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Ensuring integrity of research and peer review: lessons learned by being an editor
No full text[Note: The video and slides are both not available from this event.] Tuesday, October 14, 2025; noon to 1 p.m. (Central Time); via Zoom. "Ensuring Integrity of Research and Peer Review: Lessons Learned by Being an Editor". Mario Malički, M.D., Ph.D., Associate Director of the Stanford Program for Rigor and Reproducibility (SPORR) at Stanford University and Editor-in-Chief of Research Integrity and Peer Review (journal).[Note: The video and slides are both not available from this event.] Mario Malički, M.D., with a Ph.D. in Medical Ethics, has been an Editor-in-Chief of Research Integrity and Peer Review (RIPR) journal for six years. For this lecture, Dr. Mario Malički will provide an overview of ethical issues in research integrity and peer review encountered in his editorial work in the field. The review will include lessons learned as both an active meta-researcher and editor of peer review and research integrity studies. His talk will describe the submission checks that journals and publishers employ, as well as methods of responding to and addressing pre- and post-publication concerns. The lecture will also cover his recent research on the transparency and effectiveness of scholarly peer review.UT Southwestern--Program in Ethic
Pneumocystis jirovecii pneumonia
No full textDetailed formal protocol with illustrations and extensive bibliography.A recording of the protocol presentation is available on UT Southwestern’s Mediasite. Note: Access to the video is restricted to authorized UT Southwestern users only.UT Southwestern--Internal Medicin
The Effects of Youth Football on the Developing Brain: A Multi-Modal Neuroimaging Study
Full text linkFootball players can experience hundreds of head impacts during a single season without sustaining a mild traumatic brain injury (mTBI). There is a growing concern regarding the association between later-life neurodegenerative disease development and earlier life head injury. This association is linked to the combination of recurrent mTBI and repetitive subconcussive head impacts (RHI). Many approaches exist to evaluate the effect of RHI on the brain include advanced neuroimaging, biomechanical assessment, and neuropsychological testing. mTBI and RHI have been evaluated in high school, collegiate, and professional sports, but limited data are available for the youth age group (8-13 years old). Hence, the overall topic of this dissertation is to evaluate RHI across a season of contact American football. Previous contact sport studies of high school and collegiate athletes have shown that advanced neuroimaging techniques, such as diffusion kurtosis imaging (DKI) and magnetoencephalography (MEG), can reveal subtle changes in brain structure and function caused by RHI. Our long-term goal is to expand this work and develop a novel neuroimaging-based monitoring protocol for both subconcussive and concussive head impacts to enhance brain health in the pediatric population. These methods have the potential to enlighten future clinical management and biomarker development. This dissertation will compare biomechanical data to advanced non-invasive neuroimaging measures to better understand the effects of RHI in youth football players. The dissertation hypothesis is that RHI will lead to changes in brain structure and function. To gain a deeper understanding of the effects of RHI on brain health, our analysis will involve comparing RHI with neuroimaging measures, exploring network connectivity, and examining how RHI may modulate the relationship between function and structural neuroimaging measures. This dissertation is partitioned across 3 main parts. Specific Aim 1. Compare MEG and DKI metrics to biomechanical measures of RHI across a single season of youth football. Specific Aim 2: Evaluate the effects RHI has on the relationship between MEG and DKI data. Specific Aim 3: Analyze functional connectivity metrics across a single season of football. The highlighted methods and results encompassed in this dissertation contributes to the medical community by informing potential neuroimaging protocols in the future that could be used in RHI monitoring
What drives the survival cap?: cardiometabolic risk in people with HIV on antiretroviral therapy
Full text linkDetailed formal protocol with illustrations and extensive bibliography.A recording of the protocol presentation is available on UT Southwestern’s Mediasite. Note: Access to the video is restricted to authorized UT Southwestern users only.UT Southwestern--Internal Medicin
Do acid-producing diets threaten kidney health?
Full text linkDetailed formal protocol with illustrations and extensive bibliography.A recording of the protocol presentation is available on UT Southwestern's Mediasite. Note: Access to the video is restricted to authorized UT Southwestern users only.UT Southwestern--Internal Medicin
Intracellular Lipid Surveillance Through Interplay Between a Nuclear Receptor and Rab GTPases
No full textThe general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.Cells continuously experience fluctuations in resource availability and therefore require adaptive mechanisms to recognize these changes and respond accordingly to ensure metabolic health. Signaling mechanisms like the AMPK and mTOR pathways enable cells to monitor energy and amino acid availability, respectively, and cholesterol sensing by SREBP provides a means for cells to maintain homeostatic lipid saturation. Lipids comprise a vast class of energy-rich molecules that, altogether, are essential for most every cellular process. Yet independent of sterol sensing, it remains unclear how cells sense and respond to global lipid depletion. While starving cells initiate fatty acid β-oxidation via mammalian nuclear receptors, PPAR and HNF4, it is unknown how cells couple this catabolic process with mechanisms to increase nutrient intake and prevent further starvation. Comprised predominantly of lipid droplets, the C. elegans intestine is an excellent model for elucidating the relationship between lipid depletion and nutrient absorption in the context of lipid sensing.
