Digital Commons Network^™

A Rare Clinical Presentation Of Metastatic Crohn's Disease, Kaitlyn L Streight, Tara L Braun, Nicholas Lowe, Soo Jung Kim

Faculty, Staff and Students Publications

A 31-year-old female with a history of systemic lupus erythematous, IgA nephropathy, and psoriasis presented with a one-month history of a painful, pruritic rash under the bilateral breasts and in the genital region. Cutaneous examination revealed a large, tender ulcer under the left breast with a shiny erythematous base and peripheral hypertrophic changes. Small ulcers were present on the bilateral inguinal folds, and the labia majora were edematous with multiple erythematous papules. Histological examination of the left breast revealed ulceration with granulomatous dermatitis, consistent with a diagnosis of metastatic Crohn's disease. Metastatic Crohn's disease is a rare cutaneous manifestation of …

Using Intervention Mapping To Develop An Efficacious Multicomponent Systems-Based Intervention To Increase Human Papillomavirus (Hpv) Vaccination In A Large Urban Pediatric Clinic Network, Claire A. Crawford, Ross Shegog, Lara S. Savas, Erica L. Frost, C. Mary Healy, Sharon P. Coan, Efrat K. Gabay, Stanley W. Spinner, Sally W. Vernon

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: The CDC recommends HPV vaccine for all adolescents to prevent cervical, anal, oropharyngeal, vaginal, vulvar, and penile cancers, and genital warts. HPV vaccine rates currently fall short of national vaccination goals. Despite evidence-based strategies with demonstrated efficacy to increase HPV vaccination rates, adoption and implementation of these strategies within clinics is lacking. The Adolescent Vaccination Program (AVP) is a multicomponent systems-based intervention designed to implement five evidence-based strategies within primary care pediatric practices. The AVP has demonstrated efficacy in increasing HPV vaccine initiation and completion among adolescents 10-17 years of age. The purpose of this paper is to describe …

Age-Dependent Involvement Of Gut Mast Cells And Histamine In Post-Stroke Inflammation, Maria Pilar Blasco, Anjali Chauhan, Pedram Honarpisheh, Hilda Ahnstedt, John D'Aigle, Arunkumar Ganesan, Sriram Ayyaswamy, Frank Blixt, Susan Venable, Angela Major, David Durgan, Anthony Haag, Julia Kofler, Robert Bryan, Louise D Mccullough, Bhanu Priya Ganesh

Faculty, Staff and Students Publications

BACKGROUND: Risk of stroke-related morbidity and mortality increases significantly with age. Aging is associated with chronic, low-grade inflammation, which is thought to contribute to the poorer outcomes after stroke seen in the elderly. Histamine (HA) is a major molecular mediator of inflammation, and mast cells residing in the gut are a primary source of histamine.

METHODS: Stroke was induced in male C57BL/6 J mice at 3 months (young) and 20 months (aged) of age. Role of histamine after stroke was examined using young (Yg) and aged (Ag) mice; mice underwent MCAO surgery and were euthanized at 6 h, 24 h, …

Tfeb Regulates Murine Liver Cell Fate During Development And Regeneration, Nunzia Pastore, Tuong Huynh, Niculin J Herz, Alessia Calcagni', Tiemo J Klisch, Lorenzo Brunetti, Kangho Ho Kim, Marco De Giorgi, Ayrea Hurley, Annamaria Carissimo, Margherita Mutarelli, Niya Aleksieva, Luca D'Orsi, William R Lagor, David D Moore, Carmine Settembre, Milton J Finegold, Stuart J Forbes, Andrea Ballabio

Faculty, Staff and Students Publications

It is well established that pluripotent stem cells in fetal and postnatal liver (LPCs) can differentiate into both hepatocytes and cholangiocytes. However, the signaling pathways implicated in the differentiation of LPCs are still incompletely understood. Transcription Factor EB (TFEB), a master regulator of lysosomal biogenesis and autophagy, is known to be involved in osteoblast and myeloid differentiation, but its role in lineage commitment in the liver has not been investigated. Here we show that during development and upon regeneration TFEB drives the differentiation status of murine LPCs into the progenitor/cholangiocyte lineage while inhibiting hepatocyte differentiation. Genetic interaction studies show that …

Implementation Costs Of A Multi-Component Program To Increase Human Papillomavirus (Hpv) Vaccination In A Network Of Pediatric Clinics, Jarrod S. Eska, David R. Lairson, Lara S. Savas, Ross Shegog, C Mary Healy, Stanley W. Spinner Md, Maria E. Fernandez, Sally W. Vernon

Journal of Applied Research on Children: Informing Policy for Children at Risk

Introduction: HPV vaccination is both a clinically and cost-effective way to prevent HPV-related cancers. Increased focus on preventing HPV infection and HPV-related cancers has motivated development of strategies to increase adolescent vaccination rates. This analysis estimates the average cost associated with implementing programs aimed at increasing HPV vaccination from the perspective of the clinic decision makers. As providers and healthcare organizations consider vaccination initiatives, it is important for them to understand the costs associated with implementing these programs.

