Medicine and Health Sciences Commons^™

Strengthening The Science Of Public Health Delivery: Complexities In Implementation, Inference & Translation, Glen P. Mays

Health Management and Policy Presentations

Delivery systems for public health programs and policies are diffuse and heterogeneous across the U.S., reflecting wide variation in the capacity to implement population-level health improvement strategies. This lecture examines strategies for evaluating the causes and consequences of variation in public health delivery across the U.S., with a focus on identifying pathways for improving the health and economic effects of policy and practice.

Genetics Of Picalm Expression And Alzheimer's Disease, Ishita Parikh, David W. Fardo, Steven Estus

Sanders-Brown Center on Aging Faculty Publications

Novel Alzheimer's disease (AD) risk factors have been identified by genome-wide association studies. Elucidating the mechanism underlying these factors is critical to the validation process and, by identifying rate-limiting steps in AD risk, may yield novel therapeutic targets. Here, we evaluated the association between the AD-associated polymorphism rs3851179 near PICALM, which encodes a clathrin-coated pit accessory protein. Immunostaining established that PICALM is expressed predominately in microvessels in human brain. Consistent with this finding, PICALM mRNA expression correlated with expression of the endothelial genes vWF and CD31. Additionally, we found that PICALM expression was modestly increased with the rs3851179A …

Selectivity And Potency Of Microcystin Congeners Against Oatp1b1 And Oatp1b3 Expressing Cancer Cells, Timo H.J. Niedermeyer, Abigail Daily, Monika Swiatecka-Hagenbruch, Jeffrey A. Moscow

Pediatrics Faculty Publications

Microcystins are potent phosphatase inhibitors and cellular toxins. They require active transport by OATP1B1 and OATP1B3 transporters for uptake into human cells, and the high expression of these transporters in the liver accounts for their selective hepatic toxicity. Several human tumors have been shown to have high levels of expression of OATP1B3 but not OATP1B1, the main transporter in liver cells. We hypothesized that microcystin variants could be isolated that are transported preferentially by OATP1B3 relative to OATP1B1 to advance as anticancer agents with clinically tolerable hepatic toxicity. Microcystin variants have been isolated and tested for cytotoxicity in cancer cells …

Syphilis: A Forgotten Sexually Transmitted Disease?, Amy Burnett, Hatim A. Omar

Pediatrics Faculty Publications

Syphilis has declined significantly over the last 30 years. Due to that success, many physicians no longer have the skills to recognize its symptoms. We present a case of syphilis as a demonstration of this fact and hope that health professionals in the field of adolescent medicine will think about this diagnosis in their clinical work.

Melanoma Of The Hand: Current Practice And New Frontiers, John Brad Turner, Brian Rinker

Surgery Faculty Publications

Melanoma of the hand represents a complicated clinical entity. Anatomic features of the hand create challenges in successful management of melanoma not encountered elsewhere in the body. The objectives of this article are to outline current standards for managing melanoma of the hand including diagnosis, surgical, and chemotherapeutic management. Particular emphasis will be placed on currently debated topics of the role of sentinel lymph node biopsy, the role of Mohs micrographic surgery, tissue sparing management of subungual melanoma, and the consideration of melanoma of the hand as a distinct entity based on clinical and molecular studies.

Fused In Sarcoma Is A Novel Regulator Of Manganese Superoxide Dismutase Gene Transcription, Sanjit Kumar Dhar, Jiayu Zhang, Jozsef Gal, Yong Xu, Lu Miao, Bert C. Lynn, Haining Zhu, Edward J. Kasarskis, Daret K. St. Clair

Toxicology and Cancer Biology Faculty Publications

AIMS: FUsed in sarcoma (FUS) is a multifunctional DNA/RNA-binding protein that possesses diverse roles, such as RNA splicing, RNA transport, DNA repair, translation, and transcription. The network of enzymes and processes regulated by FUS is far from being fully described. In this study, we have focused on the mechanisms of FUS-regulated manganese superoxide dismutase (MnSOD) gene transcription.

