Public Health Commons^™

Gut Symbionts Alleviate Mash Through A Secondary Bile Acid Biosynthetic Pathway, Qixing Nie, Xi Luo, Kai Wang, Yong Ding, Shumi Jia, Qixiang Zhao, Meng Li, Jinxin Zhang, Yingying Zhuo, Jun Lin, Chenghao Guo, Zhiwei Zhang, Huiying Liu, Guangyi Zeng, Jie You, Lulu Sun, Hua Lu, Ming Ma, Yanxing Jia, Ming-Hua Zheng, Yanli Pang, Jie Qiao, Changtao Jiang

Faculty, Staff and Student Publications

The gut microbiota has been found to play an important role in the progression of metabolic dysfunction-associated steatohepatitis (MASH), but the mechanisms have not been established. Here, by developing a click-chemistry-based enrichment strategy, we identified several microbial-derived bile acids, including the previously uncharacterized 3-succinylated cholic acid (3-sucCA), which is negatively correlated with liver damage in patients with liver-tissue-biopsy-proven metabolic dysfunction-associated fatty liver disease (MAFLD). By screening human bacterial isolates, we identified Bacteroides uniformis strains as effective producers of 3-sucCA both in vitro and in vivo. By activity-based protein purification and identification, we identified an enzyme annotated as β-lactamase in B. …

Exploring The Experience Of Healthcare-Related Epistemic Injustice Among People With Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, Joanne Hunt, Jessica Runacres, Daniel Herron, David Sheffield

The Qualitative Report

Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a chronic, disabling yet clinically “contested” condition, previously theorised through a lens of epistemic injustice. Phenomena conceptually close to epistemic injustice, including stigma, are known to have deleterious consequences on a person’s health and life-world. Yet, no known primary studies have explored how people with ME/CFS experience healthcare through a lens of epistemic injustice, whilst a dearth of research explicitly exploring healthcare-related injustice from a patient perspective has been noted. This qualitative study seeks to address this gap. Semi-structured interviews and interpretative phenomenological analysis (IPA) were used to explore the experiences of …

Old Dog, New Tricks? Applying The Causal Hazard Chain Model To Burn Prevention And Injuries, Randy D. Kearns, Jeffrey E. Carter, Ernest Grant, W.L. Hickerson

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

Identifying Multilevel Predictors Of Behavioral Outcomes Like Park Use: A Comparison Of Conditional And Marginal Modeling Approaches, Marilyn E. Wende, S. Morgan Hughey, Alexander C. Mclain, Shirelle Hallum, J. Aaron Hipp, Jasper Schipperijn, Ellen W. Stowe, Andrew T. Kaczynski Ph.D.

Faculty Publications

This study compared marginal and conditional modeling approaches for identifying individual, park and neighborhood park use predictors. Data were derived from the ParkIndex study, which occurred in 128 block groups in Brooklyn (New York), Seattle (Washington), Raleigh (North Carolina), and Greenville (South Carolina). Survey respondents (n = 320) indicated parks within one half-mile of their block group used within the past month. Parks (n = 263) were audited using the Community Park Audit Tool. Measures were collected at the individual (park visitation, physical activity, sociodemographic characteristics), park (distance, quality, size), and block group (park count, population density, age structure, racial …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

Emerging Variants Develop Total Escape From Potent Monoclonal Antibodies Induced By Ba4/5 Infection, Chang Liu, Raksha Das, Aiste Dijokaite-Guraliuc, Daming Zhou, Alexander J Mentzer, Piyada Supasa, Muneeswaran Selvaraj, Helen M E Duyvesteyn, Thomas G Ritter, Nigel Temperton, Paul Klenerman, Susanna J Dunachie, Neil G Paterson, Mark A Williams, David R Hall, Elizabeth E Fry, Juthathip Mongkolsapaya, Jingshan Ren, David I Stuart, Gavin R Screaton

Faculty, Staff and Student Publications

The rapid evolution of SARS-CoV-2 is driven in part by a need to evade the antibody response in the face of high levels of immunity. Here, we isolate spike (S) binding monoclonal antibodies (mAbs) from vaccinees who suffered vaccine break-through infections with Omicron sub lineages BA.4 or BA.5. Twenty eight potent antibodies are isolated and characterised functionally, and in some cases structurally. Since the emergence of BA.4/5, SARS-CoV-2 has continued to accrue mutations in the S protein, to understand this we characterize neutralization of a large panel of variants and demonstrate a steady attrition of neutralization by the panel of …

Uterine Adenosarcoma Presenting As Uterine Inversion: A Case Study, Caitlin Witt, Chelsey Vranes, Leslie H. Clark

School of Medicine Faculty Publications

No abstract provided.

