Quantifying "Community Power" and "Racial Justice" in the Medical-Legal Partnership Literature.

Medical-Legal Partnerships (MLPs) have been widely acclaimed for promoting health equity and achieving meaningful outcomes. Yet, little to no research has analyzed if this critical work has been done with communities - through meaningful engagement and building power - or if it has been done for communities without their involvement.

The State of Pediatric Research in Hawai'i: A Comparative Bibliometric Analysis.

The current state of pediatric research in Hawai'i was analyzed using bibliometric methods. The Web of Science bibliometric database was used to retrieve 989 Hawai'i records, which were compared with 264 064 records from the United States (US). Hawai'i was compared to the country as a whole in terms of total output of research, article types, top journals, co-authorship, and subject areas. The research was also analyzed in 2 time periods, 1980-1999 and 2000-2019. It was found that the total Hawai'i pediatric research output has not kept pace with the US output. However, it was found that Hawai'i had a greater share of Asia-Pacific co-authorship. Subspecialty areas of study also differed between Hawai'i and the US, and have changed over time from a predominance of infectious diseases and immunology research to a focus on emergency medicine and orthopedics. Neonatology research has increased locally as it has nationally. Hawai'i authors tend to publish a greater percentage of full-length original research articles in the top pediatric journals compared to US authors as a whole. The set of institutions publishing pediatric research in Hawai'i has diversified over time. This analysis of the pediatric research in Hawai'i can be used by researchers, funders, and policy makers to direct future research efforts to improve the health of children in Hawai'i.

Building a Patient-Centered Medical-Legal Home in Hawaii's Kalihi Valley.

The Medical-Legal Partnership for Children in Hawai'i (MLPC) has worked to address the social determinants of health for low-income patient-families since 2009. Focused on identifying health-harming legal needs, doctors and lawyers work together to assist families with family law, housing, public benefits, education, employment, civil rights, and other concerns. Providing free, direct legal service in the medical setting allows the medical-legal partnership (MLP) team to identify community-wide concerns such as language access violations, racial discrimination, and unfair policies. These individual concerns then inform systemic advocacy and community engagement efforts. The MLPC Hawai'i team has grown through its experiences working with public housing residents, Micronesian migrant communities, and low-income families, ultimately evolving the national MLP framework to become a patient-centered "medical-legal home." This evolution is possible through the utilization of "rebellious lawyering" concepts of working with, not just on behalf of, community clients. This article will introduce the concept of a medical-legal partnership, provide examples of lessons learned from working alongside vulnerable and resilient communities, and explore the idea of the patient-centered medical-legal home as an innovative program to improve the social determinants of health and reduce health disparities.

Extracellular matrix activity and caveolae events contribute to cell surface receptor activation that leads to MAP kinase activation in response to UV irradiation in cultured human keratinocytes.

Activation of cell surface components has been implicated in the activation of downstream signaling cascade in response to UV irradiation, and yet the identity and the interaction of those components have been scantly documented. Accumulating evidence indicates that caveolae encapsulating caveolins is the location for those interactions. We found in cultured human keratinocytes that UV irradiation induced both caveolin-1 and EGFR phosphorylation. Filipin, a caveolae disruptive agent, inhibited UV-induced caveolin-1 activation. Na+-K+-ATPase catalyzes active transport of Na+ and K+ across plasma membrane of mammalian cells, inactivation of which has recently been shown to be involved in the activation of signal transduction pathways including MAP kinase cascade. We found in this study that UV inactivated Na+-K+-ATPase in time-dependent manner, Na+-K+-ATPase activity started to decrease 5 min post UV irradiation and reduced to 60% of its original activity within 1 h. Pretreatment with Flipin and MMP inhibitor recovered Na+-K+-ATPase activity lost by UV irradiation. ECIS analysis indicated that both EGF treatment and UV irradiation increased membrane electric activity which was inhibited by MMP inhibitor and Filipin. Further study showed that pretreatment of human keratinocytes with MMP inhibitor or Filipin inhibited UV-induced phosphorylation of p38 and JNK, which was however not observed in LnCap cells, a prostate cancer cell line lacking caveolin-1. UV irradiation also induced ectodomain shedding of HB-EGF in a time-dependent manner in keratinocytes. Collectively, we conclude that UV-induced MAP kinase activation is mediated by cell surface receptor activation due to the matrix activity and membrane caveolae function and inactivation of Na+-K+-ATPase.