RESULTS: Here we demonstrate that FUS is a component of the transcription complex that regulates the expression of MnSOD. Overexpression of FUS increased MnSOD expression in a dose-dependent manner and knockdown of FUS by siRNA led to the inhibition of MnSOD gene transcription. …

Redox-Modulated Phenomena And Radiation Therapy: The Central Role Of Superoxide Dismutases, Aaron K. Holley, Lu Miao, Yanming Zhao, Daret K. St. Clair, William H. St. Clair

Toxicology and Cancer Biology Faculty Publications

SIGNIFICANCE: Ionizing radiation is a vital component in the oncologist's arsenal for the treatment of cancer. Approximately 50% of all cancer patients will receive some form of radiation therapy as part of their treatment regimen. DNA is considered the major cellular target of ionizing radiation and can be damaged directly by radiation or indirectly through reactive oxygen species (ROS) formed from the radiolysis of water, enzyme-mediated ROS production, and ROS resulting from altered aerobic metabolism.

RECENT ADVANCES: ROS are produced as a byproduct of oxygen metabolism, and superoxide dismutases (SODs) are the chief scavengers. ROS contribute to the radioresponsiveness of …

Compositions And Methods For Selectively Targeting Cancer Cells Using A Thiaminase Compound, Jeffrey A. Moscow, Shuqian Liu, Younsoo Bae

Pharmaceutical Sciences Faculty Patents

Compositions and methods of treating cancer using a thiaminase compound are described. The presently-disclosed subject matter includes a method of treating cancer by administering a thiaminase compound and a thiamine-dependent enzyme inhibitor.

Exploring The Association Between Long-Term Hpsa Designation And County Population-To-Physician Ratio, Christopher Duffrin, Natalie A. Jackson

Frontiers in Public Health Services and Systems Research

Federal, state, local and public health officials utilize Health Professional Shortage Area (HPSA) designations to manage health and physician workforce development in underserved regions. HPSA designation length by county was examined to determine if there is significant association with population-to-primary care physician ratio since the inception of HPSA designations in 1978. Counties were grouped in 5 categories based on consecutive designation length and analyzed with demographic variables. This report examines the relationship of long-term HPSA status and changes in primary care physician workforce.

The Effects Of The State Of Tennessee Immunization Policy Change Of 2011 - 2012 On Vaccination Uptake In East Tennessee, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

In the United States, funding for the purchase of vaccines depend on annual Congressional allocations. These allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2012, the loss of funds allocated from the American Recovery and Reinvestment Act required action by states to ensure appropriate use of remaining funds. In Tennessee, the response was a …

Diffusion Theory And Knowledge Dissemination, Utilization And Integration, Lawrence W. Green, Judith M. Ottoson, César García, Robert A. Hiatt, Maria L. Roditis

Frontiers in Public Health Services and Systems Research

Part of the Community Health and Preventive Medicine Commons, Health and Medical Administration Commons, Health Policy Commons, Health Services Administration Commons, Health Services Research Commons, and the Public Health Education and Promotion Commons

Many accomplishments of public health have been distributed unevenly among populations. This article reviews the concepts of applying evidence-based practice in public health in the face of the varied cultures and circumstances of practice in these varied populations. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community and practitioners …

Public Health Services Most Commonly Provided By Local Health Departments In The United States, Gulzar H. Shah, Huabin Luo, Sergey Sotnikov

Frontiers in Public Health Services and Systems Research

The primary purpose of this research is to identify the most commonly performed public health services by local health departments (LHDs) and highlight variation by LHD characteristics. Data were drawn from the 2008 and 2010 National Profile of LHDs, conducted by the National Association of County and City Health Officials (NACCHO). The descriptive analysis aims to further the essential dialogue triggered by a recent Institute of Medicine (IOM) report about the standard minimum set of services that all LHDs should provide. This study identified a set of 22 activities performed by LHDs that are common in jurisdictions of all sizes. …

Community Health Assessment By Local Health Departments: Future Questions, Kay Lovelace

Frontiers in Public Health Services and Systems Research

This "Letter to the Editor" is a response to the article "Community Health Assessment by Local Health Departments: Presence of Epidemiologist, Governance, and Federal and State Funds are Critical" published in volume 2, issue 6 of this journal. It considers how LHDs develop CHAs in complex jurisdictions, the roles of other professionals in the development of CHAs, and the conduct, quality, and use of CHAs.