Assessment Of Condylar Morphology In Various Facial Types-Cbct Study, Dr.Shruti Patil

Annual Research Symposium

Mandibular condyle being part of the TMJ complex, its volume and shape play a pivotal role in treatment stability and outcomes in orthodontic and orthognathic patients over long term periods. Different loading patterns would result in different morphology of the TMJ. The association with different facial types and understanding the relationship between condylar position, morphology and jaw base divergence is limited. This study’s objective is to assess the condylar structure which includes condylar height, width and height of the fossa in different jaw base divergences.

A cross-sectional study was conducted in which 90 patients undergoing Orthodontic treatment were selected and …

Adolescent Perceptions Of Weighted Blankets And Quality Of Sleep: A Mixed Method Design, Tara D. S. Summers

The Open Journal of Occupational Therapy

Background: The purpose of this mixed methods case study was to describe the perceived sleep quality experience of an adolescent, without a pre-identified sleep need, when they used a weighted blanket during sleep.

Method: Adolescents (n = 5) 11 to 16 years of age completed a sleep diary for 7 days, sleeping with a self-selected weighted blanket for at least 3 days. A semi-structured individual interview was held after Day 7.

Results: The majority of the participants would like to continue using a weighted blanket for sleep. Eighty percent of the adolescents choose to sleep with a …

Multi-Omics Analysis Reveals Immune Features Associated With Immunotherapy Benefit In Patients With Squamous Cell Lung Cancer From Phase Iii Lung-Map S1400i Trial, Edwin Roger Parra, Jiexin Zhang, Dzifa Yawa Duose, Edgar Gonzalez-Kozlova, Mary W Redman, Hong Chen, Ganiraju C Manyam, Gayatri Kumar, Jianhua Zhang, Xingzhi Song, Rossana Lazcano, Mario L Marques-Piubelli, Caddie Laberiano-Fernandez, Frank Rojas, Baili Zhang, Len Taing, Aashna Jhaveri, Jacob Geisberg, Jennifer Altreuter, Franziska Michor, James Provencher, Joyce Yu, Ethan Cerami, Radim Moravec, Kasthuri Kannan, Rajyalakshmi Luthra, Gheath Alatrash, Hsin-Hui Huang, Hui Xie, Manishkumar Patel, Kai Nie, Jocelyn Harris, Kimberly Argueta, James Lindsay, Roshni Biswas, Stephen Van Nostrand, Seunghee Kim-Schulze, Jhanelle E Gray, Roy S Herbst, Ignacio I Wistuba, Scott Gettinger, Karen Kelly, Lyudmila Bazhenova, Sacha Gnjatic, J Jack Lee, Jianjun Zhang, Cara Haymaker

Faculty, Staff and Student Publications

PURPOSE: Identifying molecular and immune features to guide immune checkpoint inhibitor (ICI)-based regimens remains an unmet clinical need.

EXPERIMENTAL DESIGN: Tissue and longitudinal blood specimens from phase III trial S1400I in patients with metastatic squamous non-small cell carcinoma (SqNSCLC) treated with nivolumab monotherapy (nivo) or nivolumab plus ipilimumab (nivo+ipi) were subjected to multi-omics analyses including multiplex immunofluorescence (mIF), nCounter PanCancer Immune Profiling Panel, whole-exome sequencing, and Olink.

RESULTS: Higher immune scores from immune gene expression profiling or immune cell infiltration by mIF were associated with response to ICIs and improved survival, except regulatory T cells, which were associated with worse …

Surgical Intervention For Diffuse Dermal Angiomatosis Of The Breast, Caroline E. Savoie, Bethany S. Acosta, Harley J. Davis, G. William Poche

School of Medicine Faculty Publications

No abstract provided.