The work presented herein defines a novel signaling mechanism through which the transcriptional regulator of β-oxidation in C. elegans, Nuclear Hormone Receptor 49 (NHR-49), senses intracellular lipid availability and restores lipid homeostasis following starvation-induced lipid depletion by monitoring abundance of a single de novo-synthesized lipid, geranylgeranyl pyrophosphate. In this pathway, lipid availability inactivates NHR-49 through its sequestration to cytosolic transport vesicles by the geranylgeranyl-conjugated RAB-11.1 GTPase. Lipid depletion prevents NHR-49 vesicular association, thereby promoting its nuclear translocation and activation of genes involved in nutrient absorption and catabolism. Importantly, activation of endocytic recycling regulator, rab-11.2, enhances nutrient transporter residency on the cell surface. Upon investigation of how this intracellular lipid surveillance pathway relates to other homeostatic mechanisms, the findings described in the succeeding chapter establish a cooperative relationship between NHR-49 and the regulator of cytosolic protein folding, Heat Shock Factor (HSF-1), in mediating metabolic health and age progression. Through stabilizing the intestinal actin network, HSF-1 ensures proper vesicle trafficking and acts as an upstream regulator of NHR-49 in promoting lipid homeostasis. Overall, this work expands our understanding of lipid sensing and details a novel mechanism by which cells increase nutrient intake in times of metabolic demand
"¿Hacia Donde Vamos?": Interventions to Improve Pediatric Subspecialty Care for Immigrant Children in the Dallas-Area as Informed by Caregiver Experiences
Full text linkBACKGROUND: It is widely known that immigrants in the United States have insufficient access to health care and that these issues extend across the lifespan. Immigrant children, who represent approximately a quarter of all children in the US, are significantly more likely to be uninsured and to experience more difficulties accessing health care compared to their non-immigrant counterparts. Barriers to care range from language discordance, to fear, to lack of transportation and other social and structural determinants of health. In Texas specifically, immigrant children have limited insurance options available to cover non-emergency health care, and the systems for low-cost accessible care in Dallas, particularly subspecialty care, are often piecemeal at best.
OBJECTIVE: This qualitative study aims to identify the needs, barriers, existing systems, and potential interventions related to accessing pediatric subspecialty care for immigrant children in the Dallas-area based on the lived experiences of caregivers who participated in community focus groups and then provide and discuss potential research-informed interventions.
METHODS: A phenomenological approach was chosen, emphasizing individuals' lived experiences. Ten standardized questions were developed in consultation with immigrant-serving community organizations to serve as an interview guide. Participants were recruited through snowball sampling and community organizations.
Four focus groups were conducted in Spanish with seventeen participants in total. Transcripts were coded, generated into themes, and then sorted into predetermined domains: barriers, existing systems, solutions, conditions, and specialties.
RESULTS: Dentistry and dermatology were the most common specialty needs. Commonly mentioned barriers to accessing pediatric subspecialty care included high costs, fear and distrust surrounding the healthcare system, insufficient insurance, and difficulty navigating the complex healthcare system. Participants reported commonly accessing pediatric subspecialty care through emergency departments or inpatient admissions and relying on social networks for guidance.
They also note that there are unique challenges related to being a cultural/ethnic minority when approaching health care as immigrants.
Potential solutions discussed were streamlined processes of healthcare navigation, increased access to health information, health education, adequate insurance, and low-cost health care.
CONCLUSIONS: Identification of barriers to and existing systems for accessing pediatric subspecialty care for immigrant children is necessary for the design and implementation of high-quality, community-level interventions. Proposed interventions focus on nine areas: flexible scheduling and after-hours care, provider support and initiatives, accessible health information, addressing language and cultural discordance, improved information sharing and building trust, community health navigational support, academic community partnerships, financial assistance, and more accessible insurance and legislative changes. The challenges and solutions explored in this paper are relevant and applicable for Dallas as it seeks to better serve immigrant children who call the city home and can be relevant to other major diverse, urban, and metropolitan areas throughout the country
Improving Teamwork Competencies of Students in the Surgical Clinical Learning Environment
Full text linkBACKGROUND: Team-based healthcare continues to demonstrate positive effects on patient safety and outcomes. Gaps in knowledge, attitudes, and skills related to critical teamwork competencies may result in suboptimal care and avoidable adverse events. The early education and training of medical and health professions students on critical teamwork competencies is integral to driving a cultural shift in medicine toward an emphasis on patient safety.
LOCAL PROBLEM: At UT Southwestern, the institutional priority of teamwork development is reflected in the establishment of the Quality Enhancement Plan TeamFIRST. The aim of this initiative is to improve the competency of teamwork skills of students through a progressive series of interprofessional educational activities and experiences. The fourth of five TeamFIRST Modules focuses on teaching specific teamwork competencies to students in various clinical learning environments, including the Acute Care and Emergency Surgery (ACES) service at William P. Clements Jr. University Hospital (CUH).
