Medicine and Health Sciences Commons^™

Microglia In Post-Mortem Hippocampal Brain Tissue Of Male And Female Neonates After Hie, Kassandra M. Pulido, Angela N. Viaene, Amelia J. Eisch, Danielle G. Barber

Research Colloquium

Background: Hypoxic-ischemic encephalopathy (HIE) is the second-leading cause of neonatal morbidity and mortality worldwide. There are sex differences in the pathophysiology of HIE, particularly in microglia, which are critical in the immune response. Prior work highlights microglial aggregation in the hippocampus of human infants as a marker for HIE, but it is unknown whether this differs by sex.

Aim: We compare the microglial response in post-mortem hippocampal tissue from male and female neonates diagnosed with HIE vs. Controls who expired from other causes.

Methods: Using a retrospective cohort design, we reviewed medical records of neonates with hippocampal tissue in the …

Houston, We Have A Problem: Diagnostic Difficulties In The Aids Patient With Tuberculosis Infection, Hector D. Preciado, Maria E. Torres, Muhammad A. Siddiqui, Liza Salloum, Lee Gelpi, Jose E. Campo Maldonado

Research Colloquium

Background: Tuberculosis (TB) is the leading cause of infectious death worldwide with 1.5 million deaths annually and nearly 1/4th of the world’s population (1.7 billion) infected with latent tuberculosis infection (LTBI) in 2014. Its diagnosis conventionally relies on tuberculin skin testing (TST), and Interferon-Gamma Release Assay (IGRA) which relies on the production of Interferon Gamma (IFN-y) in response to Mycobacterium tuberculosis (MTB) specific antigens. IGRA is a useful tool for detecting latent TB disease, and can be used as an adjunct for the diagnosis of active TB cases. Increases in IFN-y levels might support the diagnosis of a new TB …

Comorbidity Of Mood Disorders And Upper Airway Resistance Syndrome: A Case Report, Abhishekh Pokhrel, Alexa Lissete Zarate, Alcides Amador

Research Colloquium

Background: The comorbidity of mood disorders and Upper Airway Resistance Syndrome (UARS) presents a significant challenge, especially in pediatric populations. UARS, characterized by increased upper airway resistance during sleep, often leads to disrupted sleep and daytime symptoms such as fatigue and cognitive impairment. Studies estimate UARS affects 15-30% of patients undergoing polysomnography for suspected sleep-disordered breathing. Mood & Anxiety Disorders are prevalent in patients with sleep-disordered breathing, with higher rates than in the general population.

Case Presentation: 16-year-old female, with psychiatric history of Bipolar II Disorder current episode depressed, ADHD, and Other Specified Anxiety Disorder presents for a follow-up. Since …

Keeping People Out Of The Emergency Room: Will Education Of Clinic Patients On Intra-Facility Resources Decrease Unnecessary Er Visits?, Angelo Joseph G. Pascasio, Juan C. Lopez Alvarenga, Carolina Gomez

Research Colloquium

Emergency rooms are often used as a safety net for patients unable to see their primary care doctor. Past studies have shown that urgent care centers and extended clinic hours proximal to ERs can decrease the financial and resource burden placed on hospitals. By increasing hours of the facilities associated with Knapp Medical Center, including the UTRGV-Knapp Family Medicine clinic in Mercedes and the Mid-Valley Urgent Care, it is predicted that less emergent cases can be handled in the outpatient setting thus giving patients peace of mind that their needs will be met rather than going to an emergency room. …

Navigating Economic Constraints In The Management Of Hfref - A Case Study Of An Uninsured Patient, Vamsikalayan Borra, Diana Othon Martinez, Barbara Malaga-Espinoza, Martha Solis, Nestor Gerardo Astorga, Prakhar Jain, Cesar Gutierrez

Research Colloquium

Background: Heart failure (HF) is a significant health concern, resulting in more than 500,000 new cases, 1.9 million hospitalizations, and a cost of $31 billion in the US. HF treatment aims to decrease hospitalizations, improve quality of life, and extend survival through GDMT. Social determinants of health (SoDH) have been associated with poor outcomes and higher readmission rates in HF patients. Addressing SoDH is crucial for achieving health equity and improving overall population health outcomes, per the CMS Framework for Health Equity 2022-2023. In the Rio Grande Valley, immigration is a common SoDH. It is estimated that 100,000 people are …

Heart Failure In The Setting Of Cocaine Abuse… Cause Or Progression? A Case Report., Diana Othon Martinez, Kashif Ali, Elimar Gonzalez Morales, Barbara Malaga-Espinoza, Jian Garcia, Cesar Gutierrez

Research Colloquium

Background: 1 out of 3 substance abuse emergency department visits are related to cocaine. In the US (United States), >5.5 million people consume cocaine. Hospitalizations for heart failure have a similar amount, with 5.7 million. Cocaine's cardiovascular adverse effects arise secondary to sympathetic nervous system stimulation, including decreased myocardial oxygen supply, coronary vasoconstriction, acceleration of atherosclerosis and thrombus formation. Studies have demonstrated contradictory information regarding cardiac anatomical changes (dilation/hypertrophy) secondary to chronic cocaine use. Cocaine cessation and guideline- directed medical therapy (GDMT) for HF are mainstay management. We present a case of a patient with HF and cocaine abuse.

Case …

Increasing Referrals To Local Resources For The Treatment Of Aud By Increasing Audit-C Usage By Increasing Awareness Of Aud Through Use Of Educational Materials ​, David Ortiz, Gerardo Munoz Monaco

Research Colloquium

Background: One in nine people will suffer from alcohol use disorder, if of legal drinking age. One in nine of our patients might suffer from AUD. Among those suffering from AUD, only 1.6% were found to be treated with evidence-based medications for treatment of AUD. Underdiagnosing may be a reality.

Methods: Evaluate physicians-in-training knowledge regarding AUD at time zero and after 3 months after an educational presentation is giving containing information on AUD diagnosis, treatment, and available local resources. This repeated cross-sectional data analysis aims to increase screening using the AUDIT-C tool, as well as referral/utilization to local resources. Patients …

Unmasking Atrial Flutter In An Elderly Patient With Complex Cardiac History: A Case Report On Diagnostic Challenges And Effective Management, Cesar F. Ortega, Roy Kondapavuluru, Nida Asif, Johanne Chaglasian, Fatimah Bello

Research Colloquium

Introduction: About 200,000 new patients each year are affected by atrial flutter. It is an abnormal cardiac rhythm characterized by rapid regular atrial depolarizations at a rate of approximately 300 beats/minute and a regular ventricle rate of about 150 beats/minute. It can go undiagnosed because it is often asymptomatic and usually diagnosed when patients are being evaluated for other health issues. This case report emphasizes the importance of thorough evaluation of symptoms suggestive of arrhythmia even if they occur intermittently.

Case Presentation: An 81-year-old lady with history of coronary artery disease, status post coronary artery bypass graft, valvular heart disease …

Comprehensive Diagnosis And Management Of Renal Tubular Acidosis Type 1: A Case Report, Cesar F. Ortega, Roy Kondapavuluru, Johanne Chaglasian, Nida Asif, Fatimah Bello

Research Colloquium

Introduction: Renal tubular acidosis type 1 (RTA type 1), also known as distal renal tubular acidosis, is a disorder characterized by the inability of the distal nephron to secrete hydrogen ions and reabsorb bicarbonate (HCO3-) in the presence of metabolic acidosis, leading to a chronic state of metabolic acidosis with a normal anion gap. This disorder has an estimated prevalence of 0.46- 1.60 per 10,000 people. RTA type 1 can often go undiagnosed in hospital settings due to its nonspecific presentation, such as weakness, fatigue or cramps, causing physicians to focus on empirically correcting low electrolyte levels rather than investigating …

Cocaine-Induced Left Ventricular Apical Aneurysm: A Case Report, Kennedy Olson, William Reckley, Roy Kondapavuluru, Oliverio J. Abarca Guzman, Yareli Durazo, Andres Suarez Parraga

Research Colloquium

Introduction: Cocaine, a significant source of morbidity and mortality in the United States, is one of the most frequently consumed recreational substances worldwide. Long-term use of cocaine is known to cause irreversible cardiotoxic effects, such as structural damage to the heart, electrical irregularities, diastolic heart failure, and myocardial infarctions. Cocaine-induced cardiomyopathy is associated with concentric ventricular hypertrophy alongside decreased ventricular compliance. However, recent research has hypothesized that patients who already have symptomatic cardiovascular disease are at an increased risk of developing an impairment in systolic ventricular function following chronic cocaine use, which is hypothesized to be caused by either direct …

Unraveling Dilated Cardiomyopathy Linked To An Enigmatic Mybpc3 Variant, Khiem D. Ngo, Carlos Alejos, Jennifer Rojas, Sobia Memon, James Stone

Research Colloquium

Background: Non-ischemic cardiomyopathy (NICM), can arise from various causes, including hemodynamic pathology, infections, immunologic abnormalities, toxic injuries, and genetic factors. Determining the prevalence of NICM is challenging due to varying definitions and diagnostic criteria, selection bias, and geographic variation. MYBPC3 is the primary gene known to cause restrictive cardiomyopathy, dilated cardiomyopathy, and left ventricular non-compaction. This gene encodes cMyBP-C, a structural protein of the heart muscle that interacts with actin, myosin, and titin to maintain sarcomeric integrity. While loss-of-function mutations are common, MYBPC3 missense variants of uncertain significance (VUS) are also prevalent. Individuals with MYBPC3 missense VUS predicted to disrupt …

Recovery Time Of Diabetic Patients Undergoing Arthroplasties: A Literature Review, Joshua Nwose, Yolanda V. Gutierrez, Blake Martin, Robert H. Ablove

Research Colloquium

Introduction: Arthroplasties, especially on the hip and knee are one of the most common procedures undergone as people age. There are many different comorbidities that affect the success of a surgical intervention. We sought to review current literature to determine if diabetes had a significant impact on the outcome of a procedure compared to other comorbidities.

Methods: A survey across several databases including but not limited to Pubmed, NIH, Mayo Clinic, was performed. Each article was reviewed and assessed whether diabetes had a significant impact on the efficacy of arthroplasties.

Results: We identified 10 articles regarding the post-operative outcome …

Identifying Key Predictors Of Academic Achievement In A Longitudinal Medical Research Module., Anesu Karen Murambadoro, Juan C. Lopez-Alvarenga, Kevin Garcia Valdez, Kory Deshawn Punch, Natasha N. Quailes, Nina Mourao, Elias Arellano Villanueva, Tyler Torres, Nikhilesh Anand, Bharathi Shrikanth Gadad

Research Colloquium

Background: Research engagement among medical students is often hindered by perceived time constraints, lack of motivation, inadequate facilities, and insufficient supervisory guidance. Only 7% have published research papers. Project-based programs enhance research skills but frequently lack alignment between objectives, teaching methods, and evaluation. In the Rio Grande Valley, there is limited research on these issues. This study aims to analyze the performance of pre-clerkship students in a two-year longitudinal research course.

Aim: We hypothesize that core independent variables (InVar) such as attitudes toward research (R-ATR), cognition (BCRS), self-efficacy, and competency scores will improve throughout the longitudinal Research Module. These …

Evaluating Ai Language Models For Patient Queries On Total Knee Replacement (Tkr), Brianna Guillen, Anesu Karen Murambadoro, Victoria Elizondo, Matthew Hnatow, Michael Sander

Research Colloquium

Introduction: Within the past few years, large language models (LLMs) (ChatGPT, LLaMa 3, Microsoft Copilot) have increasingly become a resource that patients engage with to learn about health care procedures, including total knee replacement (TKR). Previous studies have analyzed the efficacy of large language models in providing accurate and relevant responses to questions about various procedures. Our study aims to evaluate the clarity, validity, and understandability of LLMs to patient questions about total knee replacement and assess the consistency of these models and their effectiveness in providing accurate, valid, and guideline-adherent information to patients.

Methods: We selected 30 frequently asked …

Euglycemic Diabetic Ketoacidosis Induced By Jardiance In A 37-Year-Old Female: A Case Report, Ivan Mogollon, Juan Gomez, Rodrigo Lema, Juan Calero, Juan Ortiz, Catherine Matos, Renzo Aller, Francisco Arias, Luis Salcedo

Research Colloquium

Background: Diabetic ketoacidosis (DKA) is a complication of diabetes, very common throughout the Rio Grande Valley region, can be life threatening and is characterized by hyperglycemia, ketonemia and metabolic acidosis. Nevertheless, euglycemic diabetic ketoacidosis (euglycemic DKA) is an atypical presentation in which patients show the classic signs of DKA but with normal or near-normal blood glucose levels. The use of sodium-glucose cotransporter 2 (SGLT2) inhibitors, such as Jardiance (empagliflozin), has been associated with an increased risk of euglycemic DKA. This case report describes a case of euglycemic DKA in a 37- year-old woman with type 2 diabetes mellitus who …

Unique Considerations In The Management Of Healthcare Among Fertile Women A Case Report On Chronic Myeloid Leukemia And Pregnancy, Hermione Yamyo Monie, Taha Al Hassan, Salomon Pardo Roca, Uchechi Ehiemua, Ramiro Leal

Research Colloquium

Background: With the overturning of Roe v. Wade, the management of women who are family planning has become more complex, highlighting the necessity for comprehensive and informed healthcare. This case report underscores the importance of holistic, interdisciplinary care for women with chronic conditions like Chronic Myeloid Leukemia (CML) who are planning for pregnancy. The novelty lies in the interplay between oncological treatment and reproductive health under current legal constraints.

Case Presentation: We present the case of a 32-year-old woman, G2P0010, with a history of CML and a previous spontaneous abortion. Initially believed to be in remission, she was started …

Multifactorial Pancreatitis In A Patient With Dyslipidemia And Diabetes, Potential Role Of Glyxambi: Case Report, Ivan Mogollon, Catherine Matos, Michelle Lopez, Juan Gomez, Juan Ortiz, Juan Calero, Rodrigo Lema

Research Colloquium

Background: Acute pancreatitis is an inflammatory condition of the pancreas that can arise from various etiologies such as alcohol consumption, gallstones, hypertriglyceridemia, and use of certain medications. Hypertriglyceridemia is a significant risk factor for pancreatitis, especially in patients with uncontrolled diabetes mellitus. Medications like dipeptidyl peptidase-4 (DPP-4) inhibitors have also been implicated in rare cases of pancreatitis. This report presents a complex case of multifactorial acute pancreatitis in a patient with diabetes mellitus and dyslipidemia suspected to be induced by the medication Glyxambi and hypertriglyceridemia.

Case Presentation: A 48-year-old male with known history of diabetes mellitus and dyslipidemia presented …

New Insights Into The Mechanisms Of Skeletal Muscle Atrophy In Copd, Justin D. Mills, Hiram L. Garcia, Alex Zuo

Research Colloquium

Background: In 2020, it was estimated that there were over 480 million cases of chronic obstructive pulmonary disease (COPD) worldwide. Up to 40% of COPD patients suffer from certain degrees of muscle atrophy. The severity of this muscle atrophy is normally correlated with an increased mortality rate among these patients. The goal of this study is to underline the causes of muscle atrophy/dysfunction in the COPD population and to investigate treatment options.

Methods: We conducted an extensive literature review using the PubMed database, mainly focusing on publications from 2013 to 2024. Our objective was to identify the biological mechanisms underlying …

Tc-Ptp-Mediated Epidermal Differentiation Protects Skin From Ultraviolet B Radiation, Smaran Marupudi, Jared Hensley, Lindsey Shim, Bilal B. B. Hafeez, Dae Joon Kim

Research Colloquium

Background: The fine balance of the inverse relationship between keratinocyte proliferation and differentiation is critical in maintaining epidermal homeostasis. The disruption of this balance is one of the characteristic features of skin cancer. Exposure to ultraviolet B (UVB) radiation disrupts signaling pathways involved in the maintenance of epidermal cell homeostasis, resulting in hyperplasia and skin cancer formation. One implicated signaling pathway involved in epidermal homeostasis is tyrosine phosphorylation signaling. T-cell protein tyrosine phosphatase (TC-PTP) is a tyrosine-specific intracellular non-receptor PTP and is ubiquitously expressed in embryonic and adult tissues including skin. Our previous studies showed that TC-PTP has been shown …

Recurrent Atrial Myxoma And Transient Ischemic Atack, Abdel Martinez Borrego, Benito Moran Herrera, Eduardo Flores

Research Colloquium

Background: Myxomas are the most common primary cardiac neoplasms and are predominantly located in the left atrium, accounting for approximately 80% of cases. Clinical manifestations can vary widely, ranging from asymptomatic to severe, with potential embolic or obstructive symptoms. Diagnosis is typically made through echocardiography, although CT and MRI can also be useful diagnostic tools. The primary treatment is surgical resection; however, long-term follow-up is essential due to the risk of recurrence, which may occur up to 10 years after the initial surgery.

Case presentation: A 54-year-old female patient with a history of a 5x3x2 cm left atrial …

Integrating Artificial Intelligence With Electrocardiograms: A New Era In Cardiac Care, Abdel Martinez Borrego, Eduardo Flores

Research Colloquium

Background: The integration of artificial intelligence with electrocardiography has significantly transformed contemporary medical practice, representing a major advancement in cardiac care. These algorithms have enhanced the detection of subtle ECG patterns, improving the diagnosis of conditions such as arrhythmias and providing a more accurate diagnostic environment. However, challenges such as data privacy, algorithm transparency, and clinical integration remain. AI holds substantial potential for improving diagnostic accuracy, with several FDA-approved devices now available in the market aimed at enhancing patient outcomes. Future efforts should focus on further validation, implementation, and research to fully realize AI's capabilities in this field.

Methods: This …

The Impact Of Electronic Messaging On Hiv In A Medically Underserved Population, Blake Martin, Smaran Marupudi, Justin Heckman, Russell Wiggins

Research Colloquium

Introduction: HIV in the United States has affected all types of demographics and has been growing by 50,000 new infections each year. Healthy people 2030 states that their objectives of both reducing new HIV cases and increasing knowledge of the disease has had little to no change. We intend to decrease both short-term incidence of HIV contracture and long-term incidence of disease progression to AIDS via utilization of an electronic health messaging and outreach system.

Methods: Individuals will be registered for text alerts at their next AHEC medical appointment. The practitioner, utilizing an HIV Risk Assessment Tool would ask high-risk …

Systematic Review And Meta-Analysis Of Total Elbow Arthroplasty In Outpatient Versus Inpatient Settings, Blake Martin, Yolanda V. Gutierrez, Joshua Nwose, Robert H. Ablove, Juan Lopez-Alvarenga

Research Colloquium

Introduction: Total joint arthroplasties (TJA), including total elbow arthroplasty (TEA), are growing in number, shifting towards a younger age group, and moving more towards the outpatient setting. We are conducting this study to summarize the current knowledge about the outcomes of TEA in outpatient versus inpatient settings to allow for the best possible care when performing this procedure. We believe that outpatient TEA will have better outcomes with lower complication rates compared to inpatient TEA.

Methods: We conducted a systematic review and meta-analysis using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) framework. Electronic database searches were performed …

Clearance Of Recalcitrant Prosthetic Fungal Infection Utilizing Administration Of Voriconazole Through Intra-Articular Catheters Of The Knee, Blake Martin, Matthew Hnatow, Emma Herrera

Research Colloquium

Background: Prosthetic joint infection is a high cost and high morbidity complication of total joint arthroplasty accounting for about 1-2% of all joint replacements. Rarely fungal infections may complicate treatment and lower the rate of clearance of infection with rates as low as 50% or less in the literature. Intra-articular antibiotics have drawn more interest recently and may be a promising intervention for challenging prosthetic joint infections. We present a novel case utilizing voriconazole via intra-articular catheters with successful clearance of a recalcitrant fungal prosthetic joint infection with 2 year follow up.

Case Presentation: A case study is presented in …

Ormeloxifene Suppresses Emt In Hepatocellular Carcinoma By Targeting Β-Catenin Signaling Pathway, Shabnam Malik, Mohammed Sikander, Daniel Zubieta, Anyssa Rodriguez, Murali Yallapu, Meena Jaggi, Subhash C. Chauhan

Research Colloquium

Background: Hepatocellular carcinoma (HCC) is one of the deadliest cancers, with a five-year survival rate. While Sorafenib (SRB) is the standard therapy, it is only effective in prolonging survival for some patients, emphasizing the urgent need for alternative treatment options. Resistance to apoptosis is a defining characteristic of cancer cells and a crucial factor in cancer recurrence and relapse. Although, anticