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Various Bone Disorders Affecting the Medically Underserved South Texas Region
Get PDFBone disorders can have a devastating impact on an individual’s quality of life. The main objective of our study was to analyze various demographic disparities between various bone disorders in the demographically unique Rio Grande Valley region. We hypothesized that osteoporosis would be the most prevalent condition and that the demographics between the various conditions would vary depending on age, sex, BMI, and ethnicity but not on marital status. This was a retrospective chart review using the University of Texas Rio Grande Valley UTHealth electronic database from January 1, 2017, to January 1, 2024. Any relevant individuals seen at a UTRGV affiliated institution were included. We analyzed medical charts, via ICD-10 codes, of individuals who were diagnosed with osteoporosis, osteomalacia, rickets, Paget bone disease, and osteonecrosis. Bivariate and binary logistic regression analyses were performed to analyze the data. Hispanic ethnicity showed a decreased risk of bone disorder (estimate = −0.2814), bordering on significance (p = 0.053). Female participants had significantly higher odds of bone disorder (estimate = 0.7861, p \u3c 0.001). Obese individuals (estimate = −0.7837, p \u3c 0.001) and overweight individuals had lower odds (estimate = −0.3328, p = 0.047) of bone disorder. Underweight individuals showed higher odds of bone disorder (estimate = 0.9605, p = 0.002). The odds of bone disorder increased with age (estimate = 0.0581, p \u3c 0.001). Our results increase the knowledge of orthopedics in this region, and specifically, the bone disorders are discussed. The results may also allow physicians to better identify at-risk individuals in this community and others alike to improve the management of bone disorders. This study warrants further research on at-risk demographics to further improve the orthopedic knowledge and care of medically underserved individuals
A Rare Culprit or an Elusive Culprit in Disguise? Unraveling Wild-Type ATTR Cardiac Amyloidosis in Heart Failure With Reduced Ejection Fraction
Get PDFCardiac amyloidosis (CA) is a rare disorder caused by the deposition of abnormal proteins called amyloid in the myocardium, leading to dysfunction. The 2 most common forms of amyloidosis are AL (light chain) and ATTR (transthyretin). Diagnosing amyloidosis is challenging, especially in its early stages, due to its nonspecific symptoms and overlap with other conditions. Recent studies suggest that the incidence of wild-type transthyretin amyloidosis is rising, likely due to improved diagnostic techniques and an aging population. We present the case of a 72-year-old male with lower extremity edema, progressive shortness of breath, and worsening renal function. He had a significant medical history, including hypertension, small lymphocytic lymphoma, coronary artery disease, diabetes, and chronic kidney disease. Physical examination revealed orthostatic hypotension and peripheral neuropathy. Imaging showed restrictive cardiomyopathy with reduced ejection fraction. Laboratory tests confirmed anemia and proteinuria, while a bone marrow biopsy ruled out AL amyloidosis. A Tc-99m pyrophosphate scan confirmed the diagnosis of ATTR CA. ATTR often presents with multi-organ involvement, complicating diagnosis. This patient’s coexisting conditions, including orthostatic hypotension and renal failure, may have been aggravated by amyloidosis. Misdiagnosis between AL and ATTR can lead to inappropriate treatments, making accurate diagnosis crucial. ATTR requires transthyretin stabilizers and symptom management, while AL needs chemotherapy. Treatment of amyloidosis must be individualized, as autonomic dysfunction, arrhythmias, and renal involvement require careful management. Early diagnosis and differentiation are essential for appropriate treatment and improved outcomes in patients with multi-organ involvement
Transcription factor YBX1 orchestrates drug resistance and tumor progression in HCC
No full textDrug resistance continues to be a significant challenge in cancer treatment, responsible for over 90% of worldwide cancer-related deaths. Transcription factors (TFs), which control vital cellular processes, also play a crucial role in cancer development and resistance. In hepatocellular carcinoma (HCC), resistance to sorafenib, a primary targeted therapy, significantly impairs treatment effectiveness and worsens patient outcomes. Among TFs, Y-box binding protein 1 (YBX1) has been recognized as a regulator of aggressive cancer traits in colorectal and breast cancers. However, its role in HCC and sorafenib resistance remains unclear. This review examines YBX1’s role in HCC progression and drug resistance, its underlying molecular mechanisms, and its potential as a biomarker and therapeutic target for overcoming sorafenib resistance
A Psychometric Investigation of the Distress Tolerance Scale Short Form (DTS-SF): Reliability, Validity, and Factor Structure in a Trauma-Exposed Sample
Get PDFPerceived emotional distress tolerance refers to one’s perceived capacity to tolerate negative emotional states, and this construct is commonly identified as a transdiagnostic development and maintenance factor of psychopathology. The Distress Tolerance Scale (DTS) is a commonly used self-report measure of emotional distress tolerance, and recently an abbreviated version, the Distress Tolerance Scale-Short Form (DTS-SF), was developed. The present study examined the psychometric properties of the DTS-SF in a large sample (N = 1099) of emerging adults. Our findings demonstrated that the DTS-SF had adequate internal reliability and was strongly associated with the DTS total score. Similarly, the DTS-SF had moderate negative associations with posttraumatic stress disorder (PTSD) and depression symptom severity, as well as negative affect. Using confirmatory factor analysis, it had good model fit. Multiple group measurement invariance testing supported metric invariance when comparing individuals with a history of trauma to individuals without a history of a potentially traumatic event. Further, the DTS-SF had metric invariance, but not scalar invariance, when examining gender differences. Results indicated the DTS-SF overall has acceptable psychometric properties and may be appropriate to use as an abbreviated measure of perceived emotional distress tolerance
Exposotypes in psychotic disorders