Proportion Of Cancer Cases And Deaths Attributable To Potentially Modifiable Risk Factors In Peru, Jhony A De La Cruz-Vargas, Willy Ramos, Willer Chanduví, Lucy E Correa-López, Nadia Guerrero, Joan Loayza-Castro, Irene Tami-Maury, Diego Venegas

Faculty, Staff and Student Publications

BACKGROUND: Limited evidence exists on the population attributable fraction (PAF) of cancer cases and deaths in Latin America. In Peru several studies have been published regarding the PAF of various risk factors and their associated diseases. The objective of this study was to estimate the fraction of cancer cases and deaths attributable to potentially modifiable risk factors in Peru in 2018, before the COVID-19 pandemic in the population of 15 years old and older.

METHODS: An ecological study was conducted using the prevalence of exposure of the Peruvian population to modifiable risk factors for cancer, the relative risk associated with …

Longitudinal Regression Of Covariance Matrix Outcomes, Yi Zhao, Brian S Caffo, Xi Luo

Faculty, Staff and Student Publications

In this study, a longitudinal regression model for covariance matrix outcomes is introduced. The proposal considers a multilevel generalized linear model for regressing covariance matrices on (time-varying) predictors. This model simultaneously identifies covariate-associated components from covariance matrices, estimates regression coefficients, and captures the within-subject variation in the covariance matrices. Optimal estimators are proposed for both low-dimensional and high-dimensional cases by maximizing the (approximated) hierarchical-likelihood function. These estimators are proved to be asymptotically consistent, where the proposed covariance matrix estimator is the most efficient under the low-dimensional case and achieves the uniformly minimum quadratic loss among all linear combinations of the …

Effects Of Family Dignity Interventions Combined With Standard Palliative Care On Family Adaptability, Cohesion, And Anticipatory Grief In Adult Advanced Cancer Survivors And Their Family Caregivers: A Randomized Controlled Trial, Nannan Wang, Kun Wang, Xinyu Lu, Shuyu Zhang, Xuhan Sun, Yuxi Zhang

Faculty, Staff and Student Publications

BACKGROUND: Family involvement and comfort are equally important in palliative care. Dignity undertook a new meaning and novel challenges as a result of restrictions on visits and companionship during the pandemic. Family-centered family dignity interventions have been shown to be effective in increasing patients' sense of dignity, increasing levels of hope, and reducing psychological distress; however, the effectiveness in enhancing family adaptability and intimacy in the survivor-caregiver binary and reducing expected grief have been inconclusive.

OBJECTIVES: The primary objective of this study was to assess the efficacy of family dignity interventions on family adaptability and cohesion. The secondary objective was …

Icariin Accelerates Bone Regeneration By Inducing Osteogenesis-Angiogenesis Coupling In Rats With Type 1 Diabetes Mellitus, Sheng Zheng, Guan-Yu Hu, Jun-Hua Li, Jia Zheng, Yi-Kai Li

Faculty, Staff and Student Publications

BACKGROUND: Icariin (ICA), a natural flavonoid compound monomer, has multiple pharmacological activities. However, its effect on bone defect in the context of type 1 diabetes mellitus (T1DM) has not yet been examined.

AIM: to explore the role and potential mechanism of ICA on bone defect in the context of T1DM.

METHODS: The effects of ICA on osteogenesis and angiogenesis were evaluated by alkaline phosphatase staining, alizarin red S staining, quantitative real-time polymerase chain reaction, Western blot, and immunofluorescence. Angiogenesis-related assays were conducted to investigate the relationship between osteogenesis and angiogenesis. A bone defect model was established in T1DM rats. The …

Relationship Between Knowledge, Years Of Licensure, And Attitudes Of Midwives About Female Genital Mutilation And Its Prevalence Among Their Patients In Bawku, Ghana, Frank Debrah

Walden Dissertations and Doctoral Studies

Female genital mutilation (FGM) is one of the hindrances to girls' development. FGM is often a rite of passage between childhood and adulthood. This cross-sectional study examined the relationship between the knowledge, years of licensure, and attitudes of midwives regarding FGM and the prevalence of FGM among their patients in Bawku, Ghana. Bronfenbrenner's social ecological model served as the theoretical framework to describe the link between midwives' knowledge, attitude, years of licensure, and FGM prevalence. The knowledge and attitude of midwives were classified as exosystem factors. Hence, their direct interaction with patients is likely to affect the patient's practice of …

Clearing The Air: Innovations In Imaging For Early Detection And Management Of Chronic Obstructive Pulmonary Disease, Francesca Polverino

Faculty, Staff and Students Publications

No abstract provided.