METHODS: To understand the contextual factors and stakeholder requirements necessary to guide intervention development, a series of interview and observations were performed. Because the curriculum would bridge the clinical and educational environments, intervention development required engagement with both members of the clinical ACES Service and the educational ACES Rotation. Shared requirements from stakeholders included limiting time commitments due to competing responsibilities and activities, as well as restrictions related to the COVID-19 pandemic. The stakeholder requirement demonstrated a potential need for a mix of asynchronous, virtual education interventions and synchronous, in-person education interventions. Additionally, a critical requirement of clinical stakeholders was the development of system for students to make calls to post-operative, post-discharge patients. The primary educational stakeholder, TeamFIRST, identified nine of the twelve teamwork competencies were chosen as the focus of the teamwork curriculum - Structured Communication, Closed Loop Communication, Asking Clarifying Questions, Sharing Unique Information, Mutual Trust, Team Mental Models, Mutual Performance Monitoring, Obstacles to Teamwork, and Psychological Safety - each taught to various degrees of learning including informing, demonstrating, practicing, cognitive practice, and feedback. Measures critical determining project success included fidelity of activity participation, acceptability, feasibility, appropriateness, and effectiveness, as measured through knowledge, attitudes, confidence in skills, and skill performance.
INTERVENTIONS: An educational program focused on the development of the specific teamwork competencies to the specified depths of learning was created for the ACES Rotation. The activities of the educational program consisted of two pre-rotation activities - a Pre-Work Module and Virtual Handover Simulation - and three intra-rotation activities - a Call Clinic, Competencies Journal, and Weekly Debrief. The virtual, asynchronous Pre-Work Module consisted of a series of instructional videos orienting students to the activities and curriculum, as well as videos and a point-and-click activity that defined the teamwork competencies and provided clinical examples of each competency. The asynchronous Virtual Handover Simulation consisted of a series of videos introducing the use of structured communication in handovers and two simulated post-discharge, post-operative patient encounters that mirrored the Call Clinic processes focused on providing students an opportunity to practice creating handovers using structured communication and orient students to the Call Clinic processes. The asynchronous, intra-rotation Call Clinic allowed students to make calls to post-discharge, post-operative patients to screen for warning signs of complications, review post-operative care, and practice handovers in the clinical environment. In the asynchronous, virtual Competencies Journal, students engaged in cognitive practice by reflecting on teamwork opportunities they experienced or observed in the clinical learning environment. Lastly, the synchronous Weekly Debrief session allowed students to discuss these teamwork opportunities with faculty members and TeamFIRST leaders, receive feedback, and review information from the curriculum.
RESULTS: The educational curriculum was launched on April 5, 2021 and continues to run on the ACES Service as of the submission of this document. For analysis purposes, the results described below consist of student performance until February 15, 2023. Over this period of time, as defined as April 5, 2021 to February 15, 2023, 64 students had been enrolled in the ACES Rotation - 34 medical students and 30 physician assistant students. 47 students completed the Pre-Work Module with proper fidelity, demonstrating improved knowledge in closed-loop communication, mutual performance monitoring, and team mental models; improved attitudes in mutual performance monitoring; and improved confidence in skills in all teamwork competencies. 24 students completed the Virtual Handover Simulation with proper fidelity, demonstrating improved knowledge in IPASS and improved confidence in skills in structured communication. 12 students completed the Call Clinic activities with proper fidelity, demonstrating improved confidence in skills in structured communication. 13 students completed the Competencies Journal with proper fidelity, demonstrating improved confidence in skills in all competencies except closed-loop communication. Throughout all activities, students demonstrated high levels of attitudes towards the competencies, with the majority agreeing or strongly agreeing with their importance of the competencies in the clinical environment. Feedback from students revealed overall positive acceptability, appropriateness, and feasibility of the activities, although expressed negative themes toward time requirements due to competing activities and technology issues.
CONCLUSION: The educational curriculum and activities demonstrated novel approaches to improving aspects of teamwork competencies in the surgical clinical learning environment. Each activity exhibited various levels of effectiveness in improving teamwork competencies and was considered acceptable, appropriate, and feasible by most students. However, fidelity in participation of students in the activities was poor. Future directions of the curriculum should include improvement in the activities based on the collected student feedback and updated existing literature on best practices, including better clinical integration of activities, as well as faculty and resident participation. Furthermore, analysis of collected handovers for skill-based competency and review of patient outcomes should be performed to improve understanding of the effects of teamwork education on patient safety
Nopalitos
Full text linkThe author submitted this entry in the Creative Non-Fiction category (Amateur division) for the 2025 On My Own Time™ (OMOT) Art Show.This work received a First Place Award in the "Creative Non-Fiction" category in the 2025 OMOT show.As a child I did not have the opportunity to visit my native country. As I got older and was finally able to visit life events kept getting in the way. This piece was written after my last visit. I had the opportunity to spend time alone with my maternal grandmother, which has always been a rare occurrence as she has many grandkids and great-grand kids. It helped me to humanize her, gather family history, appreciate her sense of humor, and to gain precious memories that I will carry with me for the rest of my days