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Periventricular White Matter hyperintensities in Ischemic stroke
No full textPoster Highlight: College of Biomedical and Translational Science, RAD 2025 Award Winning Posters & Oral PresentationsBackground: White Matter hyperintensities (WMH) are hyperintense signals on T2-weighted or fluid-attenuated inversion recovery(FLAIR) brain MRI sequences. This reflects structural and functional alterations in the white matter. WMHs are common across all age groups, with prevalence increasing in older populations. Clinically, WMHs are strongly associated with an elevated risk of stroke, cognitive decline, dementia, and mortality. Larger WMH volumes are correlated with poorer outcomes in stroke recovery. WMH can be classified into periventricular (PWMH) and deep (DWMH). PWMHs are particularly associated with greater cognitive decline, elevated risk of dementia, and worse functional outcomes after stroke. However, DWMH shows minimal impact on global cognition. Histopathology studies indicate features of demyelination and axonal degeneration within WMH regions. This study seeks to identify the earliest changes driving WMH development such as microglial activation, and astrogliosis which may contribute to demyelination and axonal damage. Understanding these early stages of WMH development could provide insights into mechanisms for prevention or reversal, ultimately mitigating the cognitive, physical, and vascular consequences of WMH. Method: Three-month-old male Sprague-Dawley mice underwent transient middle cerebral artery occlusion (tMCAO). At 24 hours post-stroke, animals were perfused with saline followed by 4% formalin. Brains were fixed in 4% formalin, paraffin-embedded, and sectioned (7 μm) using a microtome. For immunohistochemistry, sections were deparaffinized, rehydrated, and subjected to antigen retrieval. After blocking with 10% donkey serum, sections were incubated overnight at 4°C with primary antibodies against Iba1 (microglial activation), GFAP (astrogliosis), MBP (myelin integrity), SMI 32 (axonal damage), and DAPI. Secondary antibodies were applied, and images were captured using an ImageXpress® PICO fluorescent microscope and a Zeiss LSM 510 META confocal microscope for Z-stack imaging. The corpus callosum and basal ganglia were selected for analysis. Quantitative analysis was conducted using ImageJ. Result: Immunohistochemical analysis revealed elevated expression of GFAP and SMI 32 in stroke animals, indicating increased astrogliosis and axonal damage. In contrast, Iba1 expression was reduced, and MBP expression was significantly higher in stroke animals. DAPI staining revealed notable changes in nuclear morphology, with stroke animals showing larger average nuclear sizes compared to controls. Additionally, there was a significant decrease in the total number of DAPI-positive nuclei, resulting in reduced nuclear density in the stroke group. Conclusion: Stroke may induce astrogliosis, axonal damage, and changes in microglial activation and nuclear morphology, suggesting early cellular alterations in periventricular white matter linked to PWMH
Building Resilience in Nurses: Leveraging Digital Tools to Combat Workplace Bullying and Foster Well-Being
No full textPoster Highlight: College of Nursing, RAD 2025 Award Winning Posters & Oral PresentationsPurpose: Workplace bullying is a significant contributor to nurse burnout and turnover which exacerbates the ongoing nursing shortage. Evidence suggests that developing resilience is an effective intervention to help nurses manage the stress associated with workplace bullying, thereby mitigating its negative impact on retention and well-being. The purpose of this study is to assess the current state of the use of digital tools, such as mobile applications, in fostering resilience among nurses and providing support for addressing workplace bullying within the nursing profession. Peer support delivered through digital tools can foster resilience among nurses experiencing workforce bullying by providing a safe space for shared experiences, emotional support, and coping strategies. Methods: A cursory literature review was conducted using PubMed, CINAHL, and ProQuest, where keywords related to workplace bullying in nursing and resilience-building through digital tools were combined using "OR/AND" operators. The search criteria included articles that 1) mentioned nursing, 2) addressed bullying or job-related stress, 3) referenced digital tools or mobile applications, 4) in the context of peer support, and 5) focused on resilience or coping strategies. Peer-reviewed articles published between 2019 and the present were included. A total of 645 articles were initially found through the search. Six relevant articles, comprising three qualitative and three quantitative studies, were analyzed for this review. Results: The literature review underscores the positive impact of digital and mobile-based interventions in the context of fostering a sense of community in enhancing resilience