) with low-dose... more The US Preventive Services Task Force recommends annual lung cancer screening (LCS) with low-dose computed tomography for current and former heavy smokers aged 55 to 80 years. There is little published experience regarding implementing this recommendation in clinical practice. To describe organizational- and patient-level experiences with implementing an LCS program in selected Veterans Health Administration (VHA) hospitals and to estimate the number of VHA patients who may be candidates for LCS. This clinical demonstration project was conducted at 8 academic VHA hospitals among 93 033 primary care patients who were assessed on screening criteria; 2106 patients underwent LCS between July 1, 2013, and June 30, 2015. Implementation Guide and support, full-time LCS coordinators, electronic tools, tracking database, patient education materials, and radiologic and nodule follow-up guidelines. Description of implementation processes; percentages of patients who agreed to undergo LCS, had ...

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jan 20, 2014

209 Background: Since 80-90% of testicular germ cell tumors (GCTs) are cured after first line the... more 209 Background: Since 80-90% of testicular germ cell tumors (GCTs) are cured after first line therapy alone, minimizing toxicity should be an important consideration in the initial treatment decision between cisplatin and carboplatin. Cisplatin has been shown to be superior in 5-year disease-free survival, but cisplatin use confers a higher risk of key long-term toxicities. This study aims to quantify this trade-off between disease-free survival and toxicities using decision analysis. We developed a mathematical decision-analytic model that simulates competing strategies of initial treatment with cisplatin or carboplatin in terms of treatment response, long-term toxicity, and mortality associated with first, second, and third line therapies for patients with good and intermediate prognosis testicular GCTs and a median age of 20 years at diagnosis. Treatment toxicities included ototoxicity, neurotoxicity, and nephrotoxicity. Monthly probabilities were weighted means derived from a sy...

Nature structural & molecular biology, 2017

Expansions of (CAG)n/(CTG)n trinucleotide repeats are responsible for over a dozen neuromuscular ... more Expansions of (CAG)n/(CTG)n trinucleotide repeats are responsible for over a dozen neuromuscular and neurodegenerative disorders. Large-scale expansions are commonly observed in human pedigrees and may be explained by iterative small-scale events such as strand slippage during replication or repair DNA synthesis. Alternatively, a distinct mechanism may lead to a large-scale repeat expansion as a single step. To distinguish between these possibilities, we developed a novel experimental system specifically tuned to analyze large-scale expansions of (CAG)n/(CTG)n repeats in Saccharomyces cerevisiae. The median size of repeat expansions was ∼60 triplets, although we also observed additions of more than 150 triplets. Genetic analysis revealed that Rad51, Rad52, Mre11, Pol32, Pif1, and Mus81 and/or Yen1 proteins are required for large-scale expansions, whereas proteins previously implicated in small-scale expansions are not involved. From these results, we propose a new model for large-sc...

BMC Cancer, 2002

Backgroud: Bone mineral density (BMD) is a marker of long-term estrogen exposure. BMD measurement... more Backgroud: Bone mineral density (BMD) is a marker of long-term estrogen exposure. BMD measurement has been used in this context to investigate the association of estrogen with breast cancer risk in three cohorts. In order to assess further BMD as a predictor of estrogen related cancer risk, the association of BMD with colorectal and corpus uteri cancer was investigated in the NHANES I Epidemiologic Followup Study (NHEFS) cohort along with breast cancer and prostate cancer. Methods: Participants were members of the NHEFS cohort who had BMD measurement in 1974-1975. Age, race, and BMI adjusted rate ratios and 95% confidence intervals were calculated for incidence of cancers of the corpus uterus, breast, colorectum, prostate, and of osteoporosis and hip fracture related to baseline BMD. Results: Data were available for 6046 individuals. One hundred cases of breast cancer, 94 prostate cancers, 115 colorectal cancers, 29 uterine cancers, 110 cases of hip fracture and 103 cases of osteoporosis were reported between 1974 and 1993. Hip fracture and osteoporosis were both significantly inversely associated with BMD. Uterine cancer was positively associated (p = 0.005, test for linear trend) and colorectal cancer negatively associated (p = 0.03) with BMD. No association was found between elevated BMD and incidence of breast cancer (p = 0.74) or prostate cancer (p = 0.37) in the overall cohort, although a weak association was seen between BMD and subsequent breast cancer incidence when BMD was measured in post-menopausal women (p = 0.04). Conclusion: The findings related to cancers of the uterus and colorectum as well as the weak association of BMD with breast cancer strengthen the use of BMD as a marker of estrogen exposure and cancer risk.

Frontiers in cell and developmental biology, 2016

TRAPP is a highly conserved modular multi-subunit protein complex. Originally identified as a &qu... more TRAPP is a highly conserved modular multi-subunit protein complex. Originally identified as a "transport protein particle" with a role in endoplasmic reticulum-to-Golgi transport, its multiple subunits and their conservation from yeast to humans were characterized in the late 1990s. TRAPP attracted attention when it was shown to act as a Ypt/Rab GTPase nucleotide exchanger, GEF, in the 2000s. Currently, three TRAPP complexes are known in yeast, I, II, and III, and they regulate two different intracellular trafficking pathways: secretion and autophagy. Core TRAPP contains four small subunits that self assemble to a stable complex, which has a GEF activity on Ypt1. Another small subunit, Trs20/Sedlin, is an adaptor required for the association of core TRAPP with larger subunits to form TRAPP II and TRAPP III. Whereas the molecular structure of the core TRAPP complex is resolved, the architecture of the larger TRAPP complexes, including their existence as dimers and multimers...