TCU Digital Repository (Texas Christian Univ.)
Not a member yet
54550 research outputs found
Sort by
Combination and Optimal Sequencing of Systemic and Locoregional Therapies in Hepatocellular Carcinoma: Proceedings from the Society of Interventional Radiology Foundation Research Consensus Panel
No full textHepatocellular carcinoma, historically, has had a poor prognosis with very few systemic options. Furthermore, most patients at diagnosis are not surgical candidates. Therefore, locoregional therapy (LRT) has been widely used, with strong data supporting its use. Over the last 15 years, there has been progress in the available systemic agents. This has led to the updated Barcelona Clinic Liver Cancer (BCLC) algorithm's inclusion of these new systemic agents, with advocacy of earlier usage in those who progress on LRT or have tumor characteristics that make them less likely to benefit from LRT. However, neither the adjunct of LRT nor the specific sequencing of combination therapies is addressed directly. This Research Consensus Panel sought to highlight research priorities pertaining to the combination and optimal sequencing of LRT and systemic therapy, assessing the greatest needs across BCLC stages
Can the recent sex-specific evolutions in elite running performances be attributed to advanced footwear technology?
No full textRecent improvements in elite running performances across all distances have been largely attributed to the introduction of advanced footwear technology (AFT), which features a curved and stiff plate working synergistically with a new generation of midsole foams demonstrating enhanced resilience and compliance. These recent improvements appear to be considerably more pronounced in women's events, highlighted by improvements in road racing world records by an average of 3.7% (range: 2.6%-5.2%) compared to mean progressions of 1.5% (range: 1.3%-1.9%) in the same men's events. Although there is a growing body of research investigating the mechanisms underpinning running performance enhancements derived from AFT, there remains no explanation for potential sex-based differences in their benefits. We overview the currently available evidence and highlight why the recent direction of AFT research provides a barrier to progress by focusing primarily on male athletes. We subsequently provide our perspective on why women may be benefiting from the new generation of shoes more than men, suggest potential mechanisms leading to hypotheses that need to be further investigated in upcoming studies, and finally propose that factors outside of footwear innovation may have concurrently driven the recently observed performance evolutions
The Association of a Single Nucleotide Variant in COL5A1 to Early Onset Keratoconus and Pectus Excavatum-Convergence of Extracellular Matrix Pathologies
No full textKeratoconus is a bilateral ocular condition characterized by irregularities and the thinning of the cornea. Decreased central corneal thickness is a hallmark of the condition, and numerous genes have played a role in altering corneal thickness and the subsequent development of keratoconus. Variants in the structural and regulatory genes of the extracellular matrix have been highly associated with keratoconus, as well as with pectus excavatum, a chest wall deformity commonly seen in connective tissue disorders. This report describes a patient with a c.1720-11T>A intronic variant in the collagen-encoding gene, COL5A1, who was diagnosed with early-onset keratoconus and demonstrated a significant pectus excavatum. This report associates a COL5A1 variant with these seemingly unrelated phenotypic associations, further advancing the literature on the topic
Performance of Google's Artificial Intelligence Chatbot "Bard" (Now "Gemini") on Ophthalmology Board Exam Practice Questions
No full textPurpose: To assess the performance of "Bard," one of ChatGPT's competitors, in answering practicequestions for the ophthalmology board certification exam. Methods: In December 2023, 250 multiple-choice questions from the "BoardVitals" ophthalmology examquestion bank were randomly selected and entered into Bard to assess the artificial intelligence chatbot'sability to comprehend, process, and answer complex scientific and clinical ophthalmic questions. A randommix of text-only and image-and-text questions were selected from 10 subsections. Each subsection included 25 questions. The percentage of correct responses was calculated per section, and an overall assessment score was determined.Results: On average, Bard answered 62.4% (156/250) of questions correctly. The worst performance was 24%(6/25) on the topic of "Retina and Vitreous," and the best performance was on "Oculoplastics," with a scoreof 84% (21/25). While the majority of questions were entered with minimal difficulty, not all questions couldbe processed by Bard. This was particularly an issue for questions that included human images and multiplevisual files. Some vignette-style questions were also not understood by Bard and were therefore omitted. Future investigations will focus on having more questions per subsection to increase available data points. Conclusions: While Bard answered the majority of questions correctly and is capable of analyzing vastamounts of medical data, it ultimately lacks the holistic understanding and experience-informed knowledgeof an ophthalmologist. An ophthalmologist's ability to synthesize diverse pieces of information and drawfrom clinical experience to answer complex standardized board questions is at present irreplaceable, andartificial intelligence, in its current form, can be employed as a valuable tool for supplementing clinicians'study methods
