USING MIXED METHODS APPROACHES TO STUDY FAMILIES AND RELATIONSHIPS.

Mixed methods research-methodologies that synthesize qualitative and quantitative approaches in the design, collection, analysis, and dissemination of research related to a specific topic or aim-is increasingly common, offering innovative empirical insight into families and relationships. We first elaborate on our definition of mixed methods research, emphasizing that there is significant heterogeneity within mixed methods approaches to studying families and relationships. Second, we discuss benefits of mixed methods projects within family and relationship research, including theory-building and innovation.

Alpha-1 Antitrypsin Deficiency in a Young Never Smoker With Novel Pi*Null Homozygous Mutation: a Case Report.

Alpha-1 antitrypsin (AAT) deficiency is an autosomal codominant disorder caused by gene mutations. PI*Z and PI*S mutations commonly underlie this deficiency, but rarer homozygous PI* (Q0) mutations may result in a complete loss of AAT. Such rare mutations lead to severe AAT deficiency and early onset of lung disease.

Metabolic engineering of CHO cells towards cysteine prototrophy and systems analysis of the ensuing phenotype.

Chinese hamster ovary (CHO) cells require cysteine for growth and productivity in fed-batch cultures. In intensified processes, supplementation of cysteine at high concentrations is a challenge due to its limited solubility and instability in solution. Methionine can be converted to cysteine (CYS) but key enzymes, cystathionine beta-synthase (Cbs) and cystathionine gamma-lyase (Cth), are not active in CHO cells resulting in accumulation of an intermediate, homocysteine (HCY), in cell culture milieu.

Genetics and Age-Related Macular Degeneration: A Practical Review for Clinicians.

Age-related macular degeneration (AMD) is a multifactorial genetic disease, with at least 52 identifiable associated gene variants at 34 loci, including variants in () and (). Genetic factors account for up to 70% of disease variability. However, population-based genetic risk scores are generally more helpful for clinical trial design and stratification of risk groups than for individual patient counseling.

Cumulative Disadvantage or Strained Advantage? Remote Schooling, Paid Work Status, and Parental Mental Health during the COVID-19 Pandemic.

During the COVID-19 pandemic, parents experienced difficulties around employment and children's schooling, likely with detrimental mental health implications. We analyze National Longitudinal Survey of Youth 1997 data (N = 2,829) to estimate depressive symptom changes from 2019 to 2021 by paid work status and children's schooling modality, considering partnership status, gender, and race-ethnicity differences. We draw on cumulative disadvantage theory alongside strained advantage theory to test whether mental health declines were steeper for parents with more disadvantaged statuses or for parents with more advantaged statuses.

Novel ancestry-specific primary open-angle glaucoma loci and shared biology with vascular mechanisms and cell proliferation.

Primary open-angle glaucoma (POAG), a leading cause of irreversible blindness globally, shows disparity in prevalence and manifestations across ancestries. We perform meta-analysis across 15 biobanks (of the Global Biobank Meta-analysis Initiative) (n = 1,487,441: cases = 26,848) and merge with previous multi-ancestry studies, with the combined dataset representing the largest and most diverse POAG study to date (n = 1,478,037: cases = 46,325) and identify 17 novel significant loci, 5 of which were ancestry specific. Gene-enrichment and transcriptome-wide association analyses implicate vascular and cancer genes, a fifth of which are primary ciliary related.

Geographic disparities in late HIV diagnoses in Tennessee: Opportunities for interventions in the rural Southeast.

Purpose: Incident HIV remains an important public health issue in the US South, the region leading the nation in HIV incidence, rural HIV cases, and HIV-related deaths. Late diagnoses drive incident HIV and understanding factors driving late diagnoses is critical for developing locally relevant HIV testing and prevention interventions, decreasing HIV transmission, and ending the HIV epidemic.

Methods: Retrospective cohort study utilizing Tennessee Department of Health (TDH) surveillance data and US Census Bureau data.

HIV and Hepatitis C Among People Who Inject Drugs in Memphis, Tennessee: an Intersectional Risk Environment Analysis of the Social Determinants of Health.