among nurses. These tools are highly valued for their accessibility, convenience, and ability to offer real-time support, allowing nurses to engage in self-paced interventions, track emotional states, and access coping strategies anytime. Mobile applications also provide privacy and anonymity, encouraging nurses to engage openly with support and peer networks. Studies show that these interventions reduce job turnover intentions, negative coping styles, stress, depression, and anxiety, while promoting positive coping strategies. Additionally, storytelling and peer sharing have been found to foster healing, human connection, and courage, which inspire nurses to recommit to their practice. Based on these findings, the literature suggests that digital tools play a crucial role in addressing workplace bullying by providing nurses with immediate access to peer support, psychological resources, and resilience-building strategies, which could reduce the effects of bullying or help the victim in dealing with the situation. Conclusion: The study suggests that utilizing digital tools or mobile applications can foster resilience and mitigate the impact of workplace bullying among nurses by offering real-time peer and community support when needed. Eliminating the culture of bullying and implementing strategies to build resilience should remain a priority within healthcare organizations. By enhancing nurses' coping abilities and mental well-being, these tools can help reduce burnout and improve retention rates. Ultimately, these efforts will contribute to a stable and satisfied workforce, leading to better patient care outcomes. Healthcare policies should support the integration of digital solutions and promote organizational changes that foster a culture of respect, well-being, and professional growth
Investigating genetic relationship between cancer and Alzheimer’s disease
No full textPoster Highlight: College of Biomedical and Translational Science, RAD 2025 Award Winning Posters & Oral PresentationsBackground: Both cancer and Alzheimer's disease (AD) are major threats to global health, ranking among the top causes of mortality and impairment. The most common kind of dementia, Alzheimer's disease (AD), is a neurodegenerative disease characterized by the progressive accumulation of amyloid plaque and neurofibrillary tangles. In cancer, abnormalities in signaling and metabolism lead to the uncontrolled growth and maintenance of cells that have undergone genetic modification. Evidence from several epidemiological studies points to a negative correlation between AD and several different types of cancer, suggesting that people with cancer are less likely to have AD, and vice versa: those with AD are less likely to get cancer. The use of genome-wide association studies (GWAS) allows for a quantitative evaluation of genetic variations throughout the genome, which in turn helps to identify common genetic loci that cause neurodegeneration and cancer to have opposite effects. Our objective is to utilize large-scale GWAS data to discover local genetic correlation (rg) between Alzheimer's disease (AD) and cancer (lung, breast, prostate, and colorectal) to comprehend potential genetic origins of the inverse link. Methods: We utilized GWAS summary statistics of lung cancer [Nₜₒₜₐₗ=85716] and AD for the analysis of local genetic correlation (rg). We meta-analyzed GWAS summary statistics for late-onset AD from two cohorts, Finnish biobank (FinnGen) G6_ALZHEIMER and Kunkle et al. [Nₜₒₜₐₗ=564274], by employing METAL. By applying LD score regression (LDSC), we determined the observed-scale SNP heritability and genome-wide genetic correlation (rg). Later on, we evaluated heritability at 2495 LD independent regions/loci using LAVA (Local Analysis of Variance and Association). Local rg assessment was carried out by following up on significantly heritable regions in both Alzheimer's disease and lung cancer. Results: A global genetic correlation of 2.48% (p=0.7168) between Alzheimer's disease and lung cancer was not statistically significant. We found negative local rg between AD and lung cancer in several positions for chromosome 6 and 19. In chromosome 6, we found local rg at chr6:27261036-28666364=-85.25% (p=0.0019), chr6:31320269-31427209=-75.41% (p=0.0126), chr6:31427210-32208901=-45.13% (p=0.0244), chr6:32586785-32629239=-49.06% (p=0.0108), chr6:32629240-32682213=-100% (p=0.0175), and in chromosome 19:45040933-45893307, rg=-35.39% (p= 0.0046). Conclusion: On chromosome 19, we found the APOE region, and there are a number of regions close to and inside the MHC locus that show negative correlations between AD and lung cancer. Despite the apparent molecular differences between the two disorders, these results point to APOE-mediated mechanisms as a potential mediator of these differences. The MHC regions also show negative associations, which suggests that immune function variability is a possible factor. We will expand our findings to include more cancers and investigate the potential role of genetically regulated gene expression in these areas as a mechanism behind the inverse correlation between AD and cancer in future studies
A Rare Case of Iatrogenic Hemothorax Following Thoracentesis Secondary to an Aberrant Posterior Intercostal Artery
No full textBackground: Thoracentesis is typically the initial procedure performed when diagnosing and treating a pleural effusion with approximately 180,000 procedures performed in the United States each year. The most common complication for this procedure is iatrogenic pneumothorax with an incidence reported as high as 6%, while bleeding is a more rare complication with hemothorax incidence of approximately 1%. Case information: A 79 year-old female with history of atrial fibrillation, COPD, DVT, type 2 diabetes, and early onset myelodysplastic syndrome presented to the ED with 1 day of chest pain and shortness of breath and was admitted to the hospital for atrial fibrillation with rapid ventricular response. Appropriate treatment was given which included Eliquis. Workup revealed a left pleural effusion of unknown origin, so ultrasound guided diagnostic thoracentesis was performed successfully with appropriate technique using a posterolateral approach and Lasix was initiated. Over the next 2 hours, the patient developed extreme dyspnea and became hemodynamically unstable warranting a transfer to the ICU. Repeat chest X-ray revealed a large left pleural effusion. Consequently, a 16 french pigtail chest tube was emergently inserted which removed 1L of sanguinous fluid. Given the rapid development of the hemothorax along with the patient’s anticoagulation treatment and recent diagnostic thoracentesis, a CT angiogram of the chest was ordered to detect any source of arterial extravasation secondary to the thoracentesis. The CT angiogram revealed an aberrant branch of the left 9th intercostal artery coursing inferiorly above the 10th rib, which was identified as the cause of the patient’s rapidly developing hemothorax. The aberrant artery was treated with coil embolization to stop the bleeding, which successfully prevented hemothorax recurrence from this vessel. Conclusions: This case illustrates a previously undocumented anatomical variant of the posterior intercostal artery which leads to a nearly fatal hemothorax despite appropriate thoracentesis technique
Body Composition and Harvest Site Variation in the Characterization of Adipose-Derived Mesenchymal Stem Cells
No full textPurpose: Adipose-derived mesenchymal stem cells (ASCs) can have self-renewal and proliferation, sparking an investigation into their potential for therapeutic utilization in cancer treatment, wound repair, and regenerative medicine. To better understand the power of ASCs, further exploration is needed to determine which donor characteristics (BMI, age, health status) make ideal candidates for harvest. It has been well established that obese ASC samples have poor proliferative capacity when compared to their lean counterparts. Additionally, subcutaneous collection sites such as those from the abdomen have historically demonstrated better proliferative and differentiation ability when compared to breast-derived samples. Methods: To test these claims, three donor cell lines (UNT008 obese abdominal, UNT008 obese breast, AA004 lean breast) were selected, thawed, and cultured utilizing a stromal medium. Cells at passage three were seeded for characterization experiments: The colony forming unit assay (CFU) was used to examine self-renewal and proliferative ability, surface marker expression was analyzed using flow cytometry, and differentiation capacity was determined with Oil Red O and Alizarin Red stains, followed by gene expression analysis using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR), after differentiating cells for 21 and 28 days using in-house adipogenic and osteogenic differentiation media, respectively. Results: Flow cytometry revealed cells were positive for typical mesenchymal markers (CD73, CD90, and CD105) and negative for hematoendothelial markers (CD3, CD14, CD31, and CD45) in all cultured samples, confirming their identity as ASCs without contamination of other stromal cells. Each cell line was capable of repopulation and formed colonies, but the most significant number of CFUs were observed in the obese abdominal ASCs. After 21 days, all adipogenically differentiated cultures formed cytoplasmic lipid droplet inclusions, as is evident from the Oil Red O staining. Gene expression of PPARγ, GLUT4, FABP4, and adiponectin were significantly increased, but leptin expression was limited. Obese breast ASCs demonstrated the largest fold change in FABP4 and PPARγ. After 28 days, all osteogenic cultures exhibited morphologic changes and most stained positive with Alizarin Red, indicating calcium deposition. Gene expression of ALP and RUNX2 were increased in all cell lines, but OpN and COL1A1 were not impressive, likely suggesting a need for a more extended osteogenic culture period. Conclusions: Based on the collected data, UNT008 obese breast ASCs demonstrated greater differentiative capacity when compared to the lean breast and obese abdominal counterparts. This is out of the ordinary from the previously reported behavior of breast ASCs, which have been known to have an impaired differentiation capacity in addition to decreased proliferative abilities. It is essential to note the preliminary nature of this study and the small sample size. Future directions include increasing statistical power with more cell lines to confirm findings and delve deeper into how ASCs from different body compositions and harvest sites influence the development of carcinomas, wound closure, and atypical tissue development
