University of North Texas
UNTHSC Scholar (University. of North Texas Health Science Center)Not a member yet
6724 research outputs found
Sort by
An atypical variation of the Deltoid Muscle- A Case Report
No full textThis case report describes an atypical deltoid variant discovered during cadaveric dissection of a middle-aged male donor. The bilateral spinal segments of the deltoid muscle (DM) were found to be encased in a distinctive fascial compartment, disconjugate from the normal morphology. The spinal segments were found to be innervated by a branch of the axillary nerve and perfused by a branch of the posterior circumflex humeral artery. Divergences from expected anatomy are important clinically in respect to surgical interventions, as correctly identifying in situ anatomy is essential for the accurate diagnosis and treatment of shoulder pathologies. Unexpected anatomical variations can cause unanticipated surgical delays, and the misidentification of in situ anatomy can be a cause for iatrogenic injury –both of which can increase the probability of unfavorable outcomes in the care of the surgical patient
Identification of ecological, locomotor, and morphological indicators of semi-terrestriality in anthropoid primates.
No full textSemi-terrestriality , the utilization of both arboreal and terrestrial environments, is commonly discussed in the primatological literature but inconsistently defined, limiting its study in fossil taxa. This project aims to fill that gap by investigating the ecological, morphological and locomotor variables that characterize semi-terrestrial taxa.
18 semi-terrestrial and 17 arboreal anthropoid taxa were identified from the literature. Ecological data were collected from mammalian demographic and environmental databases; postcranial measurements and behavioral data were collected from the literature. Three stepwise canonical variate analyses (CVA) were run (ecological, locomotor, and morphological) to identify factors that discriminate between semi-terrestrial and arboreal primates.
The ecological CVA retained population size, social group size, and percentage of leaves in the diet as variables. CV1 (55.8%) differentiated semi-terrestrial platyrrhines from arboreal and semi-terrestrial catarrhines. CV2 (26.9%) distinguished semi-terrestrial platyrrhines and catarrhines cluster away from their arboreal counterparts. The behavioral CVA retained bridging, leaping, quadrupedal walking, climbing, scrambling/clambering and bimanual suspension as variables. CV1 (62.3%) separated semi-terrestrial platyrrhines from semi-terrestrial catarrhines, while CV2 (31.5%) distinguished both semi-terrestrial taxa from arboreal taxa. The morphological CVA did not retain any size-corrected variables, with no iteration of relative long bone lengths differentiating between any of the groups.
These results indicate select ecological and locomotor variables can reliably identify semi-terrestrial taxa, helping to improve our understanding of this enigmatic behavior. Future studies should likely include measures of specific bony features to more fully investigate potential morphological indicators of semi-terrestrial behaviors
Assessing Cognitive Function: The Role of the Memory Alteration Test in Predicting Stroop Color-Word Performance within the Self-Management Program for Brain Health
No full textPurpose: The Self-Management Program for Brain Health is designed to empower participants to make lifestyle changes that enhance cognitive function and potentially delay dementia onset. This study investigates the predictive relationship between the Memory Alteration test and Stroop Color-Word (Stroop CW) performance in these participants, aiming to contribute valuable insights to the complex interplay between memory and executive processing abilities. Methods: Cognitively healthy adults (n = 21, age range 56–90) participated in the study, meeting inclusion criteria and undergoing vital sign assessment, Memory Alteration, and Stroop CW tests. The Memory Alteration test, a reliable screening tool, employed a cut-off of < 40 for cognitive impairment. Stroop CW raw scores were age-corrected, and T-scores were obtained. Statistical analyses included correlation coefficient (r) and p-value calculations. Results: A statistically significant positive correlation (r = 0.55, p = 0.009) between Memory Alteration and Stroop CW scores was observed. Subgroup analysis confirmed the hypothesis, revealing a consistent correlation pattern for those scoring below (mean Memory Alteration 37.86±0.55, Stroop CW 48.43±2.32, r = 0.88, p = 0.009) and above (mean Memory Alteration 44.93±0.85, Stroop CW 50.79±1.89, r = 0.67, p = 0.009) the normal Memory Alteration cut-off of 40. Conclusions: The study supports the predictive ability of the Memory Alteration test on Stroop CW performance in cognitively healthy adults. It underscores the clinical relevance of the Memory Alteration test as a reliable screening tool for early cognitive impairment and processing speed changes. Clinicians are encouraged to become familiar with the Memory Alteration test, considering its inclusion as an additional cognitive screening tool. By adding this brief and non-invasive assessment into routine practice, healthcare professionals can enhance their ability to identify subtle cognitive changes early on, facilitating proactive interventions and contributing to improved patient outcomes. Limitations include sample size and variability, suggesting the need for larger, more diverse samples in future research. The ongoing Self-Management Program for Brain Health presents an opportunity to address these limitations and advance our understanding of cognitive assessment and brain health.JES Edwards Foundatio
The Association of Subjective Cognitive Decline and Demographic, Social, Clinical, and Neuropsychological Factors in the HABS-HD Cohort
No full textBackground: The number of people with Alzheimer’s Disease and Related Dementias (ADRD) is projected to double by 2060 with the greatest increases in Hispanics. Mexican Americans experience an earlier onset of Alzheimer’s disease, but research shows that the illness is diagnosed much later in their lives. Sociodemographic projections predict a larger percentage of Hispanics with subjective cognitive decline (SCD) in the future. SCD is related to cognitive decline and dementia risk. This study will explore how SCD is associated with sociodemographic and clinical factors along with cognitive performance amongst Mexican Americans (MA) and non-Hispanic white (NHW) participants of the Health and Aging Brain – Health Disparities Study (HABS -HD). Methods: The HABS-HD is a longitudinal study led by the Institute for Translational Research at the University of North Texas Health Science Center. A cross-sectional analysis of data from (n=1342) cognitively normal participants aged 30 years and older was performed. The cohort (662 NHW and 690 MA) underwent a clinical interview to collect information on depression, anxiety, and co-morbidities, neurocognitive and functional examinations, brain MRI, amyloid and tau PET scans, and blood collection for biomarker review. Worry and perceived social support were evaluated using the Penn State Worry Questionnaire (PSWQ) while subjective cognitive decline was assessed using the Subjective Memory Complaints Questionnaire. Neighborhood socioeconomic status (NSES) was measured using the national area deprivation index (ADI) percentile ranking composed of education, employment, income, occupation, and housing. Global cognition was graded using the Mini-Mental State Examination (MMSE) and memory was assessed using the logical memory 1 and 2 tests. Statistical analysis was based on binary logistic regression using SCD as the dependent variable and was stratified by ethnicity with sex, age, education, and BMI as co-variants. Results: SCD was present in 49% of the sample.MA were younger, less educated, more likely to live in the most deprived neighborhoods, and had less social support (p≤0.005) In addition, they were more likely to be depressed and diabetic along with having a higher Body Mass Index (BMI) and experiencing more SCD than NHW (p≤0.005). MMSE scores were lower in in MA (p≤0.005). When looking at the logistic regression, model 1 confirmed associations of SCD with age and GDS scores in NHW, and MA. After adjustment for cognitive scores, only GDS remained significant in both races. MA living in the most deprived neighborhoods had 2.45 more chance to present SCD than those living in the least deprived neighborhoods (95% CI 1.15 to 5.19). There was no difference in NHW. Conclusion: Our study showed that individuals with a higher degree of SCD were more likely to live in high ADI neighborhoods. The idea of SCD as a proxy for objective memory impairment and AD faces many barriers in minorities. However, while chronic stress and depression burden vulnerable communities, it is possible that SCD may serve as an indicator for future cognitive impairment and prompt the establishment of strategies to address these issues in neighborhoods influenced by inequitable circumstances
31st Annual Research Appreciation Day Abstract Book
No full textAbstracts submitted for the thirty-first annual Research Appreciation Day. RAD 2024 was the fourth all-virtual RAD. In total, 242 abstracts were submitted
Quality Improvement Study: Adenosine Administration in Pediatric Patients with SVT
No full textResearch Appreciation Day Award Winner - Texas College of Osteopathic Medicine, HSC Health, 2024 Health Care Delivery AwardBackground: Supraventricular Tachycardia (SVT) is the most prevalent pediatric tachyarrhythmia requiring treatment, with an incidence rate of 1/100 to 1/250 children. Adenosine is the first-line diagnostic and therapeutic intervention for SVT, but its efficacy in pediatric patients varies. The conventional method of administering adenosine involves a 3-way stopcock. Study conducted by Weberding et.al concluded that the adenosine administration with a stopcock delivers less than intended adenosine particularly for patients that are less than 10kg. This quality improvement study aimed to rigorously assess the dose requirements for successful conversion during SVT in distinct pediatric weight groups (0-10kg, 10-20kg, >20kg). We hypothesized that children in the 0-10kg group would exhibit increased dosage needs due to potential medication loss in the 3-way stopcock.