Effectiveness of Spinal Cord Stimulation (SCS) in Reducing Opioid Consumption in Patients with Chronic Non-Cancer Pain
No full textResearch Question: Do adults taking prescription opioids for chronic, non-cancer, pain have a reduction in opioid usage following spinal cord stimulator (SCS) implantation?]Background and Significance: Chronic pain is a prevalent and serious condition that impacts many. Few studies have examined how spinal cord stimulator implantation changes perceived pain and subsequent opioid consumption before and after SCS.Materials and Methods: A retrospective study investigated the opioid consumption of 26 adults at three different times (1) Baseline (2) SCS implant date, and (3) 6 months post-SCS implant. Mean opioid consumption was calculated over the month prior and after to visit of (1), (2), and (3) to generate three separate 3-month averages. Opioid consumption was measured using Morphine Milligram Equivalents (MME). A series of paired-sample t-tests were conducted.Results: Our participant population had a significant reduction of MMEs from baseline to 6-months post-SCS implantation (p < .001). While patients¿ MME decreased from SCS implant date (M = 35.73) to 6-months post-SCS implantation (M = 24.64), this difference was not significant but revealed a trend (p = .11).Conclusion: In our study, patients using opioids for chronic non-cancer pain management, SCS modulated the perception of pain and noxious stimuli detections, resulting in a subsequent decrease in opioid consumption
Truth-Ratios, Evidential Fit, and Deferring to Informants with Low Error Probabilities
No full textSuppose that an informant (test, expert, device, perceptual system, etc.) is unlikely to err when pronouncing on a particular subject matter. When this is so, it might be tempting to defer to that informant when forming beliefs about that subject matter. How is such an inferential process expected to fare in terms of truth (leading to true beliefs) and evidential fit (leading to beliefs that fit one's total evidence)? Using a medical diagnostic test as an example, we set out a formal framework to investigate this question. We establish seven results and make one conjecture. The first four results show that when the test's error probabilities are low, the process of deferring to the test can score well in terms of (i) both truth and evidential fit, (ii) truth but not evidential fit, (iii) evidential fit but not truth, or (iv) neither truth nor evidential fit. Anything is possible. The remaining results and conjecture generalize these results in certain ways. These results are interesting in themselves-especially given that the diagnostic test is not sensitive to the target disease's base rate-but also have broader implications for the more general process of deferring to an informant. Additionally, our framework and diagnostic example can be used to create test cases for various reliabilist theories of inferential justification. We show, for example, that they can be used to motivate evidentialist process reliabilism over process reliabilism
The Identification of PAI-1 4G Polymorphisms in a Family with Unexplained Venous Thromboembolic Disease: Implications for VTE Screening
No full textResearch Question: In patients with venous thromboembolic disease and a negative standard hematologic evaluation, are there novel genetic factors associated with the development of venous thromboembolic disease?Background and Significance: Venous thromboembolic disease (VTD), including deep vein thrombosis (DVT) and pulmonary embolism (PE), affects as many as 900,000 people each year in the United States. Among those with a history of VTD, approximately one third to one half develop longer term sequalae — venous insufficiency, intractable edema, and thromboembolic pulmonary hypertension [7]. Despite recent expansion of VTD risk-reduction criteria by way of reducing known in-hospital risk factors (recent surgery, immobilization, indwelling catheterization) and promotion of healthier living, no known efforts have been made to expand current VTD evaluation criteria. Standard hematological evaluation includes Antithrombin III Deficiency, Antiphospholipid Syndrome (autoimmune platelet destruction), Factor V Leiden (resistance to Factor V inactivation), Protein C/S Deficiency, and Prothrombin G20210A mutation (excess prothrombin production) [15]. This evaluation stratifies patients in view of Virchow’s triad — hypercoagulability, stasis of blood, endothelial injury— and their predisposition to the development of VTD.Materials and Methods: The study enrolled 4 related subjects in a single family over the age of 18 who experienced a venous thromboembolic event (DVT or PE) and had undergone a standard hematologic evaluation excluding current factors associated with thrombophilia. The primary enrollment site was Consultants in Cardiovascular Medicine and Science – Fort Worth, PLLC. For subjects meeting enrollment criteria, DNA samples were collected prospectively. We used a standard oropharyngeal swab to collect DNA using standard methodology and collected 50 mL of whole blood to use for serum auto-antibody assessment. Analysis of Plasminogen Activator Inhibitor-1 (PAI-1) (SERPINE 1) for single nucleotide variants was performed using commercially available, CLIA certified genotyping assays through Quest diagnostics. Pedigree analysis was performed to identify the genetic inheritance of thrombophilia in each subject.Results: The results confirmed our suspicion for genetic variance in the PAI-1 (SERPINE 1) gene, with at least one family member heterozygous for the 4G variant. Analyses for the remaining subjects are currently pending.Conclusion: If verified by a larger cohort study, the results highlight the need to expand current hematologic evaluation criteria to include PAI-1 (SERPINE 1) and stress the importance of improved VTD screening and evaluation for at-risk family members
Loss and legacy: Reframing the studies of Julie Manet
No full textSometimes referred to as “the daughter of Impressionism” because of her unique connection to members of the Impressionist group, Julie Manet was surrounded by art from the moment she was born. Her mother, Impressionist painter Berthe Morisot, was instrumental in Julie’s artistic education and taught her to draw and paint from a young age. Orphaned at sixteen, Julie took to making art with renewed fervor after her mother’s death in 1895. This thesis treats Julie Manet as a nineteenth-century female artist and investigates how she used art in a manner distinct from how bourgeois women of this era typically utilized art. Instead of practicing art as a pleasant pass-time, Julie’s motivation for making art involved processing her grief after the loss of her mother and carrying on her family’s artistic legacy. By bringing Julie Manet’s work into conversation with the practices of Claude Monet and Marie Bashkirtseff, I seek to reframe how Julie Manet’s work is viewed by scholars. Instead of categorizing them as the inconsequential musings of an amateur, I seek to draw out their significance as to how they reveal one woman’s artistic approach to loss and life
Visualizing the effects of proline variants on the binding interface of BRCA1 and PALB2
No full textIndividuals who carry pathogenic variants in either Breast Cancer Gene 1 (BRCA1) or Partner and Localizer of BRCA 2 (PALB2) protein have an increased risk of developing breast cancer. Multiple variations of unknown significance (VUS) have been documented within the coiled-coil region of each protein. In this study, we analyzed the structural effects of five proline VUS within the binding region of BRCA1 and PALB2. We hypothesize the proline variants will inhibit coiled-coil formation and, in turn, disrupt interaction between BRCA1 and PALB2. Each coiled-coil construct was generated in vitro and its structure analyzed using circular dichroism both individually and in the presence of its wild-type binding partner. All proline variants affected the structure of BRCA1, which is suggestive of their pathogenicity. Future studies may aim to correlate structural effects with function impact to determine a threshold of structural change that can be withstood before a variant is pathogenic
The Intersection of Sustainability and Profitability when Utilizing Non-Traditional Methods in the Raising of Beef Cattle
No full textThroughout the United States, industrial agriculture has created a set of traditional methods used to raise beef cattle. These traditional methods have large adverse effects on the environment as well as profitability. The producer who took part in this case study has been managing a beef cattle operation in North Texas since 1999. This rancher's non-traditional, holistic land management and business approaches to finishing grass-fed cattle for his custom beef brand are drastically different than traditional methods. This single-case study examines the intersection of profitability and sustainability on a traditional beef cattle operation compared to a holistic, non-traditional beef cattle operation. The data collected for this study includes interviews, a review of government documents, historical management documents, soil laboratory reports, scientific journal articles, and botanical and phenological reports. The aim of this study is to examine traditional and non-conventional approaches to raising cattle, their benefits, and explain how Taggart?s ranching methods create an intersection of profitability and sustainability that may be transferable to other ranches worldwide. The findings from this study inform land management practices that boost both economic value and long-term environmental sustainability