Evidence-Based Smoking Cessation Treatment For Disparate Populations, Chizimuzo T.C. Okoli

Nursing Presentations

Overview of this presentation:

• Describe Research Group and Program of Research among disparate Populations
• Discuss smoking among persons with substance use and mental illness
• Present smoking cessation outcomes from evidence-based programs for persons with substance use disorders and mental Illness
• Conclusion with current and future Projects

Community Health Workers: Implementing A System In Kentucky, S. Makwana, Frances J. Feltner, J. Chamness, C. White, S. Mayfield Gibson

Center of Excellence in Rural Health Presentations

A Community Health Worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A CHW also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy. (American Public Health Association)

Recognized as professional members of the health …

Pharmacy Law Brief: Medications And Lawful Executions, Joseph L. Fink Iii

Pharmacy Practice and Science Faculty Publications

No abstract provided.

Acceptability Of Condoms, Circumcision And Prep Among Young Black Men Who Have Sex With Men: A Descriptive Study Based On Effectiveness And Cost, Richard A. Crosby, Angelica Geter, Ralph J. Diclemente, Laura F. Salazar

Health, Behavior & Society Faculty Publications

The current study examined and compared the willingness of young Black men who have sex with men (YBMSM) to accept pre-exposure prophylaxis (PrEP), adult male circumcision, and condoms for reducing their risk of HIV acquisition. The majority (67%) reported unprotected receptive anal sex in the last six months. About three-quarters (71%) would accept using PrEP if it was 100% effective. Cost influenced PrEP acceptance with 19% indicating acceptance at $100 per month co-pay. Of those not circumcised, 50% indicated willingness if circumcision was 100% effective. Acceptance of circumcision decreased markedly to 17% with co-pays of $100. About 73% of men …

Phanerochaete Chrysosporium Pretreatment Of Biomass To Enhance Solvent Production In Subsequent Bacterial Solid-Substrate Cultivation, Wanying Yao, Sue E. Nokes

Biosystems and Agricultural Engineering Faculty Publications

This study investigated pretreatment of corn stover using solid substrate cultivation (SSC) of Phanerochaete chrysosporium (P. chrysosporium) to improve subsequent accessibility to cellulose. Thereafter, Clostridium thermocellum (C. thermocellum) was directly inoculated onto the pretreated biomass to accomplish hydrolysis, followed by solventogenesis by introducing Clostridium beijerinckii (C. beijerinckii).

An enzyme suite containing laccase, lignin peroxidase and manganese peroxidase activity was detected during the cultivation of P. chrysosporium on corn stover within 288 h at an initial moisture content 𝓌_H2O = 80% (mass of water/total mass). Incubation factors, such as substrate moisture content and cultivation …

Pharmacogenomics In Psychiatry: From Therapeutic Drug Monitoring To Genomic Medicine, Séverine Crettol, Jose De Leon, Christoph Hiemke, Chin B. Eap

Psychiatry Faculty Publications

Psychiatry is increasingly combining new pharmacogenomic findings with therapeutic drug monitoring (TDM) to improve the safety and efficacy of pharmacotherapy. However, a distinction should be made between “nice to know” and “need to know” pharmacogenomic data because many results are statistically significant in meta-analyses but are not clinically relevant due to their low effect sizes. Some examples will illustrate this integration.

Spatiotemporal Expression Of Manf In The Developing Rat Brain, Haiping Wang, Zunji Ke, Alexander Alimov, Mei Xu, Jacqueline A. Frank, Shengyun Fang, Jia Luo

Pharmacology and Nutritional Sciences Faculty Publications

Mesencephalic astrocyte-derived neurotrophic factor (MANF) is an evolutionarily conserved neurotrophic factor which exhibited neuroprotective properties. Recent studies suggested that MANF may play a role in the neural development of Drosophila and zebra fishes. In this study, we investigated the spatiotemporal expression of MANF in the brain of postnatal and adult rats. MANF expression appeared wide spread and mainly localized in neurons. In the cerebral cortex, neurons in layer IV and VI displayed particularly strong MANF immunoreactivity. In the hippocampus, intensive MANF expression was observed throughout the subfields of Cornu Amonis (CA1, CA2, and CA3) and the granular layer of the …

