Medicine and Health Sciences Commons^™

Should Employment Division V Smith Be Overturned?, Jake Greenblum, Ryan Hubbard

School of Medicine Publications

Health professionals seeking religious exemption from caring for some patients or providing some interventions receive robust legal protection. Similarly, religiously affiliated organizations have great latitude in deciding which services to offer. These protections could soon become stronger, as the US Supreme Court considers 2 cases that revisit constraints on exemption claims established in Employment Division, Department of Human Resources of Oregon v Smith (1990). This article contends that overturning this case’s precedent might result in clinicians claiming more religious exemptions, which, barring acts of US Congress, would erode the rule of law and increase risk of harm to patients.

Recent Advances In Understanding Neural Correlates Of Anxiety Disorders In Children And Adolescents, André Zugman, Anderson M. Winkler, Daniel Samuel Pine

School of Medicine Publications

Purpose of review:

Anxiety disorders are some of the most common psychiatric diagnoses in children and adolescents, but attempts to improve outcome prediction and treatment have stalled. This review highlights recent findings on neural indices related to fear and anxiety that provide novel directions for attempts to create such improvements.

Recent findings:

Stimuli capable of provoking fear engage many brain regions, including the amygdala, medial prefrontal cortex, hippocampus, and bed nucleus of the stria terminalis. Studies in rodents suggest that sustained, low-level threats are particularly likely to engage the bed nucleus of the stria terminalis, which appears to malfunction in …

Ptsd As An Endothelial Disease: Insights From Covid-19, Adonis Sfera, Carolina Osorio, Leah Rahman, Carlos M. Zapata Martín Del Campo, Jose Campo Maldonado, Nyla Jafri, Michael Cummings, Steve Maurer, Zisis Kozlakidis

School of Medicine Publications

SARS-CoV-2 virus, the etiologic agent of COVID-19, has affected almost every aspect of human life, precipitating stress-related pathology in vulnerable individuals. As the prevalence rate of posttraumatic stress disorder in pandemic survivors exceeds that of the general and special populations, the virus may predispose to this disorder by directly interfering with the stress-processing pathways. The SARS-CoV-2 interactome has identified several antigens that may disrupt the blood-brain-barrier by inducing premature senescence in many cell types, including the cerebral endothelial cells. This enables the stress molecules, including angiotensin II, endothelin-1 and plasminogen activator inhibitor 1, to aberrantly activate the amygdala, hippocampus, and …

The Mechanism And Pattern Of Injuries Of Undocumented Immigrants Crossing The Texas-Mexico Border Along The Rio Grande Valley, Carlos H. Palacio, Bianca Cruz, Cheryl Vanier, Jose Cano, Bradford G. Scott

School of Medicine Publications

Background

Apprehensions of undocumented immigrants in the Rio Grande Valley sector of the U.S.-Mexico border have grown to account for nearly half of all apprehensions at the border. The purpose of this study is to report the prevalence, mechanism, and pattern of traumatic injuries sustained by undocumented immigrants who crossed the U.S.-Mexico border at the Rio Grande Valley sector over a span of 5 years and were treated at a local American College of Surgeons verified Level II trauma center.

Methods

A retrospective chart review was conducted from January 2014 to December 2019. Demographics, comorbidities, injury severity score (ISS), mechanism …

South To North Migration Patterns Of Tuberculosis Patients Diagnosed In The Mexican Border With Texas, Jennifer S. Curry, Bassent Abdelbary, Moncerrato García-Viveros, Juan Ignacio Garcia, Marcel Yotebieng, Adrian Rendon, Jordi B. Torrelles, Blanca I. Restrepo

School of Medicine Publications

The Mexican state of Tamaulipas serves as a migration waypoint into the US. Here, we determined the contribution of immigrants to TB burden in Tamaulipas. TB surveillance data from Tamaulipas (2006–2013) was used to conduct a cross-sectional characterization of TB immigrants (born outside Tamaulipas) and identify their association with TB treatment outcomes. Immigrants comprised 30.8% of TB patients, with > 99% originating from internal Mexican migration. Most migration was from South to North, with cities adjacent to the US border as destinations. Immigrants had higher odds of risk factors for TB [older age (≥ 65 year old, OR 2.4, 95% CI …

