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Hyperbaric Oxygen Therapy: a treatment to alleviate age-related impairments in motor and cognitive function
No full textBackground: Aging is a risk factor for a multitude of diseases, including neurodegenerative diseases such as Alzheimer’s Disease. Identifying an intervention that delays the aging process and improves common underlying mechanisms leading to disease development is an important public health endeavor. Hyperbaric oxygen therapy (HBOT), which involves breathing 100% oxygen in a pressurized chamber, has been shown to improve outcomes of stroke, AD, and other brain dysfunctions. HBOT has been shown to have positive effects for brain health, specifically by decreasing inflammation, enhancing angiogenesis by increasing the expression of HIF-1alpha, and increasing the number of circulating stem cells. In this way, this form of therapy can potentially heal and potentially reverse age-related damage to the brain. Hypothesis: We hypothesize that HBOT will result in significant motor and cognitive improvements in aged mice. Methods: Nineteen-month-old male and female C57BL/6 mice were randomly assigned to either a control group or an HBOT group. The HBOT group received 90 min of exposure at 2ATM, 5 days/week. Treatment continued through behavioral assessments, which started 1 month after initiation of the therapy. The mice then underwent tests to evaluate their motor and cognitive function. Results: HBOT improved balance, strength/reflexes, associative memory and cognitive flexibility of the aged mice. However, HBOT did not appear to affect spontaneous activity, learning/memory, or motor learning. Conclusion: HBO treatment led to domain-specific improvements in motor and cognitive function. Further work is needed to determine if sex affects the outcome of HBOT and what are the underlying mechanisms to the observed beneficial effects
Shifting the Paradigm of Night Shift Nurse Well-Being Through Innovative VR Exergame Microbreaks
No full textPurpose: Night-shift nurse well-being is a complex concern with systemic consequences that impact the health and safety of nurses, patients, and communities. The nursing practice environment is inherently demanding—physically, intellectually, and emotionally. These challenges are exacerbated during night shifts due to reduced staffing levels, fewer available resources, and less experienced personnel. Night shift nurses commonly report fatigue and sleepiness, which has been linked to work-related injuries, medication errors, missed cares, and drowsy driving related vehicle crashes. Psychological detachment and active microbreaks have been shown to mitigate the negative effects of work-related stress. The purpose of this literature review was to explore the potential of virtual reality (VR) exergame microbreaks as an innovative approach to enhance night shift nurse well-being by fostering psychological detachment and reducing cognitive fatigue. Methods: A literature review was conducted to evaluate the current state of evidence on VR exergame microbreaks. PubMed was searched using keywords including “nurses,” “night shift work,” “virtual reality,” “microbreak,” and “exergaming,” with additional sources identified through hand-searching reference lists of included articles. Articles published in English between 2019 and 2024 discussing the use of VR, exergaming, and active microbreaks to enhance well-being were included. Data extracted from the literature were analyzed to identify key factors influencing the practical implementation of VR, exergaming, and active microbreaks, with the aim of determining how these tools can be effectively integrated to improve night shift nurses’ well-being. Results: Immersive experiencing through VR accelerates psychological detachment by providing a sense of transportation away from the present physical workspace. Active microbreaks increase attention and enhance well-being. VR paired with exergaming combines physical and cognitive exercise in a fun, engaging way and mitigates the cognitive functioning deficits that are symptomatic of fatigue. Conclusion: Organizations are ethically obligated to provide a healthy, safe work environment that supports night shift nurse well-being. By creating policies that prioritize recovery through restorative work breaks, organizations can safeguard nurse and patient health and safety. Innovative strategies like VR exergame microbreaks are a feasible and highly effective tool for within shift recovery. Further research and pilot studies are needed to evaluate their effectiveness
Evidence for CSF-brain barrier heterogeneity in the lateral ventricle
No full textPoster Highlight: College of Biomedical and Translational Science, RAD 2025 Award Winning Posters & Oral PresentationsPurpose: The brain ventricular system comprises of four connected cavities through which cerebrospinal fluid (CSF) flows, allowing transmitter and nutrient delivery and waste clearance. The ventricles are lined by the CSF-brain barrier composed of an ependymal cell layer and a supporting layer of astrocytes. Historically, the CSF-brain barrier has been presented as homogeneous throughout the lateral ventricle; however, evidence suggests that the barrier is heterogeneous depending on whether the barrier lines white or grey brain matter. This study sought to determine if the ependymal and astrocyte layers varied between the walls of the lateral ventricle that border different brain matter. Methods: A four-month-old male Swiss Webster mouse was sacrificed and fixed in a 9% glyoxal/8% acetic acid solution for 24 hours. The brain was embedded in an optimal cutting temperature compound and stored