University of North Texas
UNTHSC Scholar (University. of North Texas Health Science Center)Not a member yet
6724 research outputs found
Sort by
Effects of Acupuncture on Fibromyalgia: A Literature Review
No full textPoster Highlight: College of Nursing, RAD 2025 Award Winning Posters & Oral PresentationsPurpose: Fibromyalgia (FM) is a debilitating disease causing intense, unbearable pain and fatigue; unfortunately, FM is without cure and respite comes only from symptom management, either through conventional treatment (i.e. pharmaceuticals, cognitive behavioral therapy, aerobic exercise) or complementary or alternative medicine (CAM). According to Adams et al, 66-98% of people with FM had experimented with a form of CAM because of frustrations with ineffective conventional treatments (Adams et al, 2023). Physical activity is recommended by most healthcare providers to alleviate symptoms of FM, however, these patients are faced with energy and pain-related challenges. The purpose of this literature review is to explore the effects of acupuncture on pain management and depleted energy reserves and determining the residual effects this may have on physical endurance. Methods: This literature review includes the evaluation of 7 articles involving integrative reviews and pragmatic studies and was conducted with the purpose of gathering evidence about the effects of acupuncture on patients with FM, specifically in pain severity, pain perception, and fatigue. Literature was selected from CINAHL and Google Scholar based on specific criteria: English only, full text, date range of 2019-2024, and subjects older than 18 years of age. Out of 27 articles found, 7 articles were selected. Each of the evaluated articles involves a range of questionnaires that analyzed patients’ pain severity and perceptions, sleep quality, fatigue, and overall well-being. Results: The included pragmatic studies by DiCarlo et showed that acupuncture caused a decrease in sleep disturbances, fatigue, and pain perception. A sensitivity analysis conducted by Zheng et al concluded that evidence of overall improvement in classic symptoms of FM from acupuncture treatment was lacking, compared to conclusions made in other reviews. The integrative review conducted by Pereiara et al determined that acupuncture treatment resulted in decreased insomnia and depression, increased well-being, and had fewer adverse effects than pharmaceuticals indicated for FM. The systematic review conducted by Kim et al concluded that verum acupuncture had significant pain reduction, improved sleep quality and general status, but showed no evidence of decreased fatigue compared to sham acupuncture. The 2 remaining integrative reviews of the 7 articles included in this study discussed the variance of treatment modalities of FM symptoms. No evidence was found that patients could then successfully engage in physical activities after undergoing acupuncture. Conclusion: Evidence reflects that acupuncture improves symptoms of FM; however, further data is needed to support this due to errors within the methodology. Frequent similarities in the literature review included lack of control groups, small sample sizes, presence of bias, and strictly utilized convenience sampling. Studies exploring a patient’s ability to successfully engage in physical activity after acupuncture therapy are lacking but hold promise if methodologically appropriate patient testing is conducted
Impairments in Verbal Fluency with Preserved Naming: A Cognitive Profile of Vascular Dementia
No full textPurpose: Vascular dementia (VaD) is the second most common form of dementia, characterized by executive dysfunction due to vascular damage to frontal-subcortical circuits. Regarding language abilities, verbal fluency tasks, particularly phonemic fluency, are highly sensitive to such impairments, whereas confrontation naming, measured by the Boston Naming Test (BNT), often remains intact. This study investigates the hypothesis that VaD is characterized by significant impairments in phonemic and semantic fluency tasks, with preserved performance on the BNT, distinguishing it from other dementia types such as Alzheimer’s disease (AD). The primary objective is to determine whether impairments in phonemic and semantic fluency, coupled with preserved naming ability, define the cognitive profile of vascular dementia. Methods: Archived neuropsychological test data from 40 patients (VaD = 25; controls = 15), aged 65-89, seen at an outpatient memory clinic would be analyzed. The data set would include a completed BNT, phonemic fluency test (e.g., words beginning with "F"), and semantic fluency test (e.g., naming animals). Group differences would be analyzed using