Methods: Retrospective data were collected through chart review from Cook Children’s Emergency Department spanning 01/01/2018 to12/07/2023. The study encompassed 85 patients, stratified into three weight groups (0-10kg, 10-20kg, >20kg) with 21, 20, and 40 patients, respectively. Inclusion criteria comprised pediatric patients in SVT who received adenosine with or without symptom resolution. Exclusion criteria were patients receiving additional cardiac medications, cardioversion for SVT treatment, or those later found not to be in SVT initially.
Results: The results revealed that there was no association with group and number of doses needed to convert, x2=2.64, p=0.27. Although not significant, the 0-10 group had a higher proportion of patients needing more than 1 dose to convert (18% more than 10-20kg group and 20% more than 20 plus group). Despite statistical non-significance, 72% of patients in the >20 kg group required only a single dose for successful conversion, compared to 52% in the 0-10 kg and 70% in the 10-20 kg groups. These outcomes contradict our hypothesis; however, the limited sample size, especially in the 0-10 kg and 10-20 kg populations, may contribute to this non-significance.
Conclusion: Assumption tests revealed no violations for chi-square test. These findings imply that weight group may not exert a significant influence on the required adenosine doses for successful cardioversion in pediatric SVT cases. However, the 0-10 kg group had the highest percentage of patients requiring 2 or more doses. Thus, future studies should prioritize larger sample sizes to bolster statistical power, ensuring more definitive contributions to clinical practice. This study, sponsored by Cook Children’s Medical Center and UNT Health Science Center, was IRB exempt
Specificity Protein 1 Expression and Cancer Patients Survival: Impact on Breast Cancer Patients Focusing on Race, Cancer Subclass, and Menopause
No full textPurpose: Transcription factors Specificity protein (Sp) 1 and 3 are known to regulate Baculoviral IAP Repeat-Containing 5 (BIRC5), an inhibitor of apoptosis protein, which is involved with poor prognosis and drug resistance in cancer therapy. The objective of this study is to determine the association of Sp1 expression with the prognosis of breast cancer patients using data from The Cancer Genome Atlas (TCGA) and determine the patient survival in relation to race, cancer subclass and menopause. Methods: Using TCGA data, Sp1 levels were monitored in tumor (n=1032) versus normal (non-tumor) breast tissue (n=114). Patient survival data was used to generate Kaplan Meier plots. Sp1 expression in non-tumor and tumor tissues and the association of Sp1 levels with the survival of patients with an emphasis on race, cancer subclass, menopause status and other factors were evaluated. Results: The analysis of TCGA data sets identified several cancers showing poor prognosis associated with higher expression of Sp transcription factors and BIRC5. The top cancers showing such association include adrenocortical carcinoma, brain lower grade glioma, chromophobe renal cell carcinoma, clear cell renal cell carcinoma, papillary renal cell carcinoma, hepatocellular carcinoma, pancreatic adenocarcinoma, rectal adenocarcinoma, sarcoma, and uterine corpus endometrial carcinoma. Breast cancer data showed poor survival rates with high expression of Sp1 and HER 2+ cancer type (p=0.0034). The expression of Sp1 showed significant variability amongst the Caucasian population in BRCA patient survival (p=0.046). While Sp1 expression is associated with poor survival rates in pre-, peri- and postmenopausal patients (p=0.02), the outcomes are worst among postmenopausal patients. Conclusions: The analysis of TCGA data sets showed a poor prognosis of cancer patients with high levels of Sp1, Sp3 and BIRC5. Overall survival is decreased with higher expression of these markers in multiple cancers including breast cancer. Furthermore, our findings suggest potential variations in prognosis based on factors such as race, cancer subclass, and menopausal status amongst breast cancer patients. Further research is needed to confirm the specific role of Sp transcription factors and BIRC5 in cancer patients’ survival focusing on critical variables such as age, sex, race and tumor stage
Post-traumatic Range of Motion Loss in a Professional Pianist: A Multimodal Approach
No full textBackground:
