Digital Commons Network^™

African American And African-Born Black Women’S Perspectives And Experiences With A Cervical Health Education And Hpv-Self Sampling Intervention, Shania Jones, Abubakari Wuni, Adaeze Aroh, Adebola Olamide Adegboyega

Markey Cancer Center Faculty Publications

Background/Objectives: A combination of cervical cancer prevention education and the provision of HPV self-collection kits has been found to increase the uptake of HPV testing among women. However, there is limited research evaluating the perspectives and experiences of women who have participated in a cancer prevention education and received a complimentary HPV self-collection kit. We report the experiences of women who took part in Health is Wealth: a cervical health intervention and received a complimentary HPV self-sampling kit for cervical cancer screening.

Methods: This pilot qualitative study enrolled twenty-four women who participated in one-on-one semi-structured interviews to provide feedback and …

Analysis Of Facilitators Of And Barriers To Enactment Of State Regulation Of Indoor Tanning By Minors, Carolyn J. Heckman, Anna Mitarotondo, David B. Buller, Julia Berteletti, Kevin Schroth, Jerod L. Stapleton, Robert P. Dellavalle

Markey Cancer Center Faculty Publications

Background: Indoor tanning (IT) causes skin cancers, including potentially deadly melanoma. IT often starts during youth, a critical time for deleterious skin damage. About half of the US states have enacted laws banning IT for minors under age 18.

Purpose: This study reports qualitative findings from interviews with key informants (KIs) involved in IT legislative efforts to identify/describe factors influencing law enactment, based on the multiple streams framework.

Methods: Guided by expert advisors and using snowball-sampling, KIs from 16 states with most recently enacted IT laws regulating minor access and states without restrictions were contacted. In virtual interviews, KIs shared …

Capturing Community Perspectives In A Statewide Cancer Needs Assessment: Online Focus Group Study, Jessica R. Thompson, Keeghan Francis, Caree R. Mcafee, Madeline Brown, Todd Burus, Melinda Rogers, Connie L. Sorrell, Elizabeth A. Westbrook, Lovoria B. Williams, Jennifer Redmond Knight, Elaine Russell, Natalie P. Wilhite, Pamela C. Hull

Markey Cancer Center Faculty Publications

Background: Kentucky has the highest all-site cancer incidence and mortality rates in the United States. Conducting needs assessments in a large geographic area, such as an entire state, poses challenges in collecting qualitative data from diverse rural and urban contexts. In 2021, a steering committee was formed to drive a multimethod, statewide cancer needs assessment (CNA) to identify the future priorities for all cancer-related care in Kentucky.

Objective: We aimed to report on the online focus group component of the CNA by documenting existing community resources and perceived needs across the cancer care continuum. In addition, we aimed to explore …

Cisplatin-Loaded M1 Macrophage-Derived Vesicles Have Anti-Cancer Activity In Osteosarcoma, Namrata Anand, Joseph Robert Mccorkle, David Schweer, Lan Li, Kristen S. Hill, Melissa A. Fath, Derek B. Allison, Christopher L. Richards, Jill M. Kolesar

Markey Cancer Center Faculty Publications

Osteosarcoma (OS) is a relatively rare bone malignancy that primarily affects children and young adults and is associated with significant morbidity and mortality. Cisplatin is a mainstay of treatment, but its efficacy is limited by off-target toxicities. Immunotherapy is not effective due to a poor antigenic tumor microenvironment. Here, we address these challenges by using manufactured M1 macrophage-derived vesicles (MVs) loaded with cisplatin. Human blood and mouse RAW 264.7 M1 macrophages were used to prepare empty (E-MVs) and cisplatin-loaded MVs (C-MVs). Human OS cell lines were used in vitro and in a tibia xenograft mouse model to evaluate the anti-cancer …

Examining Associations Between Sociodemographic Characteristics And Ever Breastfed Children, Nhanes 1999–2020, Jessica Amezcua, Lindsey M. West, Camelia Malkami, Marlo M. Vernon, Elinita Pollard, Justin X. Moore

Markey Cancer Center Faculty Publications

Although breastfeeding provides health benefits to both mother and child, this study aimed to explore whether disparities in breastfeeding continue to exist, particularly among non-Hispanic Black (NHB) mothers and children. We performed a cross-sectional analysis among 19,830 children in the United States (US) using the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2020. Breastfeeding initiation and duration rates increased overall from 1999 to 2020. Children who were ever breastfed were more likely to have higher body weight, older mothers, mothers who did not smoke during pregnancy, a higher family poverty–income ratio (PIR), food security, mothers in …