Methods: Healthcare provider assessment and feedback, reminders, and education; and parent education/reminder strategies were implemented in a large pediatric clinic network between …

Communication Strategies To Address Vaccine Hesitancy In Healthcare Settings And On Social Media, Lindy U. Mcgee Md, Jinny Suh Jd

Journal of Applied Research on Children: Informing Policy for Children at Risk

Abstract

Vaccine hesitancy is now recognized as a threat to global health. Its causes are complex, and it is defined by a resistance to or questioning of immunization. It is important to address vaccine hesitancy directly before people who are hesitant become vaccine refusers or anti-vaccine. Fortunately, with evidence-based information delivered with a compassionate communication style many of those who are hesitant to vaccinate can be persuaded to ultimately vaccinate. This paper aims to explain successful communication strategies used to address vaccine hesitancy in healthcare settings and on social media. Vaccine hesitant parents frequently list their child’s healthcare provider as …

Lessons From The Front Line: Advocating For Vaccine Policies At The Texas Capitol During Turbulent Times, Rekha Lakshmanan, Mha, Jason Sabo, Ma

Journal of Applied Research on Children: Informing Policy for Children at Risk

In 2003, anti-vaccine activists successfully advocated to change Texas law to make it easier for parents to send their children to public school without school required vaccinations. Over fifteen years ago, 2,314 non medical exemptions were filed. The Texas Department of State Health Services recently reported in the 2018-19 school year, 64,176 exemptions were submitted. As the number of non-medical exemptions increase, the risk for a vaccine preventable outbreak also increases.

Enacting strong immunization laws and policies, which includes improving access to vaccination, increasing education, and enhancing data collection, is cyclical. In the past ten years, over 17 pieces of …

Knowledge About The Human Papillomavirus Vaccine Among Employees At A Tertiary Cancer Center: Room For Improvement, Kristina R. Dahlstrom, Erich M. Sturgis, Ronald A. Depinho, Ernest Hawk, George P. Baum, Elenita Tamez, Rosalind S. Bello, Lori D. Stevens, Lois M. Ramondetta

Journal of Applied Research on Children: Informing Policy for Children at Risk

Introduction: The human papillomavirus (HPV) vaccine is recommended by the U.S. Centers for Disease Control and Prevention for routine vaccination of boys and girls to protect against HPV-related cancers and genital warts. To meet the Healthy People 2020 target for HPV vaccination, health care providers must understand the importance of strongly recommending the HPV vaccine to all eligible adolescents. We sought to determine HPV vaccination patterns among employees at a tertiary cancer center and their children and attitudes regarding HPV vaccination among the employees.

Methods: All employees at a tertiary cancer center were invited to participate in a cross-sectional survey …

“It Falls On All Our Shoulders”: Overcoming Barriers To Delivering Sex Education In West Texas Schools, Cristina Leos, David Wiley

Journal of Applied Research on Children: Informing Policy for Children at Risk

BACKGROUND: Many racial, socioeconomic, and geographic disparities exist in rates of teen birth and sexually transmitted infections. Increasing access to comprehensive sex education is one risk reduction strategy for these outcomes, yet access to and quality of sex education in schools often falls far below recommended standards, particularly in Texas. The current exploratory study examines barriers to effectively delivering sex education in West Texas schools and identifies strategies to help overcome these barriers. METHODS: In-depth interviews with school leaders and health education professionals (n=4) were conducted to understand teen sexual health needs in West Texas. Interviews were analyzed …

Prescriptions For Produce: An Intervention With Nutrition Education, Cooking Instruction And Produce Vouchers To Increase Fruit And Vegetable Consumption., Julie La Barba M.D., Faap, Karen Weber Cullen, Drph

Journal of Applied Research on Children: Informing Policy for Children at Risk

In this pilot study, we evaluated the feasibility of nutrition education, cooking instruction and produce vouchers for pregnant low income mothers to increase fruit and vegetable consumption. Participants were first trimester pregnant mothers receiving prenatal care at a local Federally Qualified Health Clinic (FQHC) in San Antonio. They attended a grocery shopping tour and cooking class conducted by a registered dietitian, focusing incorporating fruit and vegetables into meals, and a monthly $40 voucher, redeemable for fruit and vegetables. Mothers with high menu planning and grocery shopping skills and more fruit at home reported higher fruit intakes. Mothers with high grocery …

Texas: Averting Disease And Confronting A New Vaccine Refusal Hierarchy, Susan Wootton, Peter J. Hotez, Julie Boom

Journal of Applied Research on Children: Informing Policy for Children at Risk

No abstract provided.