at -80 °C. Brain sections were cut at a thickness of seven microns using a cryosectioning protocol and then stored in a cryoprotectant solution at -20 °C. Sections were stained with vimentin to visualize ependymal cells and GFAP to visualize astrocytes. Images were obtained using a confocal microscope and were analyzed using the Fiji ImageJ software. To examine statistical significance, ANOVA followed by Tukey's post-hoc test was used with the significance level set at p < 0.05. Results: The white matter CSF-brain barrier exhibited a multi-cell ependymal layer with cuboid ependymal cells, while the ependymal cells of the grey matter CSF-brain barrier were flatter. Vimentin-positive processes extended from the white matter barrier into the parenchyma, while no vimentin processes extended into the brain from the grey matter barrier. The ependymal cell layer bordering the white matter was significantly thicker than the cell layer bordering the grey matter. More GFAP-positive astrocytic processes were found in the white matter barrier than in the grey matter barrier. There was also the presence of vimentin/GFAP-double positive processes in the white matter barrier but not the grey matter barrier. Conclusions: These results indicate that the CSF-brain barrier is heterogeneous within the lateral ventricles. The ependymal cell layer of the white matter CSF-brain barrier is thicker than the cell layer of the grey matter CSF-brain barrier, which may contribute to differences in CSF-interstitial fluid exchange between white and grey matter. The extending vimentin-positive processes of the white matter barrier may contribute to a communicating property of ependymal cells that is varied within the lateral ventricle. Astrocytic processes within the barrier also differed, as the grey matter barrier exhibited fewer processes than the white matter barrier. These astrocytic differences may influence how different parts of the barrier respond to injury, as the astrocytes of the white matter barrier may provide extra support to the ependymal cell layer. These data establish that the barrier is heterogeneous, unlike previously thought, and warrants more investigation into the CSF-brain barrier's other cellular and molecular components that influence the underlying brain
Challenges in Public Health: The Diagnosis and Treatment of Crusted Scabies
No full textBackground: Common scabies is a parasitic dermatologic condition that often presents as an extremely pruritic rash. A rare and highly contagious variant of common scabies is crusted scabies, formerly known as Norwegian scabies. While infection with common scabies typically involves 10 to 20 mites, individuals with crusted scabies are burdened with thousands to millions of mites. Crusted scabies is characterized clinically by hyperkeratotic papules and plaques, most commonly on the palms and soles. Due to the variety of presentations seen in scabies, it can be difficult to diagnose. Case information: We present four cases of crusted scabies. An 89-year-old male with a history of dementia presented with a two-month history of a generalized pruritic rash. A 22-year-old male with a history of trisomy 21 presented with a 10-month history of mildly pruritic rash on the hands. A 54-year-old female with a history of trisomy 21 and cutaneous T-cell lymphoma presented with a three-week history of a generalized pruritic rash. Lastly, 5-year-old male with acute lymphoblastic leukemia with a minimally pruritic rash on hands and elbows that had spread to the genitals. The patients were diagnosed with skin scrapings or biopsy showing scabies mites. These patients were all treated with extended courses of oral and topical anti-parasitic medications. Conclusions: Crusted scabies poses a significant challenge to public health as a severe variant of scabies associated with high morbidity and mortality. It is most commonly seen in persons who are immunosuppressed, have an underlying neurologic disorder, or are immobile. Patients may present with skin eruption and pruritus. Patients can also present with severe illness such as erythroderma, which poses a risk for hypothermia and heart failure, acute respiratory distress syndrome, sepsis, and high-output heart failure. Scabies-related mortality in crusted scabies is high. Management of crusted scabies is different than for other types of scabies because the patient is infested with large numbers of mites. Patients may also have an altered immune response. Treatment of crusted scabies requires a combination of oral and topical treatments. Lastly, the large number of mites in crusted scabies requires more rigorous evaluation and treatment of contacts than other types of scabies. This is necessary to prevent or limit scabies outbreaks and re-infection. As many patients with crusted scabies live in congregate facilities, this requires prompt evaluation of contacts with treatment of cases and public health treatment of asymptomatic residents, staff, and visitors
Interpretable machine learning models for prolonged Emergency Department wait time prediction