Genz And Mendell-Elston Estimation Of The High-Dimensional Multivariate Normal Distribution, Lucy Blondell, Mark Kos, John Blangero, Harald H. H. Goring

School of Medicine Publications

Statistical analysis of multinomial data in complex datasets often requires estimation of the multivariate normal (MVN) distribution for models in which the dimensionality can easily reach 10–1000 and higher. Few algorithms for estimating the MVN distribution can offer robust and efficient performance over such a range of dimensions. We report a simulation-based comparison of two algorithms for the MVN that are widely used in statistical genetic applications. The venerable Mendell- Elston approximation is fast but execution time increases rapidly with the number of dimensions, estimates are generally biased, and an error bound is lacking. The correlation between variables significantly affects …

Isolated Diastolic Hypertension In The Idaco Study: An Age-Stratified Analysis Using 24-Hour Ambulatory Blood Pressure Measurements, John W. Mcevoy, Wen-Yi Yang, Lutgarde Thijs, Zhen-Yu Zhang, Jesus D. Melgarejo, José Boggia, Tine W. Hansen, Kei Asayama, Takayoshi Ohkubo, Gladys E. Maestre

School of Medicine Publications

The prognostic implications of isolated diastolic hypertension (IDH), as defined by 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines, have not been tested using ambulatory blood pressure (BP) monitor thresholds (ie, 24-hour mean systolic BP ≥75 mm Hg). We analyzed data from 11 135 participants in the IDACO (International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes). Using 24-hour mean ambulatory BP monitor values, we performed Cox regression testing independent associations of IDH with death or cardiovascular events. Analyses were conducted in the cohort overall, as well as after age stratification (≥50 years). The median age …

Endovascular Treatment For Acute Stroke Patients With A Pre-Stroke Disability: An International Survey, Sanjana Salwi, Jan A. Niec, Ameer E. Hassan, Christopher J. Lindsel, Pooja Khatri, J. Mocco, Jeffrey L. Saver, Eva A. Mistry

School of Medicine Publications

Background: It is unclear what factors clinicians consider when deciding about endovascular thrombectomy (EVT) in acute ischemic stroke patients with a pre-existing disability. We aimed to explore international practice patterns and preferences for EVT in patients with a pre-stroke disability, defined as a modified Rankin score (mRS) ≥ 2.

Methods: Electronic survey link was sent to principal investigators of five major EVT trials and members of a professional interventional neurology society.

Results: Of the 81 survey-responding clinicians, 57% were neuro-interventionalists and 33% were non-interventional stroke clinicians. Overall, 64.2% would never or almost never consider EVT for a patient …

A Case Report Of A Patient On Therapeutic Warfarin Who Died Of Covid-19 Infection With A Sudden Rise In D-Dimer, Reita N. Agarwal, Hersheth Aggarwal, Ashmit Verma, Manish Tripathi

School of Medicine Publications

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has disrupted social and economic life globally. The global pandemic COVID-19 caused by this novel SARS-CoV-2 shows variable clinical manifestations, complicated further by cytokine storm, co-infections, and coagulopathy, leading to severe cases and death. Thrombotic complications arise due to complex and unique interplay between coronaviruses and host cells, inflammatory response, and the coagulation system. Heparin and derivatives are World Health Organization (WHO) recommended anticoagulants for moderate and severe Corona Virus Disease 19 (COVID-19), that can also inhibit viral adhesion to the cell membrane by interfering with heparan sulfate-dependent binding to angiotensin-converting enzyme …

Challenges In Treating Cancer Patients With Unstable Psychiatric Disorder, Val Bellman, Nina Russell, Kartik Depala, Alexandra Dellenbaugh, Saral Desai, Ramu Vadukapuram, Shweta Patel, Sushma Srinivas

School of Medicine Publications

In this review, we first present a case of chronic myeloid leukemia with acute psychosis, and then we will discuss the incidence of cancer in patients with psychotic disorders, the manifestations of new-onset psychosis, and the prevalence of preexisting psychosis in cancer patients, coupled with their impact on the treatment, diagnosis, and prognosis of cancer. This was a case that presented with acute psychosis and was found to have an elevated white blood cell count upon admission to an inpatient psychiatric unit. He was diagnosed with chronic myeloid leukemia and successfully managed with imatinib/dasatinib therapy. Psychiatrically, he was stabilized on …

Bioactive Nanotherapeutic Trends To Combat Triple Negative Breast Cancer, Pallabita Chowdhury, Upasana Ghosh, Kamalika Samanta, Meena Jaggi, Subhash C. Chauhan, Murali M. Yallapu

School of Medicine Publications

The management of aggressive breast cancer, particularly, triple negative breast cancer (TNBC) remains a formidable challenge, despite treatment advancement. Although newer therapies such as atezolizumab, olaparib, and sacituzumab can tackle the breast cancer prognosis and/or progression, but achieved limited survival benefit(s). The current research efforts are aimed to develop and implement strategies for improved bioavailability, targetability, reduce systemic toxicity, and enhance therapeutic outcome of FDA-approved treatment regimen. This review presents various nanoparticle technology mediated delivery of chemotherapeutic agent(s) for breast cancer treatment. This article also documents novel strategies to employ cellular and cell membrane cloaked (biomimetic) nanoparticles for effective clinical …

Interferon Gamma Release Assays For Detection Of Latent Mycobacterium Tuberculosis In Older Hispanic People, Julia M. Scordo, Genesis P. Aguillón-Durán, Doris Ayala, Ana Paulina Quirino-Cerrillo, Eminé Rodriguez-Reyna, Mateo Joya-Ayala, Francisco Mora-Guzmán, Eder Ledezma-Campos, Alejandro Villafañez, Larry S. Schlesinger, Blanca I. Restrepo

School of Medicine Publications

Background: Interferon gamma release assays (IGRAs) are used to detect latent Mycobacterium tuberculosis (M.tb) infection (LTBI) in adults, but their performance in older people is not well-established. We evaluated IGRAs for LTBI detection in older Hispanic recent TB contacts (ReC) or community controls (CoC).

Methods: Cross-sectional assessment of LTBI with T-SPOT.TB and/or QuantiFERON-Gold in-tube or -Plus assay in older (≥60 years) and adult (18-50 years) Hispanic people.

Results: We enrolled 193 CoC (119 adults, 74 older persons) and 459 ReC (361 adults, 98 older persons). LTBI positivity increased with age in CoC (19%-59%, P<0.001), but was similar in ReC (59%-69%, P=0.329). Older people had lower concordance between IGRAs (kappa 0.465 vs 0.688 in adults) and more inconclusive results (indeterminate/borderline 11.6% vs 5.8% in adults, P=0.012). With simultaneous IGRAs, inconclusive results were resolved as positive or negative with the other IGRA. The magnitude of response to M.tb peptides in IGRAs was similar among age groups, but responsiveness to mitogens was lower in older people.

Conclusions: IGRAs are suitable for LTBI …

Endovascular Thrombectomy In Patients With Large Core Ischemic Stroke: A Cost-Effectiveness Analysis From The Select Study, Amrou Sarraj, Elena Pizzo, Kyriakos Lobotesis, James C. Grotta, Ameer E. Hassan, Michael G. Abraham, Spiros Blackburn, Arthur L. Day, Mark J. Dannenbaum, William Hicks

School of Medicine Publications

Background It is unknown whether endovascular thrombectomy (EVT) is cost effective in large ischemic core infarcts.

Methods In the prospective, multicenter, cohort study of imaging selection study (SELECT), large core was defined as computed tomography (CT) ASPECTS(CTP) ischemic core volume (rCBF

Results From 361 patients enrolled in SELECT, 105 had large core on CT or CTP (EVT 62, MM 43). 19 (31%) EVT vs 6 (14%) MM patients achieved modified Rankin Scale (mRS) score 0–2 (OR 3.27, 95% CI 1.11 to 9.62, P=0.03) with a shift towards better mRS (cOR 2.12, 95% CI 1.05 to 4.31, P=0.04). Over the projected …

Pharmaceutical Potential Of Laboratory Grown Cultures Of Blue-Green Algae: A Comprehensive Review And Future Possibilities, Ritu Chauhan, Abhishek Chauhan, Ashutosh Tripathi, Anuj Ranjan, Subhash C. Chauhan, Tanu Jindal

