Through support from HERCULES and the Rollins Earn and Learn (REAL) Program, six MPH students worked on HERCULES-related research projects during the 2017-2018 academic year. Read more about their experiences below.
Prevalence and Concentration of Antimicrobial Resistance Genes in Children Under 5 Years of Age Living in Maputo, Mozambique
During my first year of the MPH Epidemiology program at the Rollins School of Public Health, I had the opportunity to work as a research assistant at the Georgia Institute of Technology for Drs. Joe Brown and David Berendes. Our project focused on prevalence and concentration of antimicrobial resistance genes in children under 5 years of age living in Maputo, Mozambique as well as the role of infrastructure and environmental conditions in antimicrobial resistance. My main responsibility in this project was to conduct droplet digital polymerase chain reaction (ddPCR) on stool specimens for six gene targets of public health relevance.
During this time, I was also able to expand my oral and written communication skills through presentations at group meetings and writing abstracts. I will be continuing my role at Georgia Tech through the summer, and will present our research group’s work at a CDC-sponsored side event of the Water Microbiology Conference (oral presentation) at University of North Carolina-Chapel Hill in May 2018, American Society for Microbiology’s Microbe conference (oral and poster presentations) in Atlanta in June 2018, and the International Conference on Emerging Infectious Diseases (oral presentation) in Atlanta in August 2018. I am also using these data for my MPH thesis.
Maternal Occupational Exposure and Chromosome 21 Nondisjunction
I have had the pleasure of working for Dr. Stephanie Sherman of the Department of Human Genetics at Emory University School of Medicine for the 2017-2018 academic year while attending the Rollins School of Public Health for an MPH in Epidemiology. One of the syndromes that Dr. Sherman’s lab investigates is Trisomy 21 (also referred to as Down syndrome). Through the utilization of genetic epidemiologic approaches, we hope to better understand the underlying mechanisms of chromosome 21 nondisjunction, as well as identify environmental and other genetic aspects that play a role in the complex phenotypic presentation of Down syndrome.
My contributions for the past year have centered on occupational coding and analysis to determine if maternal occupation and subsequent environmental exposure is associated with live births with Trisomy 21 compared to those without chromosomal abnormalities. Furthermore, we have investigated if the potential associated risk is higher in cases due to Meiosis I or Meiosis II nondisjunction errors. This hypothesis arose after a study conducted by Dr. Hunter, in collaboration with Dr. Sherman, that found low socioeconomic status was associated with Trisomy 21 case outcome and that income was a significant predictor of Meiosis II chromosome 21 nondisjunction events.
As part of this project, I uploaded occupational data from our study population (N=1687) to the NIOSH Industry and Occupation Computerized Coding System to ascertain standard occupational classifications (SOCs) for each subject. For those who were not auto-coded, I assigned them an SOC manually in accordance with NIOSH guidelines. Once our study population had been fully classified, I performed statistical analyses in SAS to determine if outcome (case status) was significantly correlated with maternal occupation. Analysis and determination of environmental exposure is still underway. We hope to contribute novel findings to the larger scientific community as well as advocacy and parent support groups if we identify possible modifiable factors.
HAPIN Trial Research
During my first year as an MPH student in the Environmental Health department, I worked under Dr. Tom Clasen’s research team for the Household Air Pollution Intervention (HAPIN) Trial. This is a randomized controlled trial of liquid petroleum gas stove and fuel distribution in four low-and-middle income countries that is investigating potential health benefits among pregnant women and their children. My research interest is environmental influences on maternal and child health and this experience has allowed me to gain research skills in a field that I am passionate about.
This past year, I helped translate HAPIN study Standard Operating Procedures (SOPs) from English to Spanish for the Biomarker Core, which will be used by project field staff in Guatemala and Peru. I worked closely with Amy Lovvorn, the trial administrator, on a variety of tasks, including labeling equipment, setting up Excel tracking sheets, and REDCap data entry.
In addition to my work in the HAPIN trial, I also assisted two other individuals on Dr. Clasen’s team with data cleaning, organization, and analysis for the Gram Vikas study, an Indian matched cohort study to assess the impact of improved water supply and sanitation in rural populations in Odisha, India on child health and nutrition. Additionally, I assisted with a Cochrane review by analyzing 310 abstracts and full texts from an updated search of child feces disposal practices, and categorized them based on study eligibility criteria.
This summer, I will be completing my practicum with Dr. Lisa Thompson, a principal investigator for HAPIN, at the Guatemala field site. I have helped in translating the tool that will be used to measure child neurodevelopment in the HAPIN trial, the Development Milestones Checklist (DMC-III). We will be training fieldworkers on how to use this tool and we will assess its validity and reliability, as well as standardize anthropometry measures across fieldworkers.