Full text linkOBJECTIVE: Prolonged Emergency Department (ED) wait times lead to diminished healthcare quality. Utilizing machine learning (ML) to predict patient wait times could aid in ED operational management. Our aim is to perform a comprehensive analysis of ML models for ED wait time prediction, identify key feature importance and associations with prolonged wait times, and interpret prediction model clinical relevance among ED patients. METHODS: This is a single-centered retrospective study. We included ED patients assigned an Emergency Severity Index (ESI) level of 3 at triage. Patient wait times were categorized as <30 minutes and >/=30 minutes (prolonged wait time). We employed five ML algorithms - cross-validation logistic regression (CVLR), random forest (RF), extreme gradient boosting (XGBoost), artificial neural network (ANN), and support vector machine (SVM) - for predicting patient prolonged wait times. Performance assessment utilized accuracy, recall, precision, F1 score, false positive rate (FPR), and false negative rate (FNR). Furthermore, using XGBoost as an example, model key features and partial dependency plots (PDP) of these key features were illustrated. Shapley additive explanations (SHAP) were employed to interpret model outputs. Additionally, a top key feature interaction analysis was conducted. RESULTS: Among total 177,665 patients, nearly half of them (48.20%, 85,632) experienced prolonged ED wait times. Though all five ML models exhibited similar performance, minimizing FNR is associated with the most clinical relevance for wait time predictions. The top features influencing patient wait times and gaining the top ranked interactions were ED crowding condition and patient mode of arrival. CONCLUSIONS: Nearly half of the patients experienced prolonged wait times in the ED. ML models demonstrated acceptable performance, particularly in minimizing FNR when predicting ED wait times. The prediction of prolonged wait times was influenced by multiple interacting factors. Proper application of ML models to clinical practice requires interpreting their predictions of prolonged wait times in the context of clinical significance.The project described was supported by the National Institute on Minority Health and Health Disparities through the Texas Center for Health Disparities (NIMHD) 5S21MD012472-05 (Usha Sambamoorthi), and the National Institute of Health/Artificial Intelligence/Machine Learning Consortium to Advance Health Equity and Researcher Diversity Grant # 1OT2OD032581-01 (Usha Sambamoorthi). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH
Identifying lung cancer in Emergency Department patients outside national lung cancer screening guidelines
Full text linkBACKGROUND: Lung cancer has become the second most common cancer and the leading cause of cancer death in the United States. We aim to determine factors associated with newly diagnosed lung cancer at the Emergency Department (ED) and identify specific patient populations eligible for lung cancer diagnostic screening. METHODS: This is a single-center retrospective observational study. We included all patients aged between 50 and 80 years old, who presented to the ED seeking healthcare between January 1, 2019, and December 31, 2023. Patients' socio-demographics, clinical information, and whether they were eligible for lung cancer screening determined by the United States Preventive Services Task Force (USPSTF) guideline were analyzed and compared between patients who had newly diagnosed lung cancer at ED and those without. Factors associated with newly diagnosed lung cancer patients were determined by multivariable logistic regressions with inverse probability weighting (IPW) to account for observed selection bias of lung cancer screening eligibility. RESULTS: Out of 75,516 patients in this study, 18,641 (25%) patients had documented smoking histories. Among these, only 8,051 (10.66%) were eligible for lung cancer screening, while 18,348 patients received lung computer tomography (CT). Among all patients whose CTs were performed, 123 individuals were identified as having been newly diagnosed with lung cancer. Multivariable logistic regressions showed that the adjusted odds ratio (AOR) for eligible lung cancer diagnostic screening was 3.07 [95% confidence interval (CI): 2.08-4.53, P<0.001] without IPW and 3.49 (95% CI: 2.24-5.42, P<0.001) with IPW. Other factors associated with newly diagnosed lung cancer in ED were older age, female, and patients who spoke neither English nor Spanish. CONCLUSIONS: To optimize the identification of suitable patients for lung cancer diagnostic screening in the ED, it may be beneficial to modify the eligibility criteria beyond those currently outlined by the USPSTF guidelines. Integrating additional factors such as advanced age, female sex, and a preference for non-English languages could improve the screening's effectiveness by capturing at-risk populations that might otherwise be overlooked.None
Evaluation of Mithramycin in Combination with Chemotherapeutic Agents Against Ewing Sarcoma Cell Lines
Full text linkEwing Sarcoma (ES) is a rare, malignant bone neoplasm that is primarily diagnosed in childhood and adolescence. The aggressive nature of this neoplasm requires the use of surgery, radiation and a rigorous chemotherapy regimen. Metastatic ES carries a poor prognosis, which necessitates the development of new therapeutic agents. Mithramycin was tested in targeted therapy due to its specific inhibitory effects on the EWS-FLI1 fusion protein which is present in >85% of ES tumors. We tested the combination of Mithramycin with chemotherapeutic agents vincristine (VCR) and Etoposide (Eto) for inducing higher cytotoxicity against ES cells, CHLA10 and TC205. Cardiomyocyte cell line, H9C2 was used to test the effect on non-malignant cells. Cell viability was measured using the CellTiter-Glo kit, and the combination index was evaluated to determine the type of combination response (antagonistic, additive, or synergistic). Apoptotic cells were measured post-treatment with vehicle (DMSO, control), monotherapy (mithramycin or etoposide), or combination therapy (mithramycin + etoposide) using BD LSRII flow cytometer and analyzed utilizing FlowJo software V8.0. The apoptotic protein marker c-PARP in both