P2P: Closing the loop
No full textIntroduction: Salmonella infection can lead to severe consequences, particularly in individuals with impaired immunity, reduced gastric acidity, or prior antibiotic use, with most fatalities occurring in older patients with comorbidities.[1-4] Therefore, timely and accurate diagnosis is essential, as highlighted in this case of early detection in an immunocompromised patient. The care coordination between hospitalists and primary care physicians is crucial in patient care.[5] Case Presentation: A 63-year-old male patient with a past history of rheumatoid arthritis treated with Adalimumab, hypertension, hypothyroidism, and prostatic enlargement presented to the ER with a one-month history of intermittent fevers and a 2-week history of diffuse abdominal pain. Patient had visited his primary care 2 times for the symptoms and had blood cultures drawn 4 days before his ER visit. Routine blood work (CBC, CMP, COVID test) was normal. The patient was started on Ciprofloxacin 500 mg for a probable urinary or prostate infection. Abdominal pain brought the patient to the ER; other associated symptoms included loss of appetite, some episodes of nonbloody diarrhea, night sweats, belching but no history of chest pain, shortness of breath, or vomiting. On examination, he was in acute distress, and all systems were normal on examination except for the abdomen. His abdomen was distended, tender in all quadrants, with guarding and hypoactive bowel sounds. No fluid or organomegaly was detected. Our differentials included peritonitis, Hodgkin's lymphoma, or other infection. On admission, his white count was 24,000, LDH at 269, lactate at 4.9 with elevated LFTs, and creatinine of 1.96. The HIV test was negative. A peripheral smear revealed normal results. CT of the abdomen and pelvis was notable for the presence of a posterior superior round hypodensity with rim wall thickening and very minimal trace of subcapsular fluid. On day 3 of admission, his primary care called the provider line to discuss results.[6] It was communicated from provider to provider that a blood culture revealed the presence of Salmonella enterica spp. in one bottle. On day ten, the patient began to exhibit clinical improvement while on ceftriaxone and was discharged. Conclusion: This case illustrates the significance of timely detection and initiation of treatment of infections like Salmonella, which if go undetected, especially in an immunocompromised individual, could have detrimental outcomes. A number of serious medical errors result from miscommunication between caregivers during patient handovers. Moreover, this case emphasizes the critical role of effective communication in a rural location, where timely information sharing can significantly impact public health outcomes
An Extensive Review Regarding the Deposition of Calcium in Coronary Atherosclerotic Plaque
No full textIntroduction: Atherosclerosis, also known as coronary artery disease (CAD), is the leading cause of mortality across all cardiovascular disease in the United States. CAD is a complex mechanobiological disease characterized by the formation of a plaque within the artery wall. The enlargement of atherosclerotic plaque is driven by the deposition of fatty lipids, necrotic cells, and calcium. If left untreated, accumulation of these factors can result in a narrowed lumen and possible plaque rupture. While there has been extensive research on some of these factors, one particular area that has not been heavily explored is vascular calcification (VC). Due to its stiff mechanical properties, VC compromises artery wall biomechanics and causes increased expression of inflammatory cytokines. However, the underlying mechanisms driving calcium production are not well known. Methods: We conducted an extensive literature to identify the individual biological processes driving VC and formulate expressions that describe these processes. To do so, we employed a three-phased approach: First, we identified the key processes involved in calcium production. Second, we looked into the underlying biological mechanisms driving each process. Finally, we used phenomenological observations of these mechanisms to formulate expressions for each process. Results and Discussion: To determine how VC progresses, we first needed to establish its origin. Here, we identified vascular smooth muscle cells (VSMCs) as the core cell driving VC. We then identified 3 pathways by which calcium is produced by VSMCs. The first path is defined by general VSMC calcium production. The second path is driven by VSMC apoptosis and necrosis. We found that the intracellular calcium released during cell death forms apoptotic bodies which undergo phagocytosis. When degraded, the calcium contained within the apoptotic bodies is released into the extracellular space which ultimately contributes to VC. The third, and most significant, contributing factor is via phenotypical cell differentiation. It is known that VSMCs have the potential to undergo phenotypical differentiation into various cell phenotypes. More specifically, we found that VSMCs can transform into calcium producing osteogenic cells. The main component driving this transformation is runt-related transcription factor 2 (Runx2) which is generally known as a master regulator of bone development. Within the scope of CAD, Runx2 forces an osteogenic change in VSMCs, resulting in severe VC in mice models. Moreover, these works utilized histopathology to highlight Runx2-positive and VSMC-positive areas on cross-sectional slices of atherosclerotic mice arteries. We used this data to form an expression that approximates the likelihood of VSMCs transforming into osteogenic cells via Runx2. Since each component was derived from the literature, we utilized a rule scoring metric to validate the strength of each pathway. Using this metric, compared each pathway to different literature sources to determine agreeableness, physiological accuracy, similar methodology, and data precision. Conclusion: VSMCs are the main contributor for VC and produce calcium via three different methods: general calcification, apoptosis, and cell differentiation. With these findings, we aided in a potential method to model calcium progression. Our future aims will be to implement them into our model and produce accurate results
Sex Differences in Blood Pressure and Renal Nitric Oxide Bioavailability, Oxidative Stress, and Inflammation in Rodents Exposed to a Low Resource Environment
No full textAdverse childhood experiences (ACEs) are traumatic events, such as poverty, that occur before 18 years old. Clinical and animal studies observe increases in blood pressure (BP) for humans and rodents that have experienced an ACE or early life stressor (ELS) with sex differences. The mechanisms linking ELS and HTN are unknown, especially in rodents exposed to an impoverished environment. We used the limited bedding and nesting (LBN) rodent poverty model, which reduces bedding and nesting material by ~80% during weaning. To investigate the possible causes of HTN in ELS rodents as adults, we examined nitric oxide (NO) bioavailability, oxidative stress (OS), and inflammation in the kidneys. We hypothesize LBN males (M) in adulthood will have elevated BP, decreased renal NO bioavailability, and increased renal OS and inflammation and LBN females (F) will not. Rats were divided into 4 groups: LBN M (n=6), LBN F (n=8), CON M (n=7), and CON F (n=8). At 17 weeks, BP was recorded, kidney cortex was examined for NO bioavailability via nitrate and nitrite (NOx) concentrations, antioxidant capacity (AC), and 8-isoprostanes (marker of OS), pro-inflammatory cytokines (IL-17 and TNF-α), and anti-inflammatory cytokines (IL-10 and IL-6) by colorimetric assays. LBN M had an increase in BP vs CON M (128±4 vs 110±4 mmHg, p<0.001), LBN F and CON F showed no difference. LBN rats, regardless of sex, displayed a decrease in NOx, with LBN M displaying a 2-fold decrease in comparison to CON M (56±9 vs 102±14 uM/mg protein, p<0.05). 8-isoprostane levels were reduced in F compared to M, despite treatment (*p<0.05). There was no difference in 8-isoprostanes between treatment in each sex. However, LBN M had a 2-fold decrease in renal AC vs CON M (233±14 vs 442±12 mM Trolox/mg protein, p<0.0001) and no change was observed in LBN F vs CON F. Renal IL-17 and TNF-α did not change amongst the groups, but IL-10 was reduced by 27% (6415±659 vs 8871±1409 mg/mL/mg protein,ns) and IL-6 was reduced by 30% (3710±366 vs 5325±920 mg/mL/mg protein,ns) in LBN M vs CON M. Moreover, IL-6 was reduced by 50% in LBN M vs LBN F (3710±366 vs 7543±1117 mg/mL/mg protein, p=0.015). In summary, LBN M developed HTN in adulthood, while LBN F did not. The decrease in renal NO bioavailability and increase in renal OS may contribute to BP elevation observed in LBN M. Surprisingly, there was no increase in pro-inflammatory cytokines in LBN M. However, there were decreases in the anti-inflammatory cytokines in LBN M, suggesting a pro-inflammatory state in the kidneys. In LBN F, there were no differences in BP, NO bioavailability, OS, and inflammation. Future studies will explore renal protective mechanisms and BP regulation in LBN F. This study provides insights into the sex differences in BP and renal responses to ELS in rodents. Understanding the development and pathology of HTN induced by ACEs in the kidney may help to alleviate HTN
Determinants Impacting the Psychological Outcomes of African American Women with Breast Cancer: A Systematic Review
Full text linkThis systematic review aims to examine how limited access to quality healthcare, socioeconomic status, and cultural values and beliefs can impact the psychological outcomes of African American women with breast cancer (AAWBC), specifically in relation to depression and anxiety. While extensive research has confirmed the psychological impact of breast cancer diagnoses, there remains a significant gap in understanding these outcomes within the context of AAWBC - a population that is widely underrepresented in both breast cancer and mental health clinical trials (Stringer-Reasor, et al, 2021). This systematic review not only examines the prevalence of anxiety and depression in AAWBC but also investigates how specific determinants of health influence these psychological outcomes. A thorough analysis of existing research revealed that very few research studies address the intersection between determinants of health such as socioeconomic status, access to quality healthcare, and cultural values and beliefs with depression and anxiety in AAWBC. Furthermore, only a small number of research studies explored the mental health outcomes of AAWBC in general. This systematic review highlights a critical need for research and interventions tailored to the unique challenges faced by AAWBC. This systematic review emphasizes the importance of developing culturally sensitive and targeted mental health interventions for this underrepresented group
Linking Health to Learning: Gaps and Insights from a Rapid Review supported by the American School Health Association (ASHA)
No full textPurpose: In the past year, the American School Health Association (ASHA) has been updating its statement of core beliefs to align with the current evidence base. ASHA has been particularly interested in school health education following the COVID-19 pandemic. ASHA ‘s initiatives are aligned with and support the Whole School Whole Community Whole Child Model (WSCC) developed by the Centers for Disease Control. One element of the WSCC model is health education, which is most clearly related to ASHA Core Belief 1.3: “Health and learning are linked and essential to the development of healthy, resilient individuals and communities. Students’ health and well-being are foundational to achievement and serve as a primary predictor of overall outcomes across the life span.” This core belief was chosen in collaboration with ASHA as the focus of the rapid review, using a lens of health education. Specifically, ASHA leadership requested a rapid review of studies that examine the impact of health education on the relationship between health and learning from 2020 to the present. Methods: We developed our inclusion/exclusion criteria based on our discussion with ASHA leadership, constructed a search query, and conducted a rapid literature review among three databases: PubMed, Scopus, and ERIC, yielding 665 articles. We used Covidence software to perform the review. We screened articles based on title/abstract, which resulted in 62 articles. Next, we conducted a full-text screening and applied inclusion and exclusion criteria, resulting in twenty-one articles retained for data extraction. Results: Fifteen studies focused on a specific health topic; reproductive health education was the most common research focus and appeared in six studies. Other specific health education topics include mental health in schools, school-based health centers (SBHCs), physical activity, and other specific health behaviors. Most studies were observational with descriptive outcomes. Demographic data was limited, with 18.8% of studies not including information on the race/ethnicity of participants. The authors provided recommendations for health education strategies based on their initiatives. Community-based collaborations were the most frequently recommended strategy, appearing in fourteen studies. Conclusion: We observed that most interventions recommended multiple, overlapping strategies to support health education. The two most frequent recommendations were community-Based Approaches and Focus on Specific Health Topics. The lack of reporting racial and ethnic data was a limitation of studies. Inconsistencies in study outcomes and the definition of fundamental terms such as “health” and “health education”, further limited the comparability and generalizability of study findings. Harmonizing terms and outcomes will help accelerate research to define best practices in school health and support the potential for reproducibility. This rapid review suggests that inadequate research has been done to determine how health education has impacted the relationship between health and learning from 2020 to the present, revealing a gap in the literature. This project also supports the potential value of partnerships between academic health science centers and school health organizations to strengthen evidence-based health education