Culinary Education Programs For Children In Low-Income Households: A Scoping Review, Priscilla P Li, Guisela Mackey, Chishinga Callender, Jayna M Dave, Norma Olvera, Shana Alford, Debbe Thompson

Children’s Nutrition Research Center Staff Publications

Child obesity in the United States is at an all-time high, particularly among underserved populations. Home-cooked meals are associated with lower rates of obesity. Helping children develop culinary skills has been associated with improved nutrition. The purpose of this study is to report results from a scoping review of culinary education interventions with children from low-income families. Three databases and hand searches of relevant articles were examined. Retained articles met inclusionary criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, as appropriate. A data extraction template was developed. Data were independently extracted and verified. Only …

Proteolysis-Targeting Chimera (Protac) For Targeted Protein Degradation And Cancer Therapy, Xin Li, Yongcheng Song

Faculty, Staff and Students Publications

Proteolysis-targeting chimera (PROTAC) has been developed to be a useful technology for targeted protein degradation. A bifunctional PROTAC molecule consists of a ligand (mostly small-molecule inhibitor) of the protein of interest (POI) and a covalently linked ligand of an E3 ubiquitin ligase (E3). Upon binding to the POI, the PROTAC can recruit E3 for POI ubiquitination, which is subjected to proteasome-mediated degradation. PROTAC complements nucleic acid-based gene knockdown/out technologies for targeted protein reduction and could mimic pharmacological protein inhibition. To date, PROTACs targeting ~ 50 proteins, many of which are clinically validated drug targets, have been successfully developed with several …

Occupational Therapy’S Role With Ventricular Assist Devices And The Promotion Of Travel Protocols, Natasha Chandra, Linda Suplicki

The VAD Journal

An option for individuals diagnosed with end-stage heart failure is to receive a ventricular assist device (VAD). In 2006, Shepherd and Wilding produced an article regarding occupational therapy’s role during the VAD process as they anticipated a growing need for this area of practice. Since that time, there continues to be a lack of supporting literature on occupational therapy’s important role with this population. Therefore, the purpose of this article is to explain an occupational therapist’s contribution on the VAD team, offer opportunities and interventions for enhancing quality of life for this unique population, and discuss an innovative travel protocol …

A Goldenbraid Cloning System For Synthetic Biology In Social Amoebae, Peter Kundert, Alejandro Sarrion-Perdigones, Yezabel Gonzalez, Mariko Katoh-Kurasawa, Shigenori Hirose, Peter Lehmann, Koen J T Venken, Gad Shaulsky

Faculty, Staff and Students Publications

GoldenBraid is a rapid, modular, and robust cloning system used to assemble and combine genetic elements. Dictyostelium amoebae represent an intriguing synthetic biological chassis with tractable applications in development, chemotaxis, bacteria-host interactions, and allorecognition. We present GoldenBraid as a synthetic biological framework for Dictyostelium, including a library of 250 DNA parts and assemblies and a proof-of-concept strain that illustrates cAMP-chemotaxis with four fluorescent reporters coded by one plasmid.

Safe Patient Handling – A Case For National Legislation, David O. Oba

Dissertations and Theses (Open Access)

Introduction: This study examined the effectiveness of Safe Patient Handling (SPH) legislations in difference states across the country. In January 2006, the state of Texas legislated the Safe Patient Handling and Movement Practices Act which required all hospitals and nursing homes to implement safe patient handling and movement program. To date, 10 other states have enacted law or regulations to control work-related musculoskeletal disorders (MSDs) among healthcare workers (HW). Despite the effectiveness of these policies in the individual states, MSDs remain prevalent among HW nationwide. Hence, the call for national legislation. Methods: Using the state-level incidence rate data from the …

Physician Hospital Arrangement Influence On Nonprofit Hospital Quality,Financial Performance And Community Benefit Expenditures, Andrea Cervin

Dissertations and Theses (Open Access)

Federal policy has encouraged hospitals to provide certain quality outcomes and cost containment. Hospitals have responded by forming physician hospital organizations in attempts to achieve quality outcomes and capture reimbursements. At the same time, federal policy has awarded hospitals with nonprofit status with the requirement to provide community benefits in exchange for the tax exemption they receive. With the formation of physician hospital organizations, there remains the question of whether hospitals are achieving desired quality metrics and whether hospitals are financially viable. There is also public and media interest recently regarding whether nonprofit hospitals fulfill their obligations for community benefit …