treatment and control groups was analyzed using Western blot analysis. The results showed higher cytotoxicity for combination treatment when compared to individual agents, and the combination index confirmed the response as synergistic. H9C2 cells did not demonstrate significant decreases in cell viability when treated with combination therapy, highlighting the specificity of the treatment toward its target tissue. Flow cytometry confirmed the underlying mechanism as upregulation of apoptosis which is further supported by an increase in effector caspases 3/7 and elevated expression of c-PARP. These in vitro assays using ES cells provide preliminary evidence for the benefit of chemotherapy and mithramycin combination.This work was partially supported by Cancer Prevention and Research Institute of Texas (award# 210046) and NIH (S21MD012472, U54MD006882)
Genome-Wide Selection Scans in Mexican Indigenous Populations Reveal Recent Signatures of Pathogen and Diet Adaptation
Full text linkWhole-genome scans for natural selection signatures across Mexican indigenous populations remain underrepresented in the literature. Here, we conducted the first comparative analysis of genetic adaptation in Mexican indigenous populations using whole-genome sequencing data from 76 individuals representing 27 different ethnic groups in Mexico. We divided the cohort into northern, central, and southern populations and identified signals of natural selection within and across populations. We find evidence of adaptation to pathogenic environments in all our populations, including significant signatures in the Duffy blood group gene in central Mexican indigenous populations. Despite each region exhibiting unique local adaptation profiles, selection signatures on ARHGAP15, VGLL4, LINGO2, SYNDIG1, and TFAP2B were common to all populations. Our results also suggest that selection signatures falling within enhancers or promoters are usually connected to noncoding features, with notable exceptions like ARHGAP15 and GTDC1. This paper provides new evidence on the selection landscape of Mexican indigenous populations and lays the foundation for additional work on Mexican phenotypic characterization
Educational Escape Room Reinforcement of Infection Prevention in Third-Year Student Pharmacists
Full text linkBACKGROUND: Infection prevention and control (IPC) competencies are essential to safe patient care across practice settings. This cross-sectional survey study aimed to describe the ability of an escape room to reinforce IPC concepts and knowledge retention rates for third-year student pharmacists. METHODS: An IPC-themed escape room using a mixture of online and physical puzzles was incorporated into a third-year student pharmacist course. Students in the course took knowledge assessment and perception surveys before the escape room (T1), after the escape room (T2), and for retention at the end of the semester (T3). RESULTS: Statistically significant (p < 0.05) increases in knowledge occurred on four out of five of the knowledge assessment questions between the pre- and post-assessments (T1, T2) as well as between the pre- and retention assessments (T1, T3). Student confidence in their ability to provide patient care compliant with IPC practices also demonstrated statistically significant improvement between pre, post, and retention assessments (T1, T2, T3). CONCLUSIONS: An IPC escape room is an effective tool to reinforce IPC concepts and increases student pharmacist knowledge and confidence in patient safety practices. Future study iterations should evaluate the role of an IPC IPE event for utility across multiple health professions curricula.This research received no external funding
Altered Expression of NK Receptors in Racially/Ethnically Diverse and Risk-of-Relapse Pediatric Acute Lymphoblastic Leukemia Patients
Full text linkBackground/Objectives: Acute Lymphoblastic Leukemia (ALL) is a cancer that predominantly affects white blood cells within the blood and bone marrow of adults and children. Currently, ALL is one of the most prevalent malignancies in pediatric patients and is most seen among Caucasian and Hispanic descent, with lower incidence in African American children. The goal of the study was to investigate the expression of immune cell receptors in racial/ethnic populations and risk factors for relapse that could potentially influence the pediatric ALL outcomes. Methods: Twenty healthy subjects and forty-two pediatric ALL subjects were enrolled in the study and whole-blood was collected at diagnosis and post-chemotherapy, and the cell surface expression of various immune receptors, including 2B4, CS1, LLT1, Nkp30, and NKp46, was determined by flow cytometry. Results: Very high-risk and high-risk of relapse ALL subjects showed increased expression of LLT1 on NK cells, T cells, and monocytes at diagnosis compared to healthy subjects. CS1 was also significantly overexpressed on monocytes of very-high risk ALL subjects both at diagnosis and after the end of chemotherapy as compared to healthy subjects. Also, there was a significantly increased expression of NKp30 on T cells of Caucasians as compared to Hispanics and African Americans at diagnosis, and downregulation of CS1 and LLT1 on T cells of Caucasians post-induction chemotherapy. Conclusions: The altered expression of immune receptors in racial/ethnic and risk stratified groups may provide insights into the immune surveillance mediated by T cells and NK cells against pediatric ALL.This work was supported by the Cancer Foundation of North Texas (CRFNT) (97313), Leukemia Texas Inc. (77313b), Institute for Cancer Research, UNTHSC (RI6062), and Team Connor Childhood Cancer Foundation (77313c)