Health Research Review – The Well : The Well

Carolina’s research is extensive and productive. Here’s an overview of some recent health-related discoveries, including an applied research innovation that promises to make health care more equitable.

Innovative pulse oximeter

The added melanin sensor offers more equitable healthcare for people of color.

Pulse oximeters, which measure blood oxygen levels, often overestimate levels in patients of color due to the presence of melanin in the skin. For this reason, the Food and Drug Administration has issued a warning about restrictions on pulse oximeters in 2021.

Prototype pulse oximeter.

The Bai lab in the College of Arts and Sciences’ Department of Applied Physical Sciences has developed an innovative device that corrects for melanin before assessing blood oxygen levels. It involves a wearable, flexible patch that is placed on the skin for measurement, giving health care providers a more accurate way to diagnose and treat hypoxemia — low blood oxygen levels — in patients of color.

“This not only improves patients’ quality of life, but also reflects the need for devices that mitigate a potentially overlooked inequity in healthcare,” explains Ubin Bai, assistant professor of applied physical sciences.

Adapted from a story by the Department of Applied Physical Sciences in the College of Arts and Sciences. Find out more.

Healing damaged hearts

Protein reprograms scar in heart muscle.

Scientists at the School of Medicine have made significant progress in the promising field of cell reprogramming and organ regeneration, and the discovery, published in the journal Cell Stem Cell, could play an important role in future drugs to treat damaged hearts.

This involves a more streamlined and efficient method of reprogramming scar cells (fibroblasts) to become healthy heart muscle cells (cardiomyocytes). Fibroblasts produce fibrous, hard tissue that contributes to heart failure after a heart attack or due to heart disease. The conversion of fibroblasts into cardiomyocytes is being explored as a potential future strategy to treat, or even someday cure, this common and deadly condition.

Microscopic image of human fibroblasts reprogrammed into cardiomyocyte-like cells

Human fibroblasts reprogrammed into cardiomyocyte-like cells. Immunofluorescence shows different molecules: DNA (blue), cardiac troponin T (orange), and α-actinin (green).

Surprisingly, the key to the new technique for creating cardiomyocytes turned out to be a protein controlling the activity of a gene called Ascl1, which is known to be a crucial protein involved in the conversion of fibroblasts into neurons. The researchers thought Ascl1 was neuron-specific.

“This is an out-of-the-box discovery, and we expect it to be useful in the development of future cardiac therapies and potentially other types of therapeutic cellular reprogramming,” said lead study author Li Qian, associate professor in the Department of Pathology and Laboratory Medicine and associate director of the Heart Institute Macalister diseases.

Adapted from a story by UNC Health and the UNC School of Medicine. Find out more.

A new measure of toilet research

Process offers a blueprint for holistically comparing quality of life benefits.

High-quality shared toilets in low-income areas could improve people’s quality of life and well-being – with benefits beyond any reduction in infectious disease – according to a first-of-its-kind study published in BMJ Open.

The study focused on the urban district of Chamanculo in Maputo, the capital of Mozambique. It compared people who used higher-quality communal latrines, meaning flush toilets with solid walls and doors, to people who used existing latrines, which usually consisted of a hole in the ground hidden by makeshift walls or sheets.

The study evaluated the impact of an urban sanitation intervention using a validated multidimensional measure known as sanitation-related quality of life, or SanQoL. Those with better toilets reported a big difference in sanitation-related quality of life.

Inadequate sanitation facilities can have other negative health consequences. When people are forced to use toilets that are dirty and lack privacy, the user’s safety and dignity can be compromised. Although previous research has highlighted this – for example through focus group discussions – there has not yet been a portable, evidence-based measure that integrates multiple quality of life outcomes using a small number of questions.

Pit toilet.

Pit toilet.

“Sanitation is much more than protection against infectious disease,” said Joe Brown, an associate professor in the Department of Environmental Sciences and Engineering at the Gillings School of Global Public Health, who was among the team of researchers. “It’s about human dignity, privacy, safety and overall well-being. Showing that better sanitation can affect lives in countless positive ways helps make the policy case for more investment in critical infrastructure.”

Adapted from a story by the Gillings School of Global Public Health. Find out more.

Long Ebola and long COVID-19

Scientists are looking for clues about the long-term effects of the two viral diseases.

Survivors of the 2014 Ebola outbreak reported a wide range of lingering symptoms that included fatigue and muscle aches, as well as neurological problems. But not much is known about the persistence and severity of symptoms over time.

Researchers at the School of Medicine’s Institute for Global Health and Infectious Diseases — David Wall, MD, professor of infectious disease medicine, and William Fischer, MD, associate professor of pulmonary disease — led an NIH-funded study looking at the seven symptoms of viral Ebola disease years after infection. What researchers are learning from Ebola survivors may also help explain the long run of COVID. Like SARS-CoV-2, Ebola is an RNA virus. Wohl believes there may be a characteristic of RNA viruses that causes some people to experience prolonged symptoms.

Drs.  Billy Fischer (left) and David Wohl.

Drs. William Fisher (left) and David Wohl in Liberia as part of the WHO’s Ebola response.

In a study published in Clinical Infectious Diseases, researchers found that even five years after an acute Ebola infection, the majority of people continue to have symptoms that significantly impact their lives. The findings call for an understanding of the mechanism of post-EVD syndrome, along with therapeutic interventions to help the thousands of EVD survivors.

“Like many who have survived a long COVID, many of those who have had Ebola continue to struggle with health problems that rob them of their quality of life. We need to learn more about these post-viral phenomena, including their causes, so that we can identify appropriate treatments. What we learn from these Ebola survivors may also help us better understand long-term COVID.”

Adapted from a story by UNC Health and the UNC School of Medicine. Find out more.

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