This past year has been a great learning experience and has helped me grow as a public health student. I am looking forward to applying the skills I have gained this summer and throughout my second year at Rollins.
Interplay of fetal genetics, environmental exposures, and birth outcomes
During the first year of my MSPH program in Biostatistics, I was fortunate to work in the lab of Dr. Judith Fridovich-Keil in the Department of Human Genetics at Emory University. Generally, our research addresses the interplay of fetal genetics, environmental exposures, and birth outcomes. Specifically, I have been looking at metabolomic data derived from paired maternal serum and amniotic fluid samples from women carrying either a chromosomally normal fetus or a fetus with trisomy 21 (Down syndrome). I am asking whether the presence of a third chromosome 21 alters the fetal response to a given environmental exposure, defined by finding traces of the exposure chemical in the corresponding maternal serum sample. We know that there is variability in trisomy 21 birth outcomes; for example, about half have heart defects and half don’t, but no genetic explanation for this has been found. Thus, we hypothesize that an environmental factor could contribute to these differential outcomes.
We currently have metabolomic data sets from maternal serum and second trimester amniotic fluid samples from 39 women whose fetus had an extra chromosome 21 (cases), and 81 women whose fetus was chromosomally normal (controls). Working collaboratively with the laboratory of Dr. Dean Jones, at the Emory School of Medicine, we identified several different environmental exposures of interest, including cotinine (a metabolite of nicotine), caffeine, and triphenyl phosphate, and were able to quantify the amount of each exposure in our maternal serum samples. Using the differing levels of each exposure as our outcome parameter, we attempted to identify different metabolic features, and thus different metabolic pathways, in both cases and controls that are significantly associated with each outcome. Currently, we are working on developing a linear regression model to look at the interaction between case/control status and the level of environmental exposure, in an attempt to identify which metabolomic features contribute significantly to this interaction.
Investigating Potential Epigenetic Changes in Members of the Michigan PBB Cohort
I have just completed an eventful first year as an Environmental Health MPH student at the Rollins School of Public Health. During my time here I have had the privilege of becoming part of the team of researchers at the Michigan PBB Registry, led by Dr. Michele Marcus. Our team investigates the human health effects of a catastrophic polybrominated biphenyl (PBB) exposure that occurred in Michigan in the 1970s. As a result of this exposure, many Michiganders were unwittingly exposed to PBB through contaminated meat and dairy products, while infants were exposed in utero and through breastfeeding.
My main focus over the Fall 2017 and Spring 2018 semesters was recruiting families into our study of possible epigenetic effects within the Michigan PBB cohort. In this study, we are attempting to determine if direct PBB exposure might induce changes to the human epigenome that can be passed to the next generation, thereby potentially causing health effects among people who have never been directly exposed to PBBs.
Over the past year, I have helped identify families that may be eligible for our epigenetics study based on a specific exposure pattern within each family. This has involved interviewing participants about their family members’ past exposures to PBBs, compiling extensive family profiles, and recruiting potentially eligible families at one of our regular community meetings in Michigan. I also assisted the team in managing several other community meetings and research events. When interacting with people who have been affected by the Michigan PBB exposure, I answer any questions they may have about our research and direct them to other resources that the Michigan PBB Registry has developed specifically for community members.
Working with the Michigan PBB Registry fulfills my love of environmental health sciences as well as my passion for using science to empower communities affected by environmental health issues. I look forward to another year of supporting the Michiganders affected by PBB exposure and furthering research that may elucidate how epigenetics influence human health.
HERCULES Community Engagement Core
During my second year as an MSPH Environmental Health and Epidemiology student at Emory University’s Rollins School of Public Health, I had the opportunity to be a part of the HERCULES Community Engagement Core with Dr. Melanie Pearson and Erin Lebow-Skelley. This experience allowed me to learn about the variety of research the HERCULES Center does while improving my research translation and qualitative data gathering skills.
In my role with the Community Engagement Core, I helped coordinate the Stakeholder Advisory Board meetings, assisted with community roundtables and roadshows, and provided technical assistance to an Atlanta community concerned with their air quality. Another main task for the year was to prepare research translations (1-page, plain language summaries) of some key research that was conducted in the Atlanta area by HERCULES Center investigators. Since September of 2016, I have created 6 translations from 8 peer-reviewed articles. These articles have gone through significant editing, since getting buy-in from the scientists and the community stakeholders is vital to ensure that the translations are accurate to the science, subtly educational, and easy to understand. We also created visual infographics of the papers to help deliver the scientific information in multiple ways.
This year has been a great learning experience and has been very fulfilling for me personally. I really enjoyed helping the research Emory University conducts be accessible and usable by community members.