independent samples t-tests, with the effect sizes (Cohen’s d) calculated to determine the magnitude of differences. A stepwise discriminant function analysis would evaluate the predictive value of these measures for classifying VaD versus controls. Results: It is hypothesized that patients with VaD will exhibit significantly lower phonemic fluency scores compared to controls. It is hypothesized that Semantic fluency scores will be significantly reduced in the VaD group versus controls. It is hypothesized that no significant differences will be found in the BNT performance. It is hypothesized that a discriminant function analysis will correctly classify 80% of cases, with verbal fluency measures showing strong predictive power. Conclusions: The anticipated results would support the hypothesis that verbal fluency impairments, especially in phonemic and semantic tests, are characteristic of vascular dementia, while confrontation naming remains preserved. This cognitive profile would highlight the importance of verbal fluency tasks in differentiating VaD from other forms of dementia. The results would underscore the value of incorporating these measures into neuropsychological evaluations for early diagnosis and targeted intervention. Future studies should examine these findings in more diverse populations to enhance generalizability
UCCAO Induces Choroid Plexus Activation and Cerebroventricular Dysfunction in Aged Mice
No full textCerebrovascular diseases remain one of the leading causes of mortality worldwide, with ischemic stroke ranked as the second leading cause of death. Additionally, over 55 million individuals worldwide are living with dementia, with vascular dementia representing around 15% to 20% of these cases. In our study, the Unilateral Common Carotid Artery Occlusion (UCCAO) model was used to investigate ischemia by occluding the left common carotid artery, thereby reducing blood flow to one side of the brain. This resulted in chronic, low-level ischemia, mimicking conditions such as vascular dementia, white matter disease, and certain strokes. The choroid plexus (CP), a highly vascularized complex within the brain's ventricles, consists of polarized epithelial cells responsible for producing 60–75% of cerebrospinal fluid (CSF), which occurs through the co-transportation of water and ions, and regulating immune function, while ependymal cells facilitate CSF circulation. The increase in fluid following UCCAO, along with CP and ependymal cell activation, mirrors pathological processes in stroke, hydrocephalus, and neuroinflammatory conditions. Their activation in response to ischemia suggests blood-CSF barrier (BCSFB) dysfunction, potentially leading to increased intracranial pressure, neuroinflammation, and secondary white matter damage. Multimodal MRI was conducted three months post-UCCAO to assess white matter degeneration and cerebral ventricle enlargement in aged (20-month-old) C57 mice. T2-weighted MRI (T2W) revealed bilateral cerebroventricular enlargement, while Fluid-Attenuated Inversion Recovery (FLAIR) MRI revealed white matter hyperintensities (WMHs) in the corpus callosum across both hemispheres, including the left, right, and third ventricles, compared to sham controls. Cerebroventricular volume was significantly higher in UCCAO mice, though ventricular intensity displayed no significant difference between groups. Although T2W ventricle intensity was similar in both control and UCCAO groups, this observation alone was insufficient to fully characterize potential changes. Therefore, further immunohistochemistry (IHC) was conducted to verify CP and ventricle wall activation. The analysis revealed higher vimentin fluorescence intensity in the cerebral ventricle, an ependymal cell marker, indicating increased ependymal cell activation. Moreover, UCCAO mice exhibited elevated fluorescence of sodium-potassium-chloride cotransporter 1 (NKCC1) and sodium bicarbonate cotransporter (NBCe2), both part of a family of transporters located on the basolateral membrane, suggesting increased fluid movement and anion channel expression along the CP’s apical membrane. This rise in ventricular volume was associated with CP stimulation and white matter degeneration, including neuroinflammation, myelin disruption, and BCSFB impairment, signaling changes in brain microstructural integrity. Concurrently, microglia and astrocyte activation in the bilateral corpus callosum suggested an inflammatory response involving glial cells in the ventricular environment, highlighting the interplay between structural changes and inflammatory processes contributing to white matter integrity loss. Upregulation of vimentin and GFAP in the ventricle further indicated reactive gliosis, a common response in ischemic stroke models, where astrocytes proliferate and extend processes into affected areas. These findings suggest that CP-driven fluid movement increases ventricular pressure, leading to BCSFB dysfunction and secondary white matter damage. UCCAO-induced cerebral hypoperfusion in older mice closely replicates ischemic white matter injury observed in patients, providing a valuable tool for investigating underlying mechanisms and potential therapeutic interventions for ischemic white matter pathology seen in human MRIs