Anti-Lysophosphatidic Acid Antibodies Improve Traumatic Brain Injury Outcomes, Peter J. Crack, Moses Zhang, Maria Cristina Morganti-Kossmann, Andrew J. Morris, Jonathan M. Wojciak, Jonathan K. Fleming, Ila Karve, David Wright, Maithili Sashindranath, Yona Goldshmit, Alison Conquest, Maria Daglas, Leigh A. Johnston, Robert L. Medcalf, Roger A. Sabbadini, Alice Pébay

Internal Medicine Faculty Publications

BACKGROUND: Lysophosphatidic acid (LPA) is a bioactive phospholipid with a potentially causative role in neurotrauma. Blocking LPA signaling with the LPA-directed monoclonal antibody B3/Lpathomab is neuroprotective in the mouse spinal cord following injury.

FINDINGS: Here we investigated the use of this agent in treatment of secondary brain damage consequent to traumatic brain injury (TBI). LPA was elevated in cerebrospinal fluid (CSF) of patients with TBI compared to controls. LPA levels were also elevated in a mouse controlled cortical impact (CCI) model of TBI and B3 significantly reduced lesion volume by both histological and MRI assessments. Diminished tissue damage coincided with …

Nuclear Interaction Between Adr-Induced P65 And P53 Mediates Cardiac Injury In Inos (−/−) Mice, Marsha P. Cole, Jitbanjong Tangpong, Terry D. Oberley, Luksana Chaiswing, Kinsley K. Kiningham, Daret K. St. Clair

Toxicology and Cancer Biology Faculty Publications

Adriamycin (ADR) treatment causes an imbalance in the levels of nitric oxide (^•NO) and superoxide (O₂^•−) production leading to cardiac injury. Previously we demonstrated that mice lacking inducible nitric oxide synthase (iNOS) have increased oxidative stress and mitochondrial injury. The molecular events leading to increased mitochondrial injury in iNOS deficient mice is unknown. ADR in the absence of iNOS preferentially activates a proapoptotic pathway without a concurrent increase in prosurvival pathways. Treatment with ADR leads to an increase in DNA binding activity of nuclear factor kappa B (NFκB) and p53 in wildtype mice. Following ADR …

Nuclear Receptor 4a3 (Nr4a3) Regulates Murine Mast Cell Responses And Granule Content, Gianni Garcia-Faroldi, Fabio R. Melo, Dennis Bruemmer, Orla M Conneely, Gunnar Pejler, Anders Lundequist

Internal Medicine Faculty Publications

Nuclear receptor 4a3 (Nr4a3) is a transcription factor implicated in various settings such as vascular biology and inflammation. We have recently shown that mast cells dramatically upregulate Nuclear receptor 4a3 upon activation, and here we investigated the functional impact of Nuclear receptor 4a3 on mast cell responses. We show that Nuclear receptor 4a3 is involved in the regulation of cytokine/chemokine secretion in mast cells following activation via the high affinity IgE receptor. Moreover, Nuclear receptor 4a3 negatively affects the transcript and protein levels of mast cell tryptase as well as the mast cell’s responsiveness to allergen. Together, these findings identify …

Fundamentals Of Lung Auscultation, Abraham Bohadana, Gabriel Izbicki, Steve S. Kraman

Internal Medicine Faculty Publications

Chest auscultation has long been considered a useful part of the physical examination, going back to the time of Hippocrates. However, it did not become a widespread practice until the invention of the stethoscope by René Laënnec in 1816, which made the practice convenient and hygienic.1 During the second half of the 20th century, technological advances in ultrasonography, radiographic computed tomography (CT), and magnetic resonance imaging shifted interest from lung auscultation to imaging studies, which can detect lung disease with an accuracy never previously imagined. However, modern computer-assisted techniques have also allowed precise recording and analysis of lung sounds, prompting …