T​He​ E​Ffect​ ​Of​ U​Nconventional​ G​As​ ​And​ O​Il​ D​Rilling​ E​Missions​ ​On​ A​Sthma​ ​And​ R​Espiratory D​Iseases​ ​In​ ​The​ B​Arnett​ S​Hale​ ​Of​ T​Exas, Stella A. Okoroafor

Dissertations and Theses (Open Access)

Unconventional gas and oil drilling (UGOD) has increased substantially in the United States for more than a decade. The resultant environmental unsafe air pollution effects of UGOD both locally and regionally have been well documented in the literature. Despite the dramatic increase in unconventional well drilling and the toxicant exposure, the health consequences of UGOD remain largely uncertain. This study assesses the relationship between active wells and healthcare use for respiratory diseases by zip code from 2004 to 2008 in the Barnett shale area of Texas. The first modern shale gas well was drilled in the Barnett shale area of …

A Geospatial Examination Of The Association Between Geographic Food Access And Food Insecurity In Central Texas: The Role Of Race/Ethnicity And Urbanicity, Kathryn Janda

Dissertations and Theses (Open Access)

Food insecurity is a public health issue that affects one in ten Americans, one in seven Central Texans, and is associated with malnutrition, chronic disease, and obesity. Geographic food access is the most intervened upon aspect of food insecurity and is often measured objectively through mapping software, such as ArcGIS. Yet when geographic food access is only measured in terms of distance to food retail, analyses do not full capture the nuances of community context. Thus, other sources of data, like survey data, and demographic indicators, such as race/ethnicity and urbanicity, should be incorporated into the research exploring the association …

Determining The Drivers Of Quality Of Life In Hiv Patints Treated With Antiretroviral Therapy In Subsaharan Africa, Oubote Sangbana

Dissertations and Theses (Open Access)

During the last decade, HIV in sub-Saharan Africa has shifted from a fatal disease to a chronic condition thanks to the expansion of antiretroviral therapy (ART). As a result, the focus of care has transitioned from survival to quality of life (QoL), and the latter has become a significant outcome measure during patient follow up. Yet, the determinants of QoL among HIV patients in western and central Africa are not well known. The objective of this dissertation was to determine the main factors associated with QoL among ART-treated HIV adult patients in western and central Africa to ensure healthcare providers …

Utility Of Plasma Biomarkers In The Validation Of Reported Loc & Pta For Gcs 13-15 Patients: A Track-Tbi Pilot Study, Jeffrey Brennan

Dissertations and Theses (Open Access)

Depending on a brain injury patient to accurately report their duration of unconsciousness and amnesia is clearly flawed. We constructed biomarker-based models to validate these self-reported measurements using a GCS 13-15 subset of participants from TRACK-TBI, a multi-institutional study on traumatic brain injury. Potential covariates were assessed for significant interactions with biomarker level. We report that the predictions of LOC and PTA failed. GFAP exhibited the most consistent serum level increase between categories of both LOC and PTA. Given a number of issues with the study sample, we recommend continued investigation on the prediction of LOC and PTA using a …

Effects Of Penfluridol On Integrin-Fak Signaling And Tumor Cell Killing In Combination With Oncolytic Hsv In Glioblastoma, Mitra Nair

Dissertations and Theses (Open Access)

Integrins are known to play an important role in activating multiple intracellular pathways, one of which is focal adhesion kinase (FAK). Phosphorylation of FAK can lead to the activation of various downstream signaling pathways that can increase tumor cell growth and proliferation, making it an ideal target for cancer therapeutics. Due to the fact that many FAK inhibitors are limited in their penetration of the blood brain barrier, we investigated the use of Penfluridol, an antipsychotic drug known to attenuate integrin expression at a transcriptional level, in combination with oncolytic herpes simplex I virus (oHSV) in a glioblastoma model. We …

The Course Of Acute Stress Disorder And Post Traumatic Stress Disorder In Parents With Infants In The Neonatal Intensive Care Unit, Caroline Bertsch

Dissertations and Theses (Open Access)

NICU parents have up to a 60% chance to develop acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD) during or after their baby’s NICU stay. Emotional and demographic factors contributing to ASD/PTSD have been previously identified. Although support factors desired by NICU parents have been described, it has not yet been determined how the presence or absence of these desired support factors may impact the development of ASD/PTSD. English and Spanish speaking parents over the age of 18 were eligible to participate in a survey that assessed stress, coping and support in the NICU. Participants also completed a validated …

