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A Comparison of Post-Injury Symptomatology and Recovery Following Concussion Versus Orthopedic Injury
Get PDFOBJECTIVE: Concussion research has utilized orthopedic injury (OI) comparison groups to examine outcomes specific to concussion versus physical injury in general, due to the suggestion that preexisting, comorbid, and other injury-related factors influence post-concussion symptom reporting and recovery. The first aim of this dissertation (Study 1) was to conduct a review of the literature on post-injury symptoms and outcomes following concussion versus OI in children and adolescents, focusing on study design and synthesizing conclusions about concussion versus OI in youth populations. Incorporating findings from the review, the second objective of this dissertation (Study 2) was to collect original data from concussed youth and a carefully selected OI control group to compare symptomatology and recovery at initial presentation and 3-months post-injury to examine whether concussion outcomes are unique to a brain injury or more related to response to injury in general.
METHODS: A scoping review using MEDLINE and PubMed to query databases from 2000 to 2020 was performed. Studies were included if they reported children, adolescents, or young adults with mild traumatic brain injury (mTBI)/concussion, used an orthopedic control group, and compared post-injury outcomes, which resulted in a total of 52 articles out of the 526 initially identified. For the second study, participants age 12-18 who sustained a concussion (n = 50) were matched by sex, age, and days since injury to an OI group (n = 50). Repeated measure analyses of covariance (ANCOVAs) were used to compare post-concussion symptoms, emotional symptoms, and recovery outcomes between injury groups at initial and 3 months post-injury. Binary logistic regression analyses were used to determine predictors of prolonged recovery separately in concussion and OI groups.
RESULTS: Study 1: sixty-nine percent of the studies included in the scoping review reported differences between concussion and OI outcomes during at least one assessment time point during the recovery period, with higher and more persistent symptomatology in the concussion group. Study 2: the repeated measure ANCOVAs indicated that concussion participants reported significantly higher post-injury symptomatology and psychological sequelae within the first week of injury compared to OI subjects, but by 3 months, the groups showed no differences. Within the concussion group, females reported significantly higher symptoms compared to males, but this pattern was not observed in the OI group. Significant predictors for prolonged recovery also differed between injury groups. For the concussion group, previous concussion was the only significant predictor in our model for prolonged recovery. In the OI group, time since injury and functional impairment rating scores predicted prolonged recovery.
CONCLUSIONS: Overall, findings suggest concussion results in a unique expression of symptoms, and recovery following concussion is influenced by a specific set of concussion-related factors that are not commonly seen in OI. Clinically, a unique presentation and recovery course following concussion versus OI supports the utility of specialized concussion treatment and clinical protocols, and may help identify individuals at greater risk of prolonged recovery
Synthetic Studies of the Rubellin Natural Products
Get PDFThe effective construction of complex bioactive molecules often requires the development of innovative chemical methods to push the boundaries of organic synthesis. As the utility of available reactions increases, the complexity of possible target molecules increases analogously. This manuscript includes a review of relevant recent natural product syntheses, our studies on the rubellin class of natural products, and our investigation of a rearrangement reaction of reactive iodonium ylide intermediates.
First described are select syntheses of complex anthraquinone monomers and dimers within the past 20 years. The scientific community has found deep interest in the anthraquinone class of compounds due to their therapeutic properties and challenging structural elements. Various architecturally beautiful natural products have been successfully synthesized utilizing two main strategies: either an early-stage synthesis of the anthraquinone and further elongation of the system, or a late-stage introduction of the anthraquinone ring moiety. The retrosynthetic disconnections that shape the anthraquinone-installation strategy are emphasized.
The second and major chapter describes our studies of the anthraquinone-based rubellin natural products through various synthetic routes and our stereoselective total synthesis of (+)-rubellin C. The synthesis of a rubellin family member represents a synthetic landmark in anthraquinone natural products, as successful total synthesis has evaded the synthetic community since their isolation almost forty years ago. Our synthesis has allowed for preliminary investigation of the reported biological activity of these compounds on the intracellular protein tau, a therapeutic target for Alzheimer's Disease and other neurodegenerative tauopathies.