Background: The Southern US is confronting bourgeoning HIV and hepatitis C virus (HCV) epidemics among people who inject drugs (PWID), yet little is known about shared and unique risk factors across the region. We applied an intersectional risk environment framework to understand infectious disease outcomes for sub-groups of PWID that experience multiple axes of social marginalization related to racial and ethnic identity and social and economic vulnerability.

Methods: HIV and HCV prevalence was estimated from the first iteration of the CDC's National HIV Behavioral Surveillance respondent driven sample of PWID in Shelby County, Tennessee in 2018.

Development of Portable Electronic Health Record Based Algorithms to Identify Individuals with Diabetic Retinopathy.

Objectives: To develop, validate and implement algorithms to identify diabetic retinopathy (DR) cases and controls from electronic health care records (EHR)s. : We developed and validated EHR-based algorithms to identify DR cases and individuals with type I or II diabetes without DR (controls) in three independent EHR systems: Vanderbilt University Medical Center Synthetic Derivative (VUMC), the VA Northeast Ohio Healthcare System (VANEOHS), and Massachusetts General Brigham (MGB). Cases were required to meet one of three criteria: 1) two or more dates with any DR ICD-9/10 code documented in the EHR, or 2) at least one affirmative health-factor or EPIC code for DR along with an ICD9/10 code for DR on a different day, or 3) at least one ICD-9/10 code for any DR occurring within 24 hours of an ophthalmology exam.

Characterizing residential mobility among people with HIV in Tennessee and its impact on HIV care outcomes.

Objective: Our objective was to assess the prevalence and patterns of mobility among people with HIV (PWH) in Tennessee and its impact on HIV care outcomes.

Design: Retrospective cohort study.

Methods: We combined residential address and HIV surveillance data from PWH in Tennessee from 2016 to 2018.

Black feminist theory in maternal health research: A review of concepts and future directions.

Black maternal health and well-being has become a necessary focal point for health researchers due to higher rates of maternal mortality and morbidity for Black women. However, what is often absent from this scholarship within medical sociology is Black Feminist Theory as a framework for understanding Black women's health and well-being. Drawing on Black feminist and maternal health scholarship, I argue that integrating Black feminist approaches in maternal health research expands our understandings of what processes and mechanisms are impacting the health and well-being of Black mothers, while also highlighting the importance of maternal health research that solely centers Black women.

Type of Exchange Sex and Associated Behaviors and Outcomes Among Cisgender Men and Women at Increased Risk for HIV via Heterosexual Transmission in Six U.S. Metropolitan Areas.

Exchange sex is associated with sexual risk behaviors and poor outcomes and different types may incur different levels of risk. We assessed risk profiles of different types of exchange sex among non-injecting cisgender men and women who participated in the 2019 National HIV Behavioral Surveillance project at six sites. Six percent of men and 19% of women reported exchange sex in the past year; most engaged in non-commercial exchange sex for drugs/money with smaller percentages reporting formal sex work or non-commercial exchange sex for goods or services other than drugs/money.

Misclassification of Loss to Care Among Persons With Human Immunodeficiency Virus: Improved Capture of Silent Transfers Through Surveillance Linkage Using Statewide Mandatorily Reported Laboratory Measures.

Human Immunodeficiency Virus (HIV)-positive individuals lost to follow-up from particular clinics may not be lost to care (LTC). After linking Vanderbilt's Comprehensive Care Clinic cohort to Tennessee's statewide HIV surveillance database, LTC decreased from 48.4% to 35.

Violence, Discrimination, Psychological Distress, and HIV Vulnerability Among Men Who Have Sex With Men in Memphis, Tennessee.

Gay, bisexual, and other men who have sex with men (MSM) are disproportionally impacted by HIV. Discrimination, violence, and psychological distress (PD) may influence engagement with HIV prevention services and amplify HIV vulnerability among this priority population. These dynamics are understudied in the Southern United States.

BRCA1 mediates protein homeostasis through the ubiquitination of PERK and IRE1.

Tumors with mutations have poor prognoses due to genomic instability. Yet this genomic instability has risks and BRCA1-deficient (def) cancer cells must develop pathways to mitigate these risks. One such risk is the accumulation of unfolded proteins in BRCA1-def cancers from increased mutations due to their loss of genomic integrity.

Effect of Mindfulness Versus Loving-kindness Training on Leukocyte Gene Expression in Midlife Adults Raised in Low-Socioeconomic Status Households.

Objectives: People raised in low socio-economic status (SES) households are at an increased risk for physical illness in adulthood. A shift in gene expression profiles in the immune system is one biological mechanism thought to account for elevated disease susceptibility, with a frequently-investigated profile being the conserved transcriptional response to adversity (CTRA), characterized by increased expression of proinflammatory genes and decreased expression of antiviral and antibody-related genes.

Methods: The present study investigated, in a sample of at-risk midlife adults ( = 88), whether those randomized to learn loving-kindness meditation (LKM) in a 6-week workshop, would show a reduction in CTRA gene expression, compared to those randomized to learn mindfulness meditation (MM).

Levels of neonatal care among birth facilities in 20 states and other jurisdictions: CDC levels of care assessment tool (CDC LOCATe).

Objective: Describe discrepancies between facilities' self-reported level of neonatal care and Centers for Disease Control and Prevention Levels of Care Assessment Tool (CDC LOCATe)-assessed level.

Study Design: CDC LOCATe data from 765 health facilities in the United States, including 17 states, one territory, one large multi-state hospital system, and one perinatal region within a state, was collected between 2016 and 2021 for this cross-sectional analysis.

Result: Among 721 facilities that self-reported level of neonatal care, 33.

Assessment of Tennessee's county-level vulnerability to hepatitis C virus and HIV outbreaks using socioeconomic, healthcare, and substance use indicators.

Background: Human immunodeficiency virus (HIV), hepatitis C virus (HCV), and injection drug use are syndemic in the central Appalachian states. In Tennessee (TN), declines in HIV among persons who inject drugs (PWID) stalled, and HCV infection rates increased significantly from 2013-2017. To better target strategies to address the syndemic, county-level socioeconomic, opioid use, access to healthcare, and health factors were modeled to identify indicators predictive of vulnerability to an HIV/HCV outbreak among PWID in TN.

Examining the Ratio of Obstetric Beds to Births, 2000-2019.

The number of U.S. births has been declining.

Comprehensive Process Mapping and Qualitative Interviews to Inform Implementation of Rapid Linkage to HIV Care Programs in a Mid-Sized Urban Setting in the Southern United States.

Background: Rapid antiretroviral therapy (ART) initiation, in which people living with HIV start ART within days of diagnosis, is a key component of the US Ending the HIV Epidemic initiative.

Setting: The Memphis Metropolitan Statistical Area ranked fourth in the United States for the highest HIV incidence per 100,000 population in 2018. Rapid ART programs are limited in the Memphis Metropolitan Statistical Area, and our objective was to identify local implementation barriers.

County-Level Associations Between Pregnancy-Related Mortality Ratios and Contextual Sociospatial Indicators.

Objective: To characterize county-level differences in pregnancy-related mortality as a function of sociospatial indicators.

Methods: We conducted a cross-sectional multilevel analysis of all pregnancy-related deaths and all live births with available ZIP code or county data in the Pregnancy Mortality Surveillance System during 2011-2016 for non-Hispanic Black, Hispanic (all races), and non-Hispanic White women aged 15-44 years. The exposures included 31 conceptually-grounded, county-specific sociospatial indicators that were collected from publicly available data sources and categorized into domains of demographic; general, reproductive, and behavioral health; social capital and support; and socioeconomic contexts.

Individual, community, and structural factors associated with linkage to HIV care among people diagnosed with HIV in Tennessee.

Objective: We assessed trends and identified individual- and county-level factors associated with individual linkage to HIV care in Tennessee (TN).

Methods: TN residents diagnosed with HIV from 2012-2016 were included in the analysis (n = 3,751). Individuals were assigned county-level factors based on county of residence at the time of diagnosis.