Pathological scarring is a fibroproliferative condition that occurs after abnormal tissue repair following a lesion or infection. Treatment is typically seen in post-operative or burn patients with common scarring distributions along the face, shoulders, and trunk. However, in the case of accidental, superficial injury to the hands of a musician, there exists a unique opportunity for treatment of post-traumatic scarring. For a professional musician, music is not just a career but a profound and inseparable part of their identity that is significantly threatened by what may appear as minor scarring. Pathogenesis of scarring is unclear and complex, involving disordered angiogenesis, inflammation, and tissue deposition. For this broad pathology, there are many therapy options based in pharmacology, pressure, immobilization, photoelectricity, radiation, cryotherapy, and surgical techniques. Of these, corticosteroid injections are frequently attempted because they are not only anti-inflammatory, but also repress transcription and fibroblastic factors while promoting extracellular matrix remodeling. These properties can directly improve scar volume and elasticity. Given the extensive array of treatment options and targets, adopting a multifaceted therapy approach is vital.
Case Presentation:
A 35 year old male musician with a past medical history of cervical stenosis at C3-C6 presented with a primary concern of decreased dexterity in his right hand, secondary to direct trauma sustained in a motor vehicle accident six months prior. He also experienced dull, burning pain across his right hand that was worse in the thenar area and exacerbated by use. As a musician he practiced up to 8 hours daily and thousands of hours yearly. He saw multiple physicians and surgeons who primarily focused on pain. He had been splinted since his injury, failed trials of high dose duloxetine and anti-inflammatories, received minimal therapy and received CMC and PIP corticosteroid injections, without relief. His ROM was functionally limited on exam, with 1-2 centimeters of difference upon right thumb opposition, flexion and extension as compared to his left. His neurologic exam was unremarkable. Ultrasound showed a slightly thickened edge of his palmar aponeurosis and 2.5 mg of Kenalog was injected into this fascial plane. Additional treatments included retraining of central pain sensitization, nitroglycerin patches, anti-inflammatory and methyl-based topicals, kinesiotaping, electroacupuncture, Feldenkrais education, and arranging regular occupational therapy, soft tissue manipulation, and psychosocial counseling. This comprehensive rehabilitation approach helped the patient regain hand dexterity and ROM that was lost secondary to prolonged immobilization and scarring, ultimately facilitating his goal of returning to his prior level of playing.
Conclusion:
A multimodal treatment strategy and the use of corticosteroid injection in an atypical setting was significant to this case. Treatment of pathological scarring that occurs outside an operative or burn setting is less commonly seen or needed. The indication for this treatment strategy was decided with recognition that a centimeters level of change in ROM carried substantial meaning for this professional musician. His life was his art. As such, our approach acknowledged the profound physical and psychological impacts of his scarring and the value of comprehensive treatment and rehabilitation throughout this unique encounter
Unraveling the Molecular Nexus: Obstructive Sleep Apnea and Glaucoma in a Rat Model
No full textResearch Appreciation Day Winner - HSC College of Pharmacy, 2024 Pharmaceutical Science Research Award - 3rd PlacePurpose: Obstructive sleep apnea is a chronic sleep disorder characterized by recurring complete or partial upper airway occlusion. Over the past decade, meta-analyses have established a correlation between this disorder and glaucoma, an ocular neurodegenerative disease, and a leading cause of blindness. However, the link between these pathologies remains elusive. Understanding the mechanisms involved could influence treatment options and reduce the rate of vision loss associated with glaucoma. Using a rat model of sleep apnea, chronic intermittent hypoxia (CIH), we tested the hypothesis that mild sleep apnea initiates morphologic and metabolic changes in the retina that resemble glaucoma.