Introducing An Eating Disorder Protocol In The Pediatric Primary Care Setting, Brandi Bozarth

DNP Projects

Background: The incidence of eating disorders has been on the rise, often beginning in adolescence and continuing well into adulthood. Consequences of untreated disrupted eating patterns can affect multiple body systems and are responsible for thousands of deaths annually. Despite these facts, research and data regarding eating disorders in adolescent patients are severely deficient. There is also a lack of standardization regarding assessing eating disorders in the pediatric primary care setting, as there are no specific guidelines or screening processes recommended by the American Academy of Pediatrics for the detection of eating disorders.

Purpose: The purpose of this project is …

Evaluating The Implementation Of Social Determinants Of Health Screening In An Interdisciplinary Clinic, Taylor M. Adams

DNP Projects

Background: Social Determinants of Health (SDOH), including food, housing, interpersonal violence, and transportation are non-medical problems that can influence health outcomes (World Health Organization, 2020). Low-income minorities and public-payer groups are at considerable higher risk for social needs. Collaboration within the community can improve health outcomes (Sulley et al., 2021). A literature review revealed limited evidence of screening in dental clinic settings. Failure to identify and address SDOH needs in this population can lead to poorer health outcomes.

Purpose: The purpose of this quality improvement project was to implement and evaluate social determinants of health screening and evaluate the …

The Impact Of Code Lavender On Compassion Fatigue And Burnout Of Pediatric Bedside Staff, Sara L. Castle

DNP Projects

Background: Compassion fatigue is a significant problem in healthcare that can impact staff retention, job satisfaction, and patient outcomes. Code Lavender combats compassion fatigue by serving as a crisis intervention tool using evidence-based relaxation techniques, paired with increased support from Leadership.

Purpose: The purpose of this project was to evaluate the impact of Code Lavender on reported levels of compassion fatigue and burnout amongst pediatric bedside staff working on a 12-bed progressive care unit at a Children’s Hospital in a large Academic Medical Center.

Method: This study employed a pilot evaluation design, consisting of pre- and post-surveys utilizing questions from …

Advancing Root Trait Measurements For A Deeper Understanding Of Soil Biogeochemistry, Brian Rinehart

Theses and Dissertations--Plant and Soil Sciences

Climate change is disrupting (agro)ecosystems, with the potential for significant losses in crop productivity and ecosystem resilience due to changes in water and biogeochemical cycling. These disruptions can also release more carbon dioxide into the atmosphere through the degradation of soil organic matter. Plant roots have emerged as a potential tool for mitigating these effects, given their roles in plant function and in driving soil biogeochemistry. While this interest is growing, our ability to implement root trait selection is limited due to constraints on characterizing roots and limited clarity on the effects of traits on plant and ecosystem function. My …

Revolutionizing Grapevine Breeding Programs: A Mobile Genome Editing System For Perennial Crops, Bridget Bolt

Theses and Dissertations--Plant and Soil Sciences

Grapevine (Vitis vinifera) faces unprecedented challenges from climate change, with up to 90% of current growing regions potentially becoming unsuitable for production within decades. Traditional breeding approaches require 25-30 years for variety development, creating a time constraint incompatible with the pace of environmental change. This research establishes the approach for a novel mobile RNA-based gene editing platform that addresses longstanding bottlenecks in grapevine improvement while preserving cultivar identity and reducing breeding timelines.

This research developed a three-component system for transgene-free gene editing in grapevine. First, a mobile CRISPR/Cas9 system was established using Agrobacterium rhizogenes transformation and the cut-and-dip …

Chemoproteomic Profiling Of A Carbon-Stabilized Gold(Iii) Macrocycle Reveals Cellular Engagement With Hmox2, Sailajah Gukathasan, Chibuzor Ngozi Olelewe, Libby Ratliff, Jong H. Kim, Alyson M. Ackerman, J. Robert Mccorkle, Sean Parkin, Gunnar F. Kwakye, Jill M. Kolesar, Samuel G. Awuah