Thirdly, part of our foray into the selective rearrangements of allylic iodonium ylide species is described, in particular our utilization of ligand design to control the selectivity of these rearrangements. We examine the allylic iodonium ylide species, a reactive intermediate that can undergo many uncontrolled processes. In the presence of a metal catalyst and devised ligand, we can modulate the selectivity of this process to generate useful products
Heart transplantation using hearts that have stopped: managing the emotional rescue
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 Relationship Between Interdisciplinary Team Cohesion and Burnout in Cognitive Rehabilitation
No full textBACKGROUND: The healthcare system at large is currently experiencing unprecedented amounts of burnout (Jalili et al., 2021; Reith, 2018). Researchers are working to identify risk and protective factors (Cañadas-De la Fuente et al., 2015; Seidler et al., 2014) of burnout that might be used as points of intervention (Awa et al., 2010; Demerouti, 2015). One potential protective factor of burnout that has not been explored is interpersonal team cohesion of the interdisciplinary team. (Hellyar et al., 2019). The purpose of this study was to determine if interpersonal team cohesion was inversely related to burnout in healthcare providers.
METHODS: Emails and flyers with links to an online survey were sent to direct care staff in a cognitive rehabilitation setting. The convenience sample included 53 participants who completed the survey. Participants answered questions regarding burnout, interpersonal team functioning, depression, anxiety, and stress. Demographic variables associated with burnout were also included (Cañadas-De la Fuente et al., 2015; Shanafelt et al., 2015).
RESULTS: Twenty-six participants reported symptoms consistent with burnout. All of these participants endorsed experiencing emotional exhaustion, but no one endorsed experiencing depersonalization or diminished professional accomplishment. As such, all analyses used emotional exhaustion to examine burnout. Multiple regression was used to determine if interpersonal team cohesion predicted emotional exhaustion. While the overall model was significant (F (6,42) = 12.55, p < .001, R2 = .64), only stress ( = 0.68, p < .001) and depression ( = 0.34, p = .047) were significant predictors of emotional exhaustion. Further analysis revealed that interpersonal team cohesion did significantly predict emotional exhaustion, but only with stress included as a partial mediator.
CONCLUSIONS: The hypothesis that interpersonal team cohesion and burnout were inversely related to each other proved to be an oversimplification. Results of this study show that stress serves as a partial mediator between interpersonal functioning of interpersonal team cohesion and burnout, with lower team cohesion resulting in higher stress, which in turn results in higher levels of burnout. This implies that both interpersonal functioning of the interdisciplinary team and stress can be used as points of intervention for reducing or preventing burnout
Why?
Get PDFDetailed 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
Regrets of the Fallen
Get PDFThe author submitted this entry in the 10-Word Story category (Amateur division) for the 2023 On My Own Time (OMOT) Art Show.Many people come into this world trying to find their purpose or something that will make them be remembered. We grow up with that inspiration to be more than today but as we become adults, obligations get in the way that might not let us fulfill those dreams. Someday we will all find ourselves putting off that dream only to find out that time is not merciful. When we leave this earth, what regrets do we leave behind? Will anyone know what our dreams were? So many unspoken whispers that become screams in the afterlife
Nuclear Receptor FTZ-F1 and Downstream Target Gene Meg-8.3 Control Esophageal Gland Function in S. Mansoni
Get PDFSchistosomes infect over 200 million of the world's poorest people, yet treatment relies on a single drug. Nuclear hormone receptors are ligand-activated transcription factors that regulate diverse processes in metazoans and are known drug targets in humans. However, few nuclear hormone receptors have been characterized functionally in the parasite. During a systematic analysis of nuclear receptor function, we have identified one receptor, an FTZ-F1-like receptor that is essential for parasite survival. Using a combination of transcriptional profiling and chromatin immunoprecipitation we identify the micro-exon gene, meg-8.3, a direct transcriptional target of FTZ-F1 which is also essential for parasite survival. We find that RNAi of either ftz-f1 or meg-8.3 are required for esophageal gland function and maintenance of tissue in the worm head. Together, our data suggest that FTZ-F1 regulates meg-8.3 transcription, and this regulation is essential to esophageal gland function. These data suggest that drugs that alter the activities of proteins in the parasite's esophageal gland could have therapeutic potential
Work Life Balance
Get PDFThe author submitted this entry in the 10-Word Story category (Amateur division) for the 2023 On My Own Time (OMOT) Art Show.Inspired by the sound of the clock at my workplace, at home, on my phone, and all around me, I wrote this ten-word story to capture the feeling of time slipping out of your hands
Leaving
Get PDFThe author submitted this entry in the Fictional Short Story category (Amateur division) for the 2023 On My Own Time (OMOT) Art Show.This piece is an excerpt from a novel in progress, inspired by my grandmother's true story of fleeing Rangoon, Burma, as a young girl during WWII
Why I Paint
Get PDFThe author submitted this entry in the Open Verse Poetry category (Amateur division) for the 2023 On My Own Time (OMOT) Art Show.I write, I paint, I express. It is who I am