Methods: Rats were randomly assigned to normoxic or CIH groups. The CIH group was exposed to periodic hypoxia during their sleep phase, simulating mild sleep apnea, with oxygen reduction from 21% to 10% and reoxygenation in 6-minute cycles over 8 hours/day for 14 days. The normoxic group experienced similar conditions without changes in oxygen concentration. Subsequently, the eyes were enucleated, and the retina was evaluated for oxidative stress, inflammatory markers, metabolic changes, and hypoxic response modulation using immunohistochemistry and capillary electrophoresis.
Results: Immunofluorescence revealed increased expression of 8-OHdG, indicating oxidative stress (nucleic acid damage), as well as the cytokine TNF-α in the CIH group retina compared to controls. No statistically significant differences were observed in HIF-1α protein levels. SIRTUIN-1, a regulator of HIF-1α expression, and the levels of pyruvate dehydrogenase kinase-1 and lactate dehydrogenase-A showed no significant differences between normoxic and CIH groups.
Conclusion: The increased oxidative stress and inflammation observed suggest that CIH induces a response in the retina with features shared by early-stage glaucoma. However, the anticipated upregulation of HIF-1α and its targets did not occur, suggesting a greater reduction in oxygen concentration or a longer-term CIH interval may be necessary to observe canonical hypoxic response.
Keywords: glaucoma, sleep apnea, chronic intermittent hypoxia, inflammation, oxidative stres
FABM Training in Medical Education: Student’s Perceived Functionality of an FABM Elective
No full textBackground: Fertility Awareness Based Methods (FABMs) are methods used to track fertility by external signs with various biomarkers, such as cervical mucus, basal body temperature, and more. FABMs can be used by a couple to achieve or avoid pregnancy. FABMs have particularly been increasing in demand in recent years, as evidenced by various smartphone applications rising on the market, one of which even being FDA approved in 2018. Despite this increase in demand, medical education has notoriously not included FABMs in their curricula, due to the misconception that they are ineffective when compared to artificial birth control.
Purpose: The objective of this study was to determine which factors determine the functionality of an FABM elective with the goal of integrating the training into medical school curricula.
Methods: The optional online elective, FABMs for Family Planning and Women’s Health, was delivered from August 2020 to May 2023. Students completed pre- and post-knowledge surveys. A non-saturated binomial logistic regression was performed to determine which factors influence the students’ perceived functionality of FABMs.
Results: A total of 67% of students who completed the pre- and post-surveys reported receiving FABM education in their professional program, while 33% reported receiving no education on FABMs (n=452). Additionally, 33.4% of participants received FABM training in some form outside of their professional program, while 66.6% of participants did not. The criteria of a “functional” FABM program were defined by the student responding that they would recommend the FABM elective and that they will seek further FABM training after completing the current FABM elective. A non-saturated binomial logistic regression was performed to ascertain the effects of 9 independent variables and the likelihood that the student acknowledged the FABM elective as being functional. The logistic regression model was statistically significant [χ2(2) = 35.789, p < 0.001], and it explained 15.1% (Nagelkerke R2) of the variance in program functionality while classifying 71% of the cases correctly. The sensitivity of the model was 98% and the specificity was 7.1%. Of the 9 independent variables, two of them were statistically significant predictors of program functionality: receiving FABM training outside of medical school and the student’s specialty interest. Students who received FABM training outside of medical school had 3.90 times higher odds to perceive the FABM elective as functional compared to those students who had not received FABM training outside of medical school. Within this, students interested in family medicine or OB/GYN had an increased likelihood of perceiving the functionality of FABMs electives by a factor of 1.22 compared to students interested in psychiatry or those who were undecided.
Conclusion: It is important for medical school curricula to include FABMs training/electives because exposure can determine the receptiveness and perceived functionality of practicing with FABMs. Implementation of FABMs in medical school curriculum is critical to increase perceived practicality, particularly in students interested in fields pertaining to women’s health. It is necessary to increase awareness of family planning and infertility treatment options for women seeking alternatives to current standards of care