School of Medicine Publications

COVID-19 pandemic has taught the world researchers the urgent need for new sources and novel pharmaceuticals not only for existing diseases but also for both seasonal epidemics and future pandemics. Pharmaceutical drug discoveries for the past fifty years depended deeply on the procedure of empirical transmission of a huge number of pure bioactive compounds to provide new leads. The screening of extracts or isolating compounds is a common way to discover novel biologically active molecules. Most of the valuable Blue-Green algal metabolites are concentrated in their biomass. For existence in nature, Blue-Green algae (BGA) secrete and contain various organic substances …

Cortical And Subcortical Brain Structure In Generalized Anxiety Disorder: Findings From 28 Research Sites In The Enigma-Anxiety Working Group, Anita Harrewijn, Elise M. Cardinale, Nynke A. Groenewold, Janna Marie Bas-Hoogendam, Moji Aghajani, Kevin Hilbert, Narcis Cardoner, Daniel Porta-Casteràs, Savannah Gosnell, Anderson M. Winkler

School of Medicine Publications

The goal of this study was to compare brain structure between individuals with generalized anxiety disorder (GAD) and healthy controls. Previous studies have generated inconsistent findings, possibly due to small sample sizes, or clinical/analytic heterogeneity. To address these concerns, we combined data from 28 research sites worldwide through the ENIGMA-Anxiety Working Group, using a single, pre-registered mega-analysis. Structural magnetic resonance imaging data from children and adults (5–90 years) were processed using FreeSurfer. The main analysis included the regional and vertex-wise cortical thickness, cortical surface area, and subcortical volume as dependent variables, and GAD, age, age-squared, sex, and their interactions as …

Real-Time Mobile Teleophthalmology For The Detection Of Eye Disease In Minorities And Low Socioeconomics At-Risk Populations, Lama A. Al-Aswad, Cansu Yuksel Elgin, Vipul Patel, Deborah Popplewell, Kalashree Gopal, Dan Gong, Zach Thomas, Devon Joiner, Cha-Kai Chu, Gladys E. Maestre

School of Medicine Publications

Purpose: To examine the benefits and feasibility of a mobile, real-time, community-based, teleophthalmology program for detecting eye diseases in the New York metro area.

Design: Single site, nonrandomized, cross-sectional, teleophthalmologic study.

Methods: Participants underwent a comprehensive evaluation in a Wi-Fi-equipped teleophthalmology mobile unit. The evaluation consisted of a basic anamnesis with a questionnaire form, brief systemic evaluations and an ophthalmologic evaluation that included visual field, intraocular pressure, pachymetry, anterior segment optical coherence tomography, posterior segment optical coherence tomography, and nonmydriatic fundus photography. The results were evaluated in real-time and follow-up calls were scheduled to complete a secondary questionnaire form. Risk …

Multi-Phenotype Genome-Wide Association Studies Of The Norfolk Island Isolate Implicate Pleiotropic Loci Involved In Chronic Kidney Disease, Ngan K. Tran, Rodney A. Lea, Samuel Holland, Quan Nguyen, Arti M. Raghubar, Heidi G. Sutherland, Miles C. Benton, Nicholas B. Blackburn, Joanne E. Curran, John Blangero

School of Medicine Publications

Chronic kidney disease (CKD) is a persistent impairment of kidney function. Genome-wide association studies (GWAS) have revealed multiple genetic loci associated with CKD susceptibility but the complete genetic basis is not yet clear. Since CKD shares risk factors with cardiovascular diseases and diabetes, there may be pleiotropic loci at play but may go undetected when using single phenotype GWAS. Here, we used multi-phenotype GWAS in the Norfolk Island isolate (n = 380) to identify new loci associated with CKD. We performed a principal components analysis on different combinations of 29 quantitative traits to extract principal components (PCs) representative of multiple …

Apoc3 Genetic Variation, Serum Triglycerides, And Risk Of Coronary Artery Disease In Asian Indians, Europeans, And Other Ethnic Groups, Shiwali Goyal, Yosuke Tanigawa, Weihua Zhang, Jin-Fang Chai, Marcio Almeida, Juan M. Peralta, Donna M. Lehman, Joanne E. Curran, Ravi Duggirala, John Blangero

School of Medicine Publications

Background

Hypertriglyceridemia has emerged as a critical coronary artery disease (CAD) risk factor. Rare loss-of-function (LoF) variants in apolipoprotein C-III have been reported to reduce triglycerides (TG) and are cardioprotective in American Indians and Europeans. However, there is a lack of data in other Europeans and non-Europeans. Also, whether genetically increased plasma TG due to ApoC-III is causally associated with increased CAD risk is still unclear and inconsistent. The objectives of this study were to verify the cardioprotective role of earlier reported six LoF variants of APOC3 in South Asians and other multi-ethnic cohorts and to evaluate the causal association …

Genetic Overlap Profiles Of Cognitive Ability In Psychotic And Affective Illnesses: A Multisite Study Of Multiplex Pedigrees, Emma Knowles, Juan M. Peralta, Laura Almasy, Vishwajit Nimgaonkar, Francis J. Mcmahon, Pippa Thomson, Samuel R. Mathias, Joanne E. Curran, John Blangero

School of Medicine Publications

Background: Cognitive impairment is a key feature of psychiatric illness, making cognition an important tool for exploring of the genetics of illness risk. It remains unclear which measures should be prioritized in pleiotropy-guided research. Here, we generate profiles of genetic overlap between psychotic and affective disorders and cognitive measures in Caucasian and Hispanic groups.

Methods: Data were from 4 samples of extended pedigrees (N = 3046). Coefficient of relationship analyses were used to estimate genetic overlap between illness risk and cognitive ability. Results were meta-analyzed.

Results: Psychosis was characterized by cognitive impairments on all measures with a generalized profile of …

Frontotemporal Dementias In Latin America: History, Epidemiology, Genetics, And Clinical Research, Jorge J. Llibre-Guerra, Maria Isabel Behrens, Mirna Lie Hosogi, Lucia Montero, Teresa Torralva, Nilton Custodio, Erika Mariana Longoria-Ibarrola, Margarita Giraldo-Chica, David Aguillón, Gladys E. Maestre

School of Medicine Publications

Introduction: The historical development, frequency, and impact of frontotemporal dementia (FTD) are less clear in Latin America than in high-income countries. Although there is a growing number of dementia studies in Latin America, little is known collectively about FTD prevalence studies by country, clinical heterogeneity, risk factors, and genetics in Latin American countries.

Methods: A systematic review was completed, aimed at identifying the frequency, clinical heterogeneity, and genetics studies of FTD in Latin American populations. The search strategies used a combination of standardized terms for FTD and related disorders. In addition, at least one author per Latin American country summarized …

Whole Genome Sequence Analysis Of Platelet Traits In The Nhlbi Trans-Omics For Precision Medicine Initiative, Amarise Little, Yao Hu, Quan Sun, Deepti Jain, Jai G. Broome, Ming-Huei Chen, Florian Thibord, Caitlin Mchugh, John Blangero, Joanne E. Curran

School of Medicine Publications

Platelets play a key role in thrombosis and hemostasis. Platelet count (PLT) and mean platelet volume (MPV) are highly heritable quantitative traits, with hundreds of genetic signals previously identified, mostly in European ancestry populations. We here utilize whole genome sequencing from NHLBI's Trans-Omics for Precision Medicine Initiative (TOPMed) in a large multi-ethnic sample to further explore common and rare variation contributing to PLT (n = 61 200) and MPV (n = 23 485). We identified and replicated secondary signals at MPL (rs532784633) and PECAM1 (rs73345162), both more common in African ancestry populations. We also observed rare variation in Mendelian platelet …

Hemorrhagic Stroke Outcomes Of Kapsr Patients With Co-Morbid Diabetes And Alzheimer’S Disease, Amanda L. Trout, Christopher J. Mclouth, Patrick Kitzman, Michael R. Dobbs, Lisa Bellamy, Kelley Elkins, Justin F. Fraser

School of Medicine Publications

Background: Vascular risk factors, such as diabetes mellitus (DM), are associated with poorer outcomes following many neurodegenerative diseases, including hemorrhagic stroke and Alzheimer’s disease (AD). Combined AD and DM co-morbidities are associated with an increased risk of hemorrhagic stroke and increased Medicare costs. Therefore, we hypothesized that patients with DM in combination with AD, termed DM/AD, would have increased hemorrhagic stroke severity.

Methods: Kentucky Appalachian Stroke Registry (KApSR) is a database of demographic and clinical data from patients that live in Appalachia, a distinct region with increased health disparities and stroke severity. Inpatients with a primary indication of hemorrhagic stroke …

Normal-Tension Glaucomatous Optic Neuropathy Is Related To Blood Pressure Variability In The Maracaibo Aging Study, Jesus D. Melgarejo, Gladys E. Maestre, Luis J. Mena, Joseph H. Lee, Michele Petitto, Carlos A. Chavez, Gustavo Calmon, Egle Silva, Lutgarde Thijs, Lama A. Al-Aswad

School of Medicine Publications

Hypoperfusion of the optic nerve might be involved in the pathogenesis of normal-tension glaucomatous optic neuropathy (GON). Mean arterial pressure (MAP) drives ocular perfusion, but no previous studies have addressed the risk of GON in relation to blood pressure (BP) variability, independent of BP level. In a cross-sectional study, 93 residents of Maracaibo, Venezuela, underwent optical coherence tomography, visual field assessments and 24-h ambulatory BP monitoring between 2011 and 2016. We investigated the association of normal-tension GON with or without visual field defects with reading-to reading variability of 24-h MAP, as captured by variability independent of the MAP level (VIMmap). …

An In-Vivo 1h-Mrs Short-Echo Time Technique At 7t: Quantification Of Metabolites In Chronic Multiple Sclerosis And Neuromyelitis Optica Brain Lesions And Normal Appearing Brain Tissue, George Tackley, Yazhuo Kong, Rachel Minne, Silvia Messina, Anderson M. Winkler, Ana Cavey, Rosie Everett, Gabriele C. Deluca, Andrew Weir, Matthew Craner

School of Medicine Publications

Highlights

• NAAG likely contributes to the total NAA differences between multiple sclerosis lesion and normal appearing brain tissue.

• myo-Inositol was not shown to be different between chronic AQP4Ab-NMOSD brain lesions and normal appearing brain tissue.

• An optimised MRS methodology is described, using 7T field strength and correcting for tissue T2 water relaxion differences.

• 7-tesla MRS profiles of chronic brain lesions and normal appearing white matter are presented for MS and AQP4Ab-NMOSD.

Abstract

Magnetic Resonance Spectroscopy (MRS) allows for the non-invasive quantification of neurochemicals and has the potential to differentiate between the pathologically distinct diseases, multiple sclerosis (MS) and …

Amygdala Functional Connectivity And Negative Reactive Temperament At Age 4 Months, Courtney A. Filippi, Sanjana Ravi, Maya Bracy, Anderson M. Winkler, Chad Sylvester, Daniel Samuel Pine, Nathan A. Fox

School of Medicine Publications

Objective

Infant amygdalaconnectivity correlates with maternal reports of infant temperament characterized by novelty-evoked distress and avoidance. However, no studies have examined how human infant amygdala connectivity relates to direct observations of novelty-evoked distress. This study examined the link between amygdala connectivity and infant novelty-evoked distress using direct observation of temperament.

Method

Novelty-evoked distress was assessed at 4 months of age (N = 90) using a standardized reactivity assessment and parent report. Within 3 weeks of assessment, resting-state functional magnetic resonance imaging was collected in a subset of infants (n = 34). Using a whole-brain voxelwise approach, amygdala connectivity associated …

Emergence Of Cationic Polyamine Dendrimersomes: Design, Stimuli Sensitivity And Potential Biomedical Applications, Partha Laskar, Christine Dufès

School of Medicine Publications

For decades, self-assembled lipid vesicles have been widely used in clinics as nanoscale delivery systems for various biomedical applications, including treatment of various diseases. Due to their core–shell architecture and versatile nature, they have been successfully used as carriers for the delivery of a wide range of therapeutic cargos, including drugs and nucleic acids, in cancer treatment. Recently, surface-modified polyamine dendrimer-based vesicles, or dendrimersomes, have emerged as promising alternatives to lipid vesicles for various biomedical applications, due to their ease of synthesis, non-immunogenicity, stability in circulation and lower size polydispersity. This mini-review provides an overview of the recent advances resulting …

Bilingual Problem-Solving Training For Caregivers Of Adults With Dementia: A Randomized, Factorial-Design Protocol For The Cades Trial, Shannon B. Juengst, Charlene Supnet, Chung Lin (Novelle) Kew, Valeria Silva, Marlene Vega, Gang Han, Brendan Kelley, Matthew Lee Smith, Gladys E. Maestre

School of Medicine Publications

Objective: Caregivers of individuals with Alzheimer's disease and related dementias (ADRD) often experience debilitating caregiver burden and emotional distress. To address these negative emotional consequences of caregiving, we will test and refine a strategy training intervention - Problem-Solving Training (PST) - that promotes self-efficacy and reduces caregiver burden and depressive symptoms. Previous research supports efficacy of PST; however, we do not know exactly how many PST sessions are needed or if post-training "boosters" are required to maintain PST benefits. Additionally, we translated and culturally-adapted PST into "Descubriendo Soluciones Juntos" (DSJ), our novel intervention for Spanish-speaking caregivers.

Method: In this 2 …

Circulating Fatty Acids Associated With Advanced Liver Fibrosis And Hepatocellular Carcinoma In South Texas Hispanics, Jingjing Jiao, Suet-Ying Kwan, Caroline M. Sabotta, Honami Tanaka, Lucas Veillon, Marc O. Warmoes, Philip L. Lorenzi, Ying Wang, Peng Wei, Jose Luis Almeda, Joseph B. Mccormick, Susan P. Fisher-Hoch

School of Medicine Publications

Background: Hispanics in South Texas have high rates of hepatocellular carcinoma (HCC) and nonalcoholic fatty liver disease (NAFLD). Liver fibrosis severity is the strongest predictive factor of NAFLD progression to HCC. We examined the association between free fatty acids (FA) and advanced liver fibrosis or HCC in this population.

Methods: We quantified 45 FAs in plasma of 116 subjects of the Cameron County Hispanic Cohort, 15 Hispanics with HCC, and 56 first/second-degree relatives of Hispanics with HCC. Liver fibrosis was assessed by FibroScan.

Results: Advanced liver fibrosis was significantly associated with low expression of very long chain (VLC) saturated FAs …

Urinary Proteomics Combined With Home Blood Pressure Telemonitoring For Health Care Reform Trial: Rational And Protocol, Lutgarde Thijs, Kei Asayama, Gladys E. Maestre, Tine W. Hansen, Luk Buyse, Dong-Mei Wei, Jesus D. Melgarejo, Jana Brguljan-Hitij, Hao-Min Cheng, Fabio De Souza

School of Medicine Publications

Background: Hypertension and diabetes cause chronic kidney disease (CKD) and diastolic left ventricular dysfunction (DVD) as forerunners of disability and death. Home blood pressure telemonitoring (HTM) and urinary peptidomic profiling (UPP) are technologies enabling prevention.

Methods: UPRIGHT-HTM (Urinary Proteomics Combined with Home Blood Pressure Telemonitoring for Health Care Reform [NCT04299529]) is an investigator-initiated 5-year clinical trial with patient-centred design, which will randomise 1148 patients to be recruited in Europe, sub-Saharan Africa and South America. During the whole study, HTM data will be collected and freely accessible for patients and caregivers. The UPP, measured at enrolment only, will be …

Multivariate Analysis Of 1.5 Million People Identifies Genetic Associations With Traits Related To Self-Regulation And Addiction, Richard Karlsson Linnér, Travis T. Mallard, Peter B. Barr, Sandra Sanchez-Roige, James W. Madole, Morgan N. Driver, Holly E. Poore, Ronald De Vlaming, Andrew D. Grotzinger, Mark Z. Kos

School of Medicine Publications

Behaviors and disorders related to self-regulation, such as substance use, antisocial behavior and attention-deficit/hyperactivity disorder, are collectively referred to as externalizing and have shared genetic liability. We applied a multivariate approach that leverages genetic correlations among externalizing traits for genome-wide association analyses. By pooling data from ~1.5 million people, our approach is statistically more powerful than single-trait analyses and identifies more than 500 genetic loci. The loci were enriched for genes expressed in the brain and related to nervous system development. A polygenic score constructed from our results predicts a range of behavioral and medical outcomes that were not part …