Chemistry Faculty Publications

In this work, we discovered a novel organometallic gold(III) macrocycle, Au-Mac1, that demonstrates anticancer potency in a panel of triple-negative breast cancer cells (TNBC), and based on this complex, a biotinylated-Au-Mac1 probe was designed for target identification via chemoproteomics, which uncovered the engagement of HMOX2 of the heme-energy metabolism pathway. Using orthogonal chemical biology and molecular biology approaches, including immunoblotting, flow cytometry, and cellular thermal shift assays, it was confirmed that Au-Mac1 engages HMOX2 in cells. Downstream effects of Au-Mac1 on the depletion of mitochondrial membrane proteins and bioenergetics point to the potential role of HMOX2 in cancer. Importantly, Au-Mac1 …

Iodinated Disinfection Byproduct Formation From Iohexol In Sunlit And Chlorinated Urban Wastewaters, Reagan Patton Witt, Marcelo I. Guzman

Chemistry Faculty Publications

Iodinated disinfection by-products (I-DBPs) are of growing concern due to their elevated toxicity compared to their chlorinated counterparts, with links to adverse health effects such as bladder cancer and miscarriages. Medical imaging agents like iohexol, commonly used in healthcare facilities, introduce iodine into wastewater systems. This study investigates the photodegradation of iohexol and the subsequent formation of products, including I-DBPs, during simulated final wastewater treatment under chlorination and sunlight exposure. Experiments were conducted with solutions containing 30 μM iohexol, 3 mg L⁻¹ humic acids, and 5.5 mg L⁻¹ hypochlorite. Samples were irradiated at λ ≥ 295 nm and …

Improving Proteostasis Of Trafficking-Deficient GabaAReceptor Variants By Activating Ire1, Xu Fu, Ya Juan Wang, Kyung A. Lee, Lucie Y. Ahn, Xi Chen, Brock T. Harvey, Meng Wang, Hailey Seibert, Pei Pei Zhang, Adrian Guerrero, Ashleigh E. Schaffer, Christopher I. Richards, R. Luke Wiseman, Jeffery W. Kelly, Ting Wei Mu

Chemistry Faculty Publications

Gamma-aminobutyric acid type A receptors (GABA_ARs) are essential for maintaining the excitation–inhibition balance in the central nervous system. Genetic variations of GABA_ARs result in a variety of neurological disorders, such as epilepsy. A key pathogenic mechanism involves protein misfolding and defective assembly of GABA_ARs in the endoplasmic reticulum (ER), resulting in impaired surface expression and loss of function. Here, we investigated three trafficking-deficient variants of the GABA_AR α1 subunit (GABRA1), including D219N (ClinVar Variation ID: 127232), G251D (Variation ID: 419523), and P260L. We demonstrated that selective pharmacological activation of the IRE1/XBP1s signaling …

Characterization Of The Solid-State Bonding For Simulated Charge And Seam Welds In The Porthole Die Extrusion Process, Randall L. Bowers

Theses and Dissertations--Chemical and Materials Engineering

The isothermal (ISO-T) compression configuration is ideal for utilizing as a material input of flow stress at temperature and strain rate in models of the porthole die extrusion process due to the isothermal nature of the test. Micro-tensile testing was conducted to validate the solid-state welding integrity of the ISO-T samples at various temperatures and strain rates. Results of the mechanical testing were correlated with fractography and microstructural evaluations of the welds to confirm bonding behavior. Both clean interface conditions and oxidation and lubrication layers were evaluated to simulate the difference of seam and charge welds in the process. Results …

Computational Modeling Of The Heat Treatment Of White Oak Bound For Spirit Maturation, Kate E. Mclarney-Popham

Theses and Dissertations--Chemical and Materials Engineering

Maturation of distilled spirits in white oak barrels is a long standing practice known to have great impact on spirit character. Much of this impact can be controlled by the thermal modification of the barrel, since thermal degradation of the wood determines what wood compounds are available to interact with the spirit during maturation. In this work, a computational model for the thermal degradation of wood was developed and, with flavor compound data from literature, was used to investigate the effect of heat treatment on lignin-derived flavor compounds. The computational model in this work accounted for three solid species, three …

The Optimization And Manufacturing Scale-Up Of Polymeric Membranes Using Eco-Friendly Solvents, David Lu

Theses and Dissertations--Chemical and Materials Engineering

Polymeric membranes have become a prominent technology applied in water filtration due to the lower cost, energy input, and simpler manufacturing process relative to other separation technologies. However, the environmental impact of polymeric membrane fabrication remains a hindrance due to the use of hazardous solvents derived from fossil fuels (e.g., DMAc, NMP, DMF) that pose a risk to the environment and human health. Whereas recent studies have demonstrated the proof-of-concept of polymeric membrane derived from eco-friendly solvents, the next steps of optimizing and upscaling the production of these membranes remains understudied and a gap between lab-scale studies and the path …

Bacteria-Engineered Vesicles For Cancer Immunotherapy: From Immunomodulation In Vitro To Anti-Tumor Effects In Melanoma Models, Lan Li

Theses and Dissertations--Chemistry

Bacterial vesicles hold immense potential in various biomedical fields. Among these, outer membrane vesicles (OMVs) produced by Gram-negative bacteria are the most extensively studied. While the exact mechanism of OMV production remains unclear, numerous environmental factors have been shown to influence both their yield and composition. In this study, we investigated the effect of three different antimicrobial families on OMV production by E. coli. Interestingly, antimicrobials within the same family did not provide the same effects on OMV yield, suggesting that OMV production may not directly correlate with the antimicrobial mechanism of action. OMVs have demonstrated tumor-inhibitory activity in multiple …

Chromatographic And Electrophoretic Analysis Of Lignin-Derived Monomers And Dimers: Extraction Method Development And Evaluation Of Cyclodextrins For Recovery, Anjam Sadik

Theses and Dissertations--Chemistry

Biorefineries play a vital role in reducing dependence on fossil fuels and addressing global warming concerns. Unfortunately, investment in biorefineries remains limited due to economic sustainability concerns. One approach to enhance the economic viability of biorefineries is by fully utilizing the potential of feedstocks, particularly lignocellulosic biomass, which is commonly used in these processes. Traditional processing methods often alter the lignin portion of biomass, making it unsuitable for further utilization. However, when retained in its native form, lignin can serve as a valuable source of chemicals that contribute to the economic sustainability of biorefineries.

The lignin-first approach, which removes lignin …

Insights Into Factors Influencing Radical Coupling Chemistry Of Monolignols During Lignification And Induced Changes In Plant Secondary Metabolism, Rachel Poornima Sutherland

Theses and Dissertations--Chemistry

Lignin is a complex aromatic biopolymer and an important constituent in plant cell walls. The process of lignin biosynthesis, known as lignification, is poorly understood and challenging to study but has important implications in a variety of fields including sustainable energy, bioengineering, and materials science and is therefore of interest to pursue. In the final stage of lignification, H-, G-, and S-monolignols are oxidized by laccase and peroxidase enzymes to generate radical species that couple to form dimers and further oligomeric species to ultimately produce the lignin polymer. Biomimetic lignin model systems utilize in vitro oxidative coupling reactions as an …

Impact Of Catastrophic Brain Injury Guidelines On Organ Donation Rates, Kristen D. Nordham, Danielle Tatum, Abdallah S. Attia, Mayur B. Patel, Anil Paramesh, Juan C. Duchesne, Jeffry Nahmias, Amelia W. Maiga, Allan B. Peetz, Pascal O. Udekwu, Anquonette Stiles, Chloe Shell, Joshua D. Stodghill, Taneen Maghsoudi, Erin Iacullo, Bryant Mclafferty, Erin Coonan, Ryan M. Boudreau, Steven A. Zimmerman, Berje Shammassian, Tanya Egodage, Isabella Aramento, Patrick Morris, Jacob Metheny, Michael S. Farrell, Matthew D. Painter, Owen T. Mccabe, Philomene Spadafore

Surgery Faculty Publications

BACKGROUND One third of organ donors suffer catastrophic brain injury (CBI). There are no standard guidelines for the management of traumatic CBI prior to brain death, and not all trauma centers have institutional CBI guidelines. In addition, there is high variability in management between institutions with guidelines. Catastrophic brain injury guidelines vary and may include various combinations of hormone therapy, vasopressors, fluid resuscitation, and other practices. We hypothesized that centers with CBI guidelines have higher organ donation rates than those without. METHODS This prospective, observational EAST-sponsored multicenter trial included adult (18+ years old) traumatic-mechanism CBI patients at 33 level I …

Design And Synthesis Of Novel Ligands For Bioorthogonal Catalysis, Asymmetric Synthesis, And Ferromagnetic Behavior, Alexander G. Olivelli

Theses and Dissertations--Chemistry

Small molecule metal complexes have diverse applications including usage as catalysts, single molecule magnets, photosensitizers and pharmaceuticals. The first research project in this work reports a new ligand which dimerizes upon coordination to afford a trinuclear Cu(I) complex. Due to the coordination geometry of the Cu(I) metal centers, paired with the strong nitrogen coordinating groups, the resulting complex is resistant to oxidation even in the presence of strong oxidants. The complex is shown to be efficient in the CuAAC reaction and used to tag anticancer drug candidates in vitro. The next project focuses on a series of amidine-based ligands featuring …

Secondhand Tobacco Smoke Exposure And Sleep Disturbance In School-Aged Children In Appalachian Ohio, Ketrell Mcwhorter, Christine Kim, Timothy J. Hilbert, Danielle E. Mcbride, Anthony A. Mangino, Patrick J. Parsons, Kurunthachalam Kannan, Erin N. Haynes

Epidemiology and Environmental Health Faculty Publications

Introduction: Secondhand tobacco smoke (SHS) exposure remains a major public health concern for children and has been implicated in sleep disturbances through biological and behavioral mechanisms. Different methods of measuring SHS exposure have yielded inconsistent results. This study examined the relationship between SHS exposure and sleep among rural Appalachian 7–9-year-olds, utilizing three SHS measurements: natural log-transformed (ln) serum cotinine concentrations, dichotomized serum cotinine levels (≥0.05 vs. <0.05 ng/ml), and parent/caregiver report of ≥1 smoker in the home. We hypothesized SHS-exposed children would have a significantly higher prevalence of sleep disturbance—e.g., short sleep, frequent snoring, night awakenings—compared to unexposed, regardless of measurement method. Methods: We used data from the Marietta Community Actively Researching Exposure Study, a cohort of 404 children in Marietta and Cambridge, Ohio. Sleep disturbances were parent/caregiver-reported. Linear models were used for continuous outcomes to estimate beta coefficients; log-binomial models with generalized estimating equations (exchangeable correlation) were applied for dichotomized outcomes to estimate prevalence ratios (PR), each with 95% confidence intervals (CI). Results: Twenty-six percent of children had a parent/caregiver report of ≥1 sleep disturbance. There was a 35% increased prevalence of short sleep [PR = 1.35 (95%CI:1.02–1.80), p =.04] with each unit increase of ln serum cotinine levels, adjusting for age, sex, parent education, BMI percentile, and history of breathing difficulties in the past two years. Increasing ln serum cotinine levels were associated with a significant 5.5-min decrease in average sleep duration in age-adjusted models. Conclusions: Higher SHS exposure was associated with poorer sleep outcomes, with serum cotinine emerging as the only measure linked to short sleep, underscoring the importance of smoke-free environments, particularly in rural communities, and objective exposure assessment.

Piglet Nursing Location Along The Sow’S Udder Line Affects Piglet Weight Gain And Subsequent Weaning Weight, Shannon Dierking, Harold J. Monegue, Merlin Lindemann

Animal and Food Sciences Faculty Publications

Background: There is a linear correlation between piglet weaning weight and average daily gain during the post-nursery period. A key factor that influences piglet weight gain during lactation is milk intake. Thus, the variation in piglet weaning weight is hypothesized to be, to some extent, a result of differences in milk production among individual mammary glands. Objective: The objective of this study was to evaluate the impact of piglet nursing location throughout lactation on piglet weaning weight, with a secondary objective of determining the impact of piglet birth weight on nursing location selection. Methods: Teat pairs were labeled from anterior …

Effects Of Ethanol And Neuropeptide-Y Signaling On Neurogenic Markers In The Hippocampus, Cassidy Taylor Leibold

Theses and Dissertations--Psychology

According to the National Survey of Drug Use and Health in 2023, 28.9 million people over the age of 12 in the United States meet criteria for an Alcohol Use Disorder (AUD). AUDs result in a range of both social and behavioral consequences, caused by damage to the central nervous system. The hippocampus is a brain structure that undergoes cellular changes in the presence of ethanol, thus causing structural and functional damage. Impairments in neurogenesis, or the production of new neurons, due to ethanol exposure result in decreased plasticity and consequently memory impairments. The mechanisms of these ethanol-induced decreases in …

Factors Of Willingness To Pay For Equine Veterinary Services, Olivia Gibson, Shuoli Zhao, C. Jill Stowe

Animal and Food Sciences Faculty Publications

This study estimates correlates of willingness-to-pay (WTP) for routine, elective, and urgent equine veterinary services in the United States. Through a nationwide online survey of US horse owners aged 18 and older, a payment card approach was utilized to elicit WTP for annual vaccinations, a lameness exam, and emergency colic surgery. Based on the results from an interval regression model, we found that financial capacity, income level, and the number of horses owned were significant predictors of WTP across all three service types. These findings have implications for equine veterinary practice management and client communication regarding treatment costs.

Resilience After Prenatal Substance Exposure: Exploring The Role Of Cumulative And Specific Protective Factors In Predicting Toddlerhood Temperament Profiles, Anjeli Elkins

Theses and Dissertations--Psychology

Objective

Prenatal exposure to common substances, including nicotine, marijuana, cocaine, methamphetamine, opiates, and alcohol, has been linked to a wide range of psychiatric disorders and neurodevelopmental impairments. Identifying protective factors that may improve temperament profiles in toddlers who have experienced prenatal substance exposure may protect against these adverse outcomes and is crucial for developing targeted early interventions.

Methods

Participants (n=92; Mage = 28.7 years; 47.0% White) were biological mothers of toddlers (Mage = 22.6 months) with prenatal substance exposure. Mothers responded to an online survey that gathered information on substance use during pregnancy, proposed perinatal protective factors, and child temperament. …

Multidimensional Health Outcomes In Lgbtq+ Older Adults In The United States: Individual And Community-Level Protective Factors, Emily P. Lapidus

Theses and Dissertations--Psychology

Despite a lifetime of systematic barriers, LGBTQ+ individuals age into late adulthood, likely due to various protective factors. Guided by the Iridescent Life Course Framework (ILCF; Fredriksen-Goldsen & Muraco, 2019), I analyzed unique protective factors at two levels: (1) individual psychological factors (i.e., resilience, identity management) and (2) community-level factors (i.e., LGBTQ+ community connectedness, social support). Health was operationalized as mental health, physical health, and health-promoting behaviors. The present study accounted for covariates (i.e., financial barriers to healthcare, felt subjective age discrepancy, lifetime discrimination). I hypothesized that both stronger individual and community factors would be associated with better physical and …

"We Talk About It At The Dinner Table": Parent Discussions Of Identity And Politics In Diverse Adoptive Families In The United States, Abigail L. Moore

Theses and Dissertations--Psychology

Parents discussing identity and politics with their diverse adolescents can be protective against experiences of political stress and negative outcomes (Anderson, 2023). Identity discrepancies between parents and adolescents may complicate these conversations (McCrimmon et al., 2024). However, this research often only focuses on only one identity (e.g., race or gender; Mendez, 2022). Because negative political climates affect multiple identities simultaneously (Kassing et al., 2021), the current study explores political conversations in diverse, adoptive family contexts with varying (un)shared identities. Through reflexive thematic analysis (Braun & Clarke, 2021), 7 major themes were developed. Results suggest that identity discrepancies may underlie a …

Associations Between Queer Parent Family Socialization And Adolescent Outcomes Among Diverse Lgbtq+ Parent Families In The U.S., Nita U. Kulkarni

Theses and Dissertations--Psychology

Queer parent family socialization refers to the way LGBTQ+ parents talk with their children about what it means to be queer in society, how to handle discrimination, and ways to have pride in their family’s identity. This construct has been linked with positive well-being outcomes in children, and this study used a strengths-based, mixed- methods framework informed by Minority Stress Theory and intersectionality to examine how queer parent family socialization related to several adolescent well-being outcomes, namely internalizing behaviors, social competence, and adaptive coping. Participants recruited across two projects were 191 queer parents with an adolescent and 114 adolescents with …

Putative Mechanisms Of Personality Change In Treatment, Hannah Croom

Theses and Dissertations--Psychology

BPD Compass was designed to engage the BPD-relevant traits from the Alternative Model of Personality Disorders in the DSM-5 by targeting putative mechanisms associated with these personality domains: aversive reactivity to engage negative affectivity, attachment insecurity to engage antagonism, and self-efficacy to engage disinhibition. The goal of the present study was to test the associations between putative mechanisms and respective personality traits. We used multilevel structural equation modeling to test if personality domains and putative mechanisms changed in treatment, if changes in putative mechanism were associated with changes in respective personality domain, and if within-person changes in putative mechanisms predicted …