Stress behavior-induced atopic dermatitis mimicking interdigital tinea pedis
No full textBackground: Psychodermatology is an interdisciplinary branch of psychosomatic medicine that addresses interactions between the psyche and skin. Stress is often a key exacerbating factor and highlights the bidirectional relationship between psychological factors and skin conditions. Atopic dermatitis (AD) is a chronic skin condition affecting both pediatric and adult populations with an estimated global prevalence of 2.6%, or approximately 204 million people. AD classically presents with a pruritic, red, and scaly rash. Here, we present a case of biopsy-proven AD likely induced by stress-associated behaviors related to patient-identified obsessive-compulsive habits. Case Presentation: A 61-year-old African American female presented for persistent itching and white discoloration in the interdigital spaces of both feet. She had seen multiple clinicians without improvement and failed multiple oral and topical antifungal trials. Dermatologic history was significant for chronic AD on the bilateral elbows and knees and managed with clobetasol 0.05% ointment. Self-reported allergies included over thirteen foods and medications. On physical exam, there were white scaly macerated plaques between the second through the fifth interdigital spaces of the right foot with similar lesions between the fourth and fifth digit of the left foot. Clinical examination was consistent with tinea pedis. Histopathology demonstrated epidermal hyperplasia with mild spongiosis, hyperkeratosis, and focal parakeratosis. A Periodic acid-Schiff stain was negative for hyphae. This was consistent with AD and secondary lichen simplex chronicus. After obtaining the biopsy results, further questioning revealed the patient had developed an abscess between her buttocks 8-years ago requiring drainage and hospitalization for methicillin-resistant staphylococcus aureus. She feared developing another infection and followed a strict hygiene regimen that involved bathing for 2-hours twice per day. Bathing habits involved close inspection of her skin while scrubbing with soap. The patient disclosed she had self-diagnosed herself with obsessive-compulsive disorder and stated her children agreed her behavior was extreme. Recommended behavior modification therapy included decreasing the frequency of scrubbing and to replace rubbing with a new habit of applying petroleum jelly. Hydrocortisone 2.5% cream was prescribed. On 6-week follow-up, the patient reported improved pruritus but continued bathing for 4-hours daily. Conclusions: Our case demonstrates an atypical presentation of AD complicated by psychiatric factors perpetuating dermatologic symptoms. In this case, skin biopsy provided a clue to diagnosis. Patient workup should include a thorough assessment of medical and social history, psychological state, and inquiry into living habitus and/or environment. While this patient’s presenting symptoms slowly improved, her disease process stems from underlying stress-associated habits and behaviors. An interdisciplinary care team may be optimal for the long-term management of psychocutaneous disorders to address dermatologic and psychiatric components of the disease with the goal of halting perpetuation of the disease cycle
Effect of Doxil-like Liposomes on Contact Angle of Albumin
No full textPurpose: Liposomes are nanovesicles constituted by a phospholipid bilayer surrounding an aqueous core that encapsulates hydrophilic and hydrophobic therapeutic agents, enhancing stability and bioavailability and allowing for controlled release in tissues. Since the initial FDA approval of the first liposomal formulation, Doxil, 30 years ago, numerous strategies have been explored to improve and tailor this formulation to specific targets and overcome the limitations of these nanocarriers. When liposomes interact with biological fluids, especially plasma, they are coated with plasma proteins, forming what is today called 'protein corona' that can affect their performance in several ways not yet fully understood. In this study, we propose a novel method to characterize