Interdisciplinary

Thomas Gillespie, PhD

ASSOCIATE PROFESSOR, ECAS, ENVIRONMENTAL SCIENCES

Timothy Read, PhD

PROFESSOR, SCHOOL OF MEDICINE, INFECTIOUS DISEASES

Metagenome-Wide Characterization of Antimicrobial Resistance in Rural Madagascar within a One Health Framework

Antimicrobial resistance (AMR) is one of the greatest threats to our health, food security, and development. There is growing evidence that environmental bacteria serve as a reservoir for novel antimicrobial resistance genes; however, knowledge of transmission dynamics and prevalence of community-acquired antimicrobial resistance in humans and animals is limited. Nearly all bacterial pathogens have been found to contain antimicrobial resistance genes, but standard molecular methods can only focus on a few pathogens with only a narrow spectrum of capturable genes. Shotgun metagenomic sequencing of such samples can facilitate culture-independent analysis of complex microbiota and assist in the identification of hotspots and routes of transmission of AMR across ecological gradients. The need to keep pace with new disease trends and emerging threats to human and animal health necessitate the expansion of AMR surveillance and research in ecosystems. To advance this process, we propose to apply shotgun metagenomic sequencing to a unique bio-banked set of human and animal fecal samples linked to a rich dataset established by PI Gillespie in rural Madagascar. This approach will allow us to taxonomically profile the microbiota (bacterial, viral, and fungal) and compare resistance patterns among humans, domestic animals, peridomestic rodents, and wildlife to characterize this novel resistome. This project will generate results that will fuel collaborative, interdisciplinary investigations addressing a priority topic and unmet needs related to both 1) reservoirs of resistance as a threat to global health security and 2) AMR as a challenge for improving health outcomes in rural, resource-limited communities.

Nicholas A Giordano, PhD 

ASSISTANT PROFESSOR, NELL HODGSON WOODRUFF SCHOOL OF NURSING

Mara L.Schenker, MD

ASSOCIATE PROFESSOR, SCHOOL OF MEDICINE, ORTHOPAEDICS

Integrating Life Care Specialists into Orthopaedic Trauma Care Settings to Improve Postoperative Patient Recovery

Combatting substance use, and subsequently opioid-related overdose deaths, are among the most urgent public health priorities facing the nation. Efforts to address these concerns over the past decade have resulted in a steep decline in prescribing opioids in clinical orthopaedic practice, often coming at the expense of effective pain management for patients. Mitigating both opioid related-risk and the impact of under managed pain in the most vulnerable patient populations requires innovative data-driven clinical interventions that provide patients access to evidence-based pain management. Therefore, the objective of this pilot randomized controlled trial is to examine how the integration of a trained Life Care Specialist, a novel member of the clinical care team, impacts postoperative recovery related to pain, opioid utilization, and functional outcomes following orthopaedic trauma. The Life Care Specialist is a unique resource for participants during their hospitalization and can assist with identifying and utilizing non-pharmacologic pain management approaches during hospitalization and as they transition home. The Life Care Specialists works with participants to assess, communicate, and educate them on the risk of opioid misuse and provide clinical care coordination for patients with complex needs. Uniquely this study will examine the effect of the intervention on the biopsychosocial presentations of pain by utilizing both objective functional actigraphy collected outcomes as well as patient-reported outcomes. Findings will improve upon current approaches aimed at optimizing pain management and reducing opioid-related risk following orthopaedic trauma. This study will provide the data needed for our interdisciplinary team to pursue larger federal funding.

Donna Maney, PhD

PROFESSOR, ECAS, PSYCHOLOGY

Addressing Sex as a Biological Variable at Emory University

In 2016, the NIH implemented a policy requiring researchers to address sex as a biological variable (SABV) in all basic and preclinical research. Intended to address long-standing issues of exclusion and health inequities, the new criteria were also designed to improve scientific rigor and reproducibility. Since the policy went into effect, the inclusion of women and female animals/materials has increased, but its on research and publishing practices has been uneven across research areas. Currently, little is known about barriers to implementation of SABV. For scientists who study non-human vertebrates and tissues or cells, the new policy may pose novel methodological questions. For example, there may be difficulties conceptualizing and operationalizing sex itself; sex comprises a range of biological characteristics that do not all conform to a binary and do not always align within a single organism. In addition, there are likely to be practical difficulties such as limited access to necessary materials and expertise. Using in-depth interviews, this project seeks to clarify how researchers are approaching SABV at Emory and to identify specific barriers that complicate its implementation. Successful completion of the aims will have multiple positive impacts, including the development of tools to assess SABV implementation broadly across Emory University and beyond. By placing emphasis on self-study as well as on thoughtful consideration of the complexities and challenges of inclusive biomedical research, this project has the potential to place Emory as a leader in the informed implementation of SABV and strengthen Emory’s ability to secure funding in SABV-relevant areas.