B Cell Tolerance In Health And Disease, Murali Gururajan, Vishal J. Sindhava, Subbarao Bondada

Microbiology, Immunology, and Molecular Genetics Faculty Publications

B lymphocyte receptors are generated randomly during the bone marrow developmental phase of B cells. Hence, the B cell repertoire consists of both self and foreign antigen specificities necessitating specific tolerance mechanisms to eliminate self-reactive B cells. This review summarizes the major mechanisms of B cell tolerance, which include clonal deletion, anergy and receptor editing. In the bone marrow presentation of antigen in membrane bound form is more effective than soluble form and the role of dendritic cells in this process is discussed. Toll like receptor derived signals affect activation of B cells by certain ligands such as nucleic acids …

Bis-Quaternary Ammonium Cyclophane Compounds That Interact With Neuronal Nicotinic Acetylcholine Receptors, Peter A. Crooks, Linda P. Dwoskin, Guangrong Zheng, Sangeetha Sumithran, Davis D. Allen, Zhenfa Zheng, Paul Lockman

Pharmaceutical Sciences Faculty Patents

Provided are bis-quaternary ammonium cyclophane compounds which are modulators of nicotinic acetylcholine receptors. Also provided are methods of using the compounds for modulating the function of a nicotinic acetylcholine receptor, and for the prevention and/or treatment of central nervous system disorders, substance use and/or abuse, and or gastrointestinal tract disorders.

Enhancing Transdermal Delivery Of Opioid Antagonists And Agonists Using Codrugs Linked To Bupropion Or Hydroxybupropion, Audra L. Stinchcomb, Peter A. Crooks, Mohamad O. Hamad, Paul K. Kiptoo

Pharmaceutical Sciences Faculty Patents

The present invention is directed to novel codrugs comprising bupropion or hydroxybupropion and an opioid antagonist or an opioid agonist joined together by chemical bonding. The codrugs provide a significant increase in the transdermal flux across human skin, as compared to the basic opioid antagonist or opioid agonist.

Estimating The Costs Of Foundational Public Health Capabilities: A Recommended Methodology, Dwight V. Denison, Cezar B. Mamaril, Glen P. Mays, Lizeth C. Fowler, Workgroup On Public Health Cost Estimation

Health Management and Policy Reports

The Institute of Medicine’s 2012 report on public health financing recommended the convening of expert panels to identify the components and costs of a “minimum package of public health services” that should be available in every U.S. community. The report recommended that this minimum package include a core set of public health programs that target specific, high-priority preventable health problems and risks, along with a set of “foundational public health capabilities” that are deemed necessary to support the successful implementation of public health programs and policies. In response to this recommendation, the Robert Wood Johnson Foundation, in collaboration with the …

Neuronal Growth Cones And Regeneration: Gridlock Within The Extracellular Matrix, Diane M. Snow

Spinal Cord and Brain Injury Research Center Faculty Publications

The extracellular matrix is a diverse composition of glycoproteins and proteoglycans found in all cellular systems. The extracellular matrix, abundant in the mammalian central nervous system, is temporally and spatially regulated and is a dynamic "living" entity that is reshaped and redesigned on a continuous basis in response to changing needs. Some modifications are adaptive and some are maladaptive. It is the maladaptive responses that pose a significant threat to successful axonal regeneration and/or sprouting following traumatic and spinal cord injuries, and has been the focus of a myriad of research laboratories for many years. This review focuses largely on …

Proteoglycans: Road Signs For Neurite Outgrowth, Justin A. Beller, Diane M. Snow

Spinal Cord and Brain Injury Research Center Faculty Publications

Proteoglycans in the central nervous system play integral roles as "traffic signals" for the direction of neurite outgrowth. This attribute of proteoglycans is a major factor in regeneration of the injured central nervous system. In this review, the structures of proteoglycans and the evidence suggesting their involvement in the response following spinal cord injury are presented. The review further describes the methods routinely used to determine the effect proteoglycans have on neurite outgrowth. The effects of proteoglycans on neurite outgrowth are not completely understood as there is disagreement on what component of the molecule is interacting with growing neurites and …