the formation and role of the protein corona on the surface properties of liposomes using an innovative contact angle technique. The contact angle allows for obtaining information on the surface characteristics of films, such as wettability, surface tension, hydrophilicity, and interaction energy. Methods: Liposomes composed of Hydrogenated Soybean Phosphatidylcholine (HSPC), cholesterol, and polyethyleneglycol (PEG) (in various amounts) were prepared using the thin-film layer hydration method and sonication for particle size reduction. Contact angles of water, albumin, and liposomes-albumin solutions were measured on glass slides (reference surface) using an OCA-20 from Dataphysics. Results: Albumin when interacting with glass, after an initial hydrophilization of the surface (within the first 2 seconds of interaction), caused a consistent decrease in water contact angle in a concentration-dependent manner, reaching a plateau at concentrations above 5 mg/mL. Liposomes exhibited surface activity and reduced the water contact angle on glass. PEG-free liposomes displayed a higher contact angle, similar to the water contact angle. Increasing the PEG content caused a reduction in contact angle, with Doxil liposomes being the most surface-active.When liposomes were added to the albumin mixture, the reduction in contact angle was more pronounced than albumin alone. This effect was influenced by the PEG content in the liposome composition, highlighting PEG’s role in modulating interactions. Conclusions: The modified contact angle method presented here can be used to assess and quantify interactions between plasma proteins, surfaces, and drug delivery vehicles such as Doxil liposomes. Through this measurement, we can better understand the role that physicochemical properties of the liposomal formulation play in the formation of protein corona, and, our data provided insights into how liposome composition influences their performance and activity, particularly regarding surface-interface interactions. This method might serve as a preclinical tool to screen drug delivery systems and predict their efficacy by quantifying their protein interactions before getting into the target
Valid and Reliable Attitude Scales for Measuring Clinician's Attitudes Towards Telehealth Assisted Sexual Assault Forensic Exams Using a Pre-Post Survey
Full text linkThe success of telehealth programs to guide clinicians to perform sexual assault medical forensic examinations relies on clinicians' positive attitudes toward telehealth services, though no validated tools to measure these variables exist. This study aims to report validity and reliability of a novel tool with two scales: Positive Beliefs and Acceptance scales for hospital nurse clinicians at sites initiating the Texas Teleforensic Remote Assistance Center (Tex-TRAC). An analysis of pre-post cross-sectional data of hospital nurse clinicians (N = 121) trained in the use of Tex-TRAC telehealth technology at seven participating hospitals in Texas from July 2022 to May 2023 was performed. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy and Bartlett's test of Sphericity sample size analysis were performed. Exploratory Factor Analysis (EFA) was applied for validity and internal consistency reliability Cronbach alpha (alpha) values were described for two scales: Positive Beliefs and Acceptance scales. Positive Beliefs scale has a KMO value of 0.810 and Barlett's test of sphericity (chi(2) (6) = 380.47, P < .001). Acceptance scale has a KMO value of 0.832 and Barlett's test of sphericity (chi(2) (28) = 432.19, P < .001). After Promax Oblique rotation, the final four-item Positive Beliefs scale had alpha = .894; the final five-item Acceptance scale had alpha = .876. Validity and reliability of both scales demonstrated potential usefulness for future telehealth interventions engaging Sexual Assault Nurse Examiners. Continued use of these scales could provide additional information that can be leveraged in training curriculum of similar telehealth programs like Tex-TRAC.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Tex-TRAC was supported by grant number 2019-V3-GX-K019, awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. Tex-TRAC is also supported through an agreement with the Texas Attorney General's Office in response to Senate Bill 71, establishing a statewide telehealth center for sexual assault medical forensic examinations. The opinions, findings, and conclusions or recommendations expressed by the Tex-TRAC team are those of the contributors and do not necessarily represent the official position or policies of the U.S. Department of Justice or the Texas OAG
How Does Cognitive Impairment Affect Postural Sway?
No full textPurpose: Falls are a major cause of injury amongst Americans, specifically those over 65, and identifying those at risk is vital to prevent future incidents. Postural sway, measured via force plates is an indicator of fall risk. This sway data, when compared to medical history, is useful in evaluating how health impacts susceptibility to falls. This study seeks to evaluate how cognitive impairment, mild and severe, affects postural sway. Methods: Family Medicine and Geriatric patients performed two 30 second intervals of quiet standing on a Bertec force plate as an additional vital sign. Two conditions were performed on firm surfaces: with eyes open (EO) and with eyes closed (EC). Patients focused on a target for the EO portion and stood on the force plate for 30 seconds while data was collected. The patient then performed a 30 second eyes closed trial. We identified 366 subjects, older than 65 years, who underwent both postural sway measurements and cognitive assessment with either the Mini Mental State Exam (MMSE) or the Montreal Cognitive Assessment (MoCA). Of these 366 subjects, 258 were scored as cognitively healthy individuals (healthy) and served as the control group. 73 subjects scored as mild cognitive impairment (mild) and 35 scored as severe cognitive impairment (severe). Twenty postural sway metrics were compared between groups using 2-tail t-tests for both the EO and EC conditions. Significant values at both conditions, EO and EC, were noted at p < 0.05. Results: We found no significant differences in any postural sway measurements between the mild and healthy groups, in both the EO and EC conditions. Several measures differed between severe and healthy groups, these being standard deviation center of pressure AP, root mean square center of pressure AP, average radial distance, standard deviation radial distance, area of center of pressure and the area of center of gravity, all in the EC trials. There were three significantly different variables between the severe and mild groups, only in the EC trials. These were average radial distance, root mean square of radial distance, and area of the center of gravity. No significant differences were noted between groups in the EO trials. Conclusion: The significant difference in postural sway during the EC conditions between severe and healthy groups suggests that severe cognitive impairment may increase fall risk, and these subjects rely more heavily on vision to maintain balance. More research is necessary to confirm this finding. According to our study, mild cognitive impairment does not increase postural sway. We note several limitations of this study including sample size, specifically in the severe group and the lack of testing on an unstable surface (although this is likely unsafe for our sample population). Future testing should seek to evaluate how cognitive impairment influences fall risk alongside common comorbid conditions
Atypical Presentation of CD4+ Small/Medium T-cell Lymphoproliferative Disorder
No full textIntroduction: Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (PCSM-LPD) is a rare cutaneous disorder that until 2016, was classified as a primary cutaneous lymphoma. PCSM-LPD histopathologically consists of a localized proliferation of small to medium-sized T lymphocytes. Clinically there is minimal to no systemic involvement. It typically presents as an asymptomatic, solitary red-purple nodule, papule, or plaque on the face. PCSM-LPD has an indolent course and an excellent prognosis. It is important to recognize PCSM-LPD as a distinct entity from primary cutaneous lymphoma to avoid treatments with side effects. Case Presentation: A 68-year-old female with a history of insulin-dependent type 2 diabetes mellitus complicated by diabetic neuropathy, major depressive disorder, gastroesophageal reflux, and essential hypertension presented with a two-month history of progressively increasing, small, itchy bumps on the right cheek. On examination, there were scattered, non-tender, pink, non-scaly papules limited to her right cheek. A punch biopsy revealed a nodular infiltrate of small regular appearing CD4+/CD3+ lymphocytes with a T-cell receptor gamma gene arrangement, most consistent with PCSM-LPD. At follow-up, it was noted that her lesions had improved around the biopsy site. She was subsequently treated with intralesional triamcinolone injections and is currently pending follow-up. Learning Points: PCSM-LPD is a rare cutaneous disease with an undetermined malignant potential. Despite its uncertain malignant potential, PCSM-LPD typically follows a benign course with an excellent prognosis. PCSM-LPD most commonly presents as a solitary asymptomatic lesion. However, in some cases, multiple lesions may appear. In other instances, they can be pruritic. Due to its routinely benign course aggressive treatment or extensive diagnostic work-up is not recommended. PCSM-LPD is an indolent disease with no long-term risk of secondary lymphomas. For this reason, imaging modalities and bone marrow evaluations are low-yield. Conservative management including local treatment modalities and clinical observation can be used with a high degree of success and should be considered before invasive or systemic treatments
The Effect of Minority Status on the Mental Health of Adolescent and Young Adult Cancer Patients
Full text linkNurturing a Culture of Innovation in Health Science Education: Best Practices from the HSC Scholarship of Teaching and Learning Collective
Full text linkThis presentation shares key insights and lessons learned from the design, implementation, and evaluation of the HSC Scholarship of Teaching and Learning (SoTL) Collective, a peer-led professional development program at UNTHSC. Anchored in Communities of Practice (CoP) theory and evaluated using the Kirkpatrick Model, the initiative supports cross-disciplinary collaboration, innovation, and faculty agency in educational research. The presentation chronicles the program's development, from initial planning to campus-wide engagement and institutional alignment, while also presenting qualitative evidence of impact on professional identity, pedagogical leadership, and organizational culture. Through faculty narratives and strategic planning tools, this session demonstrates how a SoTL-focused CoP model can cultivate a sustainable ecosystem for health science education innovation