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Perceptions Of Patient-Healthcare Provider Relationships In The Management Of Type 2 Diabetes, Desiree D. Lacey

Walden Dissertations and Doctoral Studies

The patient-healthcare provider relationship (PPR) is the foundation of clinical care: it is established as a human relationship and has a profound effect on health outcomes. Though PPR has been studied in multiple health domains, there is very little on its role in managing Type 2 diabetes mellitus (T2DM). The purpose of this phenomenological qualitative research study was to better understand the challenges faced by healthcare providers (HCP) and T2DM patients within the clinical PPR for diabetes selfmanagement. The health belief model served as the theoretical framework and the diabetes self-management education program as the conceptual framework. Participants were recruited …

Hhp-3 Comparing Fitness Data Of Cadets In South Carolina To The General Population: A Pilot Study, Justen Chatman, Ming-Chi Sung, Matthew Brisebois

SC Upstate Research Symposium

BACKGROUND: To prepare for physically challenging environments, it is expected that military personnel achieve higher levels of physical fitness than the general population. The recent COVID-19 pandemic impacted physical activity levels among many of America’s youth, and thus, new recruits may be entering military service with lower fitness levels. It is also unknown how fitness levels of army cadets in upstate South Carolina compare to the general population. Therefore, the purpose of this pilot study was to compare anthropometric and fitness variables of army cadets from upstate South Carolina to data from the general population. METHODS: A sample of 22 …

A Case Of “Neptune’S Fix Elixir” - The Dangerous Consequences Of Unregulated Use Of Tianeptine In Over-The-Counter Products, Priscilla Lozano, Maya Qutob Do, Eduardo Espiridion

Tower Health Research Day

No abstract provided.

The Local Is Global: The Science Of Coffee Roasting And Brewing, Elliana Boer

23rd Annual A. Paul and Carol C. Schaap Celebration of Undergraduate Research and Creative Activity (2024)

Our interdisciplinary project on coffee and justice considered the impact of local choices on global coffee producers from both science and humanities perspectives. The science focused on further improving the quality of specialty coffee to create a higher demand for these upmarket beans, thereby allowing coffee producers to earn a more livable wage. Three experiments were conducted to test specialty coffee best practices. The first focused on the baked defect, which may occur when the rate of rise of bean temperature drops during the roasting process. The roasting process has three phases (drying, Maillard, and development); the second experiment tested …

Gaza War: Too Many Citizens Being Killed, Sheraz Yaqub, Bjørn Edwin, Zane Hammoud, Gabriel Herrera-Almario, Buthaina Jabir, Kristoffer Lassen, Pål Dag Line, Miguel Angel Lopez-Gonzalez, Michael Puttick, Mohammed Ahmed Idrees Saadelnour, José Sampaio-Neto, Raghuram Sampath, Konstantin V. Sementsov, Ajith K. Siriwardena, Ernesto Sparrelid, Alberto Büge Stein, Robert Sutcliffe, Helena Taflin, Hany Takla, Silvio Valdec, Cherisse N. Vinoya, Waleed Zaid, Stephen J. Wigmore

School of Dentistry Faculty Publications

No abstract provided.

Childhood Cancer Survivorship: Navigating A New Normal In Middle Tennessee, Karli M. Beaumont

OTD Capstone Projects

Monroe Carell Jr. Children’s Hospital at Vanderbilt in partnership with Vanderbilt-Ingram Cancer Center offers REACH for Cancer Survivorship, a pediatric cancer survivorship clinic. REACH provides a full range of follow-up care designed to meet the physical, emotional, and practical needs of survivors and continuous surveillance of deleterious effects of cancer and its treatments. The purpose of this project was to meet population and agency needs through research of long- and late-term sequela while advocating for occupational therapy’s role in the oncology population through the proactive therapy and prospective surveillance models. The process of creating this project included synthesizing the literature, …

Evaluation Of Seizure Recognition And First Aid Training Course And Improving Self-Efficacy Related To Medical Emergencies In Mississippi, Anna Katherine Herrington, Collin Earl Wayne Crawson, Daniel Robert Zuckerman

Honors Theses

Within recent years, there has been increased attention to the growing physician shortage across the United States. This shortage has placed substantial strain upon regions of lower healthcare access, particularly those of rural regions such as much of the state of Mississippi. As rural healthcare providers are placed under more strenuous conditions, they encounter issues of increased patient volume, lack of a trauma team, or adequate transportation to higher-level care facilities. These issues may exacerbate the present inequities in cost of living, access to adequate healthcare, and the distress caused by these concerns. Individuals with epilepsy are one cohort with …

Capn2 Correlates With Insulin Resistance States In Pcos As Evidenced By Multi-Dataset Analysis, Xi Luo, Yunhua Dong, Haishan Zheng, Xiaoting Zhou, Lujuan Rong, Xiaoping Liu, Yun Bai, Yunxiu Li, Ze Wu

Faculty, Staff and Student Publications

OBJECTIVE: IR emerges as a feature in the pathophysiology of PCOS, precipitating ovulatory anomalies and endometrial dysfunctions that contribute to the infertility challenges characteristic of this condition. Despite its clinical significance, a consensus on the precise mechanisms by which IR exacerbates PCOS is still lacking. This study aims to harness bioinformatics tools to unearth key IR-associated genes in PCOS patients, providing a platform for future therapeutic research and potential intervention strategies.

METHODS: We retrieved 4 datasets detailing PCOS from the GEO, and sourced IRGs from the MSigDB. We applied WGCNA to identify gene modules linked to insulin resistance, utilizing IR …

Ensemble-Based Mutational Profiling And Network Analysis Of The Sars-Cov-2 Spike Omicron Xbb Lineages For Interactions With The Ace2 Receptor And Antibodies: Cooperation Of Binding Hotspots In Mediating Epistatic Couplings Underlies Binding Mechanism And Immune Escape, Nishank Raisinghani, Mohammed Alshahrani, Grace Gupta, Gennady M. Verkhivker

Mathematics, Physics, and Computer Science Faculty Articles and Research

In this study, we performed a computational study of binding mechanisms for the SARS-CoV-2 spike Omicron XBB lineages with the host cell receptor ACE2 and a panel of diverse class one antibodies. The central objective of this investigation was to examine the molecular factors underlying epistatic couplings among convergent evolution hotspots that enable optimal balancing of ACE2 binding and antibody evasion for Omicron variants BA.1, BA2, BA.3, BA.4/BA.5, BQ.1.1, XBB.1, XBB.1.5, and XBB.1.5 + L455F/F456L. By combining evolutionary analysis, molecular dynamics simulations, and ensemble-based mutational scanning of spike protein residues in complexes with ACE2, we identified structural stability and binding …

Latent Classification Of Multi-Model Non-Homogeneous Continuous-Time Markov Chains, Joonha Chang

Dissertations and Theses (Open Access)

The continuous-time Markov chain (CTMC) model and latent clustering models are commonly used to study longitudinal measures of categorical outcomes. Because of its simple but powerful Markovian property, CTMC models have been widely used in medical and public health researches. Due to limitations in the standard CTMC model, there have been some studies on non-homogeneous continuous-time Markov chain (NH-CTMC) that utilized time-dependent rates, but the progresses have been limited. NH-CTMC can be more powerful than CTMC by its default nature of time-dependent rate that can be fitted to a wider range of applications in medical studies. In this study, we …

Identifying A Group Of Factors Predicting Cognitive Impairment Among Older Adults, Longgang Zhao, Yuan Wang, Eric Mishio Bawa, Zichun Meng, Jingkai Wei, Sarah Newman-Norlund, Tushar Trivedi, Hatice Hasturk, Roger Newman-Norlund, Julius Fridriksson Ph.D., Anwar T. Nerchant

Faculty Publications

Background

Cognitive impairment has multiple risk factors spanning several domains, but few studies have evaluated risk factor clusters. We aimed to identify naturally occurring clusters of risk factors of poor cognition among middle-aged and older adults and evaluate associations between measures of cognition and these risk factor clusters.

Methods

We used data from the National Health and Nutrition Examination Survey (NHANES) III (training dataset, n = 4074) and the NHANES 2011–2014 (validation dataset, n = 2510). Risk factors were selected based on the literature. We used both traditional logistic models and support vector machine methods to construct a composite score …