Get PDFPsychiatry lags in adopting etiological approaches to diagnosis, prognosis, and outcome prediction compared to the rest of medicine. Etiological factors such as childhood trauma (CHT), substance use (SU), and socioeconomic status (SES) significantly affect psychotic disorder symptoms. This study applied an agnostic clustering approach to identify exposome clusters “Exposotypes (ETs)” and examine their relationship with clinical, cognitive, and functional outcomes. Using data from individuals with psychotic disorders (n = 1,350), and controls (n = 623), we assessed the relationship between the exposotypes and outcomes. Four exposotypes were identified: ET1 characterized by high CHT and SU; ET2, high CHT; ET3, high SU; ET4, low exposure. Compared to ET4, ET1 demonstrated higher positive and general symptoms, anxiety, depression, impulsivity, and mania; ET2 had higher anxiety, depression, and impulsivity; ET3 had better cognitive and functional outcomes with lower negative symptoms. Intracranial volume was largest in ET3, and smallest in ET2. No group differences in schizophrenia polygenic risk scores were found. The age of onset was 5 years earlier in ET1 than in ET4. These findings provide insight into the complex etiological interplay between trauma, and SU, as well as their unique effects on clinical symptoms, cognition, neurobiology, genetic risk, and functioning
Research advances and conservation needs for the protection of the Salas y Gómez and Nazca ridges: A natural and cultural heritage hotspot in the southeastern Pacific ocean
No full textOne of the main objectives of the BBNJ Treaty is to enable States to establish large-scale marine protected areas (MPAs) to encompass at least 30 % of areas beyond national jurisdiction (ABNJ) by 2030, contributing to the Kunming-Montreal Global Biodiversity Framework. We reviewed geological, oceanographical, biological, ecological, cultural and governance information on the Salas y Gómez and Nazca ridges in the southeast Pacific (SEP), described current and future threats, reviewed conservation measures and analyzed what remains to be done to achieve their effective protection. We point the relevance of creating a MPA under the BBNJ treaty and the establishment of specific actions from key intergovernmental organizations to conserve the fragile and unique ecosystems of this region facing multiple threats. Among other measures we propose the closure of the area to fishing, the enactment of effective conservation measures, the rejection of exploratory fishing and the increase of research and capacity-building activities within the region. Protecting this area will have major global benefits for ecosystem connectivity, climate regulation, food security, and other ecosystem services. It would also be seen as a global example for conserving biodiversity in ABNJ by collaboration between neighboring countries with common interests in a shared environment, contributing to global conservation goals. The information gathered here is key to build the scientific basis for decision-making on sustainable use, management, and conservation of biodiversity inhabiting the islands and seamounts of the Salas y Gómez and Nazca ridges, a natural and cultural heritage hotspot in the middle of the SEP
Changes in household composition and their effects on the academic achievement of orphans and vulnerable children affected by HIV in rural Zambia
No full textThe African kinship system facilitates the movement of children and adults between households to mitigate hardship, yet few studies have documented membership changes in rural African households over time and addressed the effects of these household dynamics on the developmental outcomes of children. We used a household inventory instrument to document the number of changes in household membership experienced by 93 households in rural Zambia between two timepoints (∼2 years apart). We then used multilevel models to evaluate the effects of migration and household change on the academic learning of the children affected by HIV residing in these households, positing migration between households as a proxy for household connectivity and a potential protective factor for children. Our inventoried households experienced on average 4.12 changes in membership over the measured period. About half of these changes were due to children under 10 moving between relatives’ households. No effects of these migration-related variables were found on children’s academic progress at the family level. Household connectivity, as operationalized by the movement of individuals between households, may be typical to these children’s home life and were not shown to be detrimental to their academic learning
Health status: the pivot point in trusting smart health-care systems and providers for use
No full textPurpose – This research aims to investigate the interplay between individuals’ health status and their level of trust in both smart health-care systems and health-care providers and how these factors influence the decision to use such systems.
Design/methodology/approach – Drawing upon institution-based trust and affordance theories, the authors developed and empirically examined a research model using a sample from a prominent US university. Findings – The findings reveal that both types of trust, specifically trust in smart health-care systems and trust in health-care providers, positively influence the intention to use these systems. Additionally, the authors identified that health status plays a dual moderating role in this context. It positively moderates the relationship between trust in health-care system providers and the intention to use, suggesting that individuals with better health are more inclined to use smart health-care systems when trust in providers is high. Conversely, health status negatively moderates the relationship between trust in the system and the intention to use it. This implies that trust in the system exerts a more pronounced influence on the intention to use the system among individuals with lower health status. This heightened impact can be attributed to the increased necessity for the system’s benefits among this group.
Research limitations/implications – While the power analyses suggest our sample size is sufficient, caution is warranted when interpreting the study’s conclusions. These results have substantial implications for researchers and providers of smart health-care systems. They underscore the intricate dynamics between trust, health status and technology use, offering valuable insights for future investigations in this domain. Furthermore, they guide the design and implementation of smart health-care systems, emphasizing the need to consider the nuanced influence of health status on trust and use intentions.
Originality/value – Past research has focused on individuals’ trust in understanding the adoption of smart health-care systems; however, it did not consider how individuals’ health status can moderate their trust and intention to adopt such systems. In this study, the authors close this gap by investigating the moderating role of health status in the relationships between two types of trust and intention to use smart health-care systems through the lens of institution-based trust theory and affordance theor