Surgical Management And Outcome Of Newly Diagnosed Glioblastoma Without Contrast Enhancement (Low-Grade Appearance): A Report Of The Rano Resect Group, Ameya A Jategaonkar, Vivian F Kaul, Eric Lee, Eric M Genden

Faculty, Staff and Student Publications

The palatomaxillary structure plays critical roles in both form and function of the midface. Surgical defects of the palate and maxilla can be associated with significant morbidity and deformity. Various defect classification systems have been used to assist in reconstruction and rehabilitation. Reconstructive options include prosthetic rehabilitation, local flaps, and free tissue transfer. Here, we review the functional and surgical anatomy of the palatomaxillary complex, defect classification systems, and provide an overview of reconstructive options.

Table-To-Text: Generating Descriptive Text For Scientific Tables From Randomized Controlled Trials, Qiang Wei

Dissertations and Theses (Open Access)

Unprecedented amounts of data have been generated in the biomedical domain, and the bottleneck for biomedical research has shifted from data generation to data management, interpretation, and communication. Therefore, it is highly desirable to develop systems to assist in text generation from biomedical data, which will greatly improve the dissemination of scientific findings. However, very few studies have investigated issues of data-to-text generation in the biomedical domain. Here I present a systematic study for generating descriptive text from tables in randomized clinical trials (RCT) articles, which includes: (1) an information model for representing RCT tables; (2) annotated corpora containing pairs …

Ic 011 Guide To University Of Texas School Of Allied Health Sciences Records, 1973-1995, University Of Texas Health Science Center At Houston School Of Allied Health Sciences

Institutional Finding Aids

The University of Texas School of Allied Health Sciences contains catalogs, admission applications, newsletters, and brochures. See more at IC 011.

Implementation Of Genetic Carrier Screening In The Ob Population: Healthcare Cost Impact And Recommendation Adherence, Aranza Gonzalez Cendejas

Dissertations and Theses (Open Access)

Background. The recent increases in availability of and demand for genetic testing have been observed alongside concerns regarding the appropriate ordering of such tests by providers, and subsequent unnecessary costs to the healthcare system. Professional organizations, such as ACOG and ACMG, develop guidelines to aid providers in ordering appropriate genetic testing. In this study, the ordering of carrier screening by obstetricians and genetic counselors was used to determine if duplicate genetic testing was taking place at a large academic institution along with adherence to ACOG and ACMG carrier screening guidelines.

Methods. A retrospective chart review of primigravida and multigravida women …

Understanding Motivation To Lead In Nurses, Janete Sheiner

Dissertations and Theses (Open Access)

Background: Nurse leaders are indispensable to the delivery of quality, patient-centered care. They are influential in the practice environment, contributing to front-line staff job satisfaction. They work to improve retention, turnover, organizational health, and patient outcomes. Yet, there is a dearth of research investigating the motivating factors that appeal to, encourage, discourage, and help retain nurse leaders in their roles. The forecast of a shortage of nurse leaders, along with the reluctance of nurses to assume leadership roles, is affecting healthcare organizations throughout the United States. An in-depth understanding of the underlying factors related to motivation that appeal to, encourage, …

Caregivers Of Medically Fragile Children With Technology Needs, Vuong Prieto

Dissertations and Theses (Open Access)

Background: Medically fragile children (MFC) with technology needs have complex and challenging health care needs in the home setting. Providing care can have both negative and positive psychological and social impacts on the caregivers’ health related quality of life (HRQOL).

Aims: a) To examine the relationship between caregiver burden, caregiving satisfaction, and HRQOL in caregivers of MFC with technology needs. b) To identify caregiver and child related variables of caregiver burden and caregiving satisfaction.

Methods: A cross sectional study was conducted over four months at a children’s hospital and outpatient clinics. Caregivers completed three one-time surveys (Zarit Burden Interview, Caregiving …

Left Ventricular Assist Device Adjustment Impacted By Patient Trajectory: A Qualitative Exploratory Study, Brittany Rhoades

Dissertations and Theses (Open Access)

Background: Left Ventricular Assist Devices (LVADs) are used as advanced therapy for advanced heart failure in order to sustain patients until a heart transplant is available (bridge to transplant, ‘BTT’) or until the end of life (destination therapy, ‘DT’). Despite the differences in treatment trajectory, BTT and DT patients are provided the same education. Currently it is unknown if the two groups compare to living with the LVAD regarding adjustment.

Aims: The aim of this study was to explore LVAD patient experience, describe how patients construct the impact of the LVAD on daily life and self-care and compare the findings …