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The 2022 Symposium On Dementia And Brain Aging In Low- And Middle-Income Countries: Highlights On Research, Diagnosis, Care, And Impact, Raj N. Kalaria, Gladys Maestre, Simin Mahinrad, Daisy Acosta, Rufus Akinyemi, Suvarna Alladi, Ricardo F. Allegri, Faheem Arshad, David Oluwasayo Babalola, Noe Garza

School of Medicine Publications and Presentations

Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC-focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging …

Clinical Efforts Double Disparity For Nonphysician Urim Faculty: Implications For Academic Family Medicine, Stacy A. Ogbeide, Deepu George, Adrian Sandoval, Yajaira Johnson-Esparza, Maria Montanez Villacampa

School of Medicine Publications and Presentations

With a new definition of high-quality primary care and the shift in nonphysician faculty’s role as core faculty members in family medicine residency programs, new attention is needed on the delineation of clinical efforts and clinical efforts disparities across disciplines (eg, psychology, marriage and family therapy, pharmacy) within departments of family medicine. Additionally, those who identify as underrepresented in medicine (URiM), specifically those who are nonphysician faculty, are dually impacted by the clinical efforts double disparity. This paper examines the current landscape of clinical efforts in academic family medicine for physician faculty and nonphysician faculty as well as discusses how …

Statistical Genetic Approaches To Investigate Genotype-By-Environment Interaction: Review And Novel Extension Of Models, Vincent P. Diego, Eron G. Manusov, Marcio Almeida, Sandra Laston, David Ortiz, John Blangero, Sarah Williams-Blangero

School of Medicine Publications and Presentations

Statistical genetic models of genotype-by-environment (G×E) interaction can be divided into two general classes, one on G×E interaction in response to dichotomous environments (e.g., sex, disease-affection status, or presence/absence of an exposure) and the other in response to continuous environments (e.g., physical activity, nutritional measurements, or continuous socioeconomic measures). Here we develop a novel model to jointly account for dichotomous and continuous environments. We develop the model in terms of a joint genotype-by-sex (for the dichotomous environment) and genotype-by-social determinants of health (SDoH; for the continuous environment). Using this model, we show how a depression variable, as measured by the …

A Comparative Analysis Of Positive And Negative Stimuli For Takotsubo Cardiomyopathy: A Pooled Analysis Of Two Studies And A Systematic Review, Arankesh Mahadevan, Vamsikalayan Borra, Lakshmi Prasanna Vaishnavi Kattamuri, Vikash Jaiswal, Ikechukwu R. Ogbu

School of Medicine Publications and Presentations

Takotsubo cardiomyopathy (TTC) is characterized by transient myocardial dysfunction triggered by both negative and positive emotional experiences, known respectively as broken heart syndrome (BHS) and happy heart syndrome (HHS). Despite the scarcity of comparative analyses between HHS and BHS in the literature, our pooled analysis, incorporating two retrospective registry analyses of 1395 TTC patients (57 HHS and 1338 BHS), reveals that while BHS is more prevalent, both conditions exhibit similar clinical presentations and outcomes. Statistical analyses, utilizing binary random effects models, indicate that diabetes mellitus is less common in HHS patients and serves as a predictor for BHS. Furthermore, there …

The Power Of Promotores: Enhancing The Ability Of Medical Students To Provide For And Communicate With Underserved Populations, Jesse Allen, Suzette Jimenez, Ricardo Belmares, Jose Manuel De La Rosa, Nathan A. Holland, Jessica Chacon

School of Medicine Publications and Presentations

To increase community health knowledge, the El Paso Health Education and Awareness Team (EP-HEAT) was established at Paul L. Foster School of Medicine. The Medical Student Run Clinic (MSRC) emphasizes community health care access. Promotores de salud (community health workers) increase health care awareness and connect predominantly underserved communities with resources. Surveys were conducted to determine how EP-HEAT and MSRC patients’ communication with promotores affected their access to health care and communication skills. Surveys demonstrated that 91% of EP-HEAT members agreed that working with promotores improved their communication ability. All MSRC patients surveyed stated interacting with promotores helped improve health …

Promoting Diverse Perspectives: Addressing Health Disparities Related To Alzheimer's And All Dementias, Gladys Maestre, Carl Hill, Percy Griffin, Stephen Hall, William Hu, Jason Flatt, Ganesh Babulal

School of Medicine Publications and Presentations

Dementia research lacks appropriate representation of diverse groups who often face substantial adversity and greater risk of dementia. Current research participants are primarily well-resourced, non-Hispanic White, cisgender adults who live close to academic medical centers where much of the research is based. Consequently, the field faces a knowledge gap about Alzheimer's-related risk factors in those other groups. The Alzheimer's Association hosted a virtual conference on June 14–16, 2021, supported in part by the National Institute on Aging (R13 AG072859-01), focused on health disparities. The conference was held entirely online and consisted of 2 days of core programming and a day …

Metabolic Syndrome Traits Exhibit Genotype-By-Environment Interaction In Relation To Socioeconomic Status In The Mexican American Family Heart Study, Vincent P. Diego, Eron G. Manusov, Xi Mao, Marcio A. Almeida, Juan M. Peralta, Joanne E. Curran, Michael C. Mahaney, Harald H. H. Goring, John Blangero, Sarah Williams-Blangero

School of Medicine Publications and Presentations

Background: Socioeconomic Status (SES) is a potent environmental determinant of health. To our knowledge, no assessment of genotype-environment interaction has been conducted to consider the joint effects of socioeconomic status and genetics on risk for metabolic disease. We analyzed data from the Mexican American Family Studies (MAFS) to evaluate the hypothesis that genotype-by-environment interaction (GxE) is an essential determinant of variation in risk factors for metabolic syndrome (MS).

Methods: We employed a maximum likelihood estimation of the decomposition of variance components to detect GxE interaction. After excluding individuals with diabetes and individuals on medication for diabetes, hypertension, or dyslipidemia, we …

Gene Expression Networks Regulated By Human Personality, Coral Del Val, Elisa Díaz De La Guardia-Bolívar, Jorge Igor Zwir, Pashupati Mishra, Alberto Mesa, Ramiro Salas, Guillermo F. Poblete, Gabriel A. De Erausquin, Emma Raitoharju, Mika Kähönen

School of Medicine Publications and Presentations

Genome-wide association studies of human personality have been carried out, but transcription of the whole genome has not been studied in relation to personality in humans. We collected genome-wide expression profiles of adults to characterize the regulation of expression and function in genes related to human personality. We devised an innovative multi-omic approach to network analysis to identify the key control elements and interactions in multi-modular networks. We identified sets of transcribed genes that were co-expressed in specific brain regions with genes known to be associated with personality. Then we identified the minimum networks for the co-localized genes using bioinformatic …

Identifying The Best Cutoff Value Of The Fecal Occult Blood Immunochemical Test In The Detection Of Advanced And Neoplastic Colorectal Lesions [Identificación Del Mejor Punto De Corte De La Prueba Inmunoquímica De Sangre Oculta En Heces En La Detección De Lesiones Colorrectales Avanzadas Y Neoplásicas], Patricia Gaggero, Eduardo Fenocchi, Cecilia Silva, Juan C. Lopez-Alvarenga, Natalia Lambert, Fabian Batista, Sergio Sobrino-Cossio, Jonathan R. White, Adolfo Parra-Blanco

School of Medicine Publications and Presentations

Objective: Screening is an effective tool for detecting colorectal lesions in asymptomatic subjects. There is a positive correlation between fecal immunochemical test (FIT) values and the size of tumors. Despite the efficacy of screening, the detection of colorectal cancer (CRC) remains low. The primary objective was to evaluate the best FIT cutoff value for detecting advanced adenomas and CRC among individuals at average risk in a country with a high incidence and morbidity from CRC.

Methods: This observational and prospective study analyzed consecutive cases in 1461 asymptomatic subjects with a positive FIT (≥ 100 ng hemoglobin [Hb]/ mL) referred for …

Contemplating On The End Of Integrated Care-Part Ii: Living The Questions To Foster Adaptability, Deepu George, Parinda Khatri

School of Medicine Publications and Presentations

This article extends the use of the ecocycle planning framework to describe challenges ahead for the integrated care and Collaborative Family Healthcare Association (CFHA). The authors make the case that to remain agile and adaptable, there are contextual, ecological, and moral challenges that integrated care and CFHA should keep in the forefront as they navigate the future of an inequitable health care system that is morphing at a rapid pace. These influences include but are not limited to challenges of social determinants of health, artificial intelligence, generational differences in technology among older and younger populations, the moral issue of poverty, …

Pre-Infection Innate Immunity Attenuates Sars-Cov-2 Infection And Viral Load In Ipsc-Derived Alveolar Epithelial Type 2 Cells, Satish Kumar, Jose C. Granados, Miriam Aceves, Juan M. Peralta, Ana C. Leandro, John M. Thomas, Sarah Williams-Blangero, Joanne E. Curran, John Blangero

School of Medicine Publications and Presentations

A large portion of the heterogeneity in coronavirus disease 2019 (COVID-19) susceptibility and severity of illness (SOI) remains poorly understood. Recent evidence suggests that SARS-CoV-2 infection-associated damage to alveolar epithelial type 2 cells (AT2s) in the distal lung may directly contribute to disease severity and poor prognosis in COVID-19 patients. Our in vitro modeling of SARS-CoV-2 infection in induced pluripotent stem cell (iPSC)-derived AT2s from 10 different individuals showed interindividual variability in infection susceptibility and the postinfection cellular viral load. To understand the underlying mechanism of the AT2′s capacity to regulate SARS-CoV-2 infection and cellular viral load, a genome-wide differential …

Hip Preservation Surgery In Patients With Femoroacetabular Impingement Syndrome And Acetabular Dysplasia Improves Functional Measures And Pain Catastrophizing, John M. Gaddis, Rafael De Souza, Benjamin Montanez, Paul A. Nakonezny, Bretton Laboret, Ryan Bialaszewski, Joel Wells

School of Medicine Publications and Presentations

Background Chronic hip pain is a debilitating condition that severely reduces one's quality of life. Prior studies uncovered a link between hip pathologies and pain catastrophizing, anxiety, and depression. The purpose of this study was to investigate whether hip preservation surgery in patients with femoroacetabular impingement syndrome (FAIS) and acetabular dysplasia (AD) improves functional outcomes and pain catastrophizing. Methods Patients with FAIS and AD were requested to complete a hip questionnaire both preoperatively and postoperatively at a single academic center (University of Texas Southwestern Medical Center, Dallas, Texas, USA). Pain catastrophizing was evaluated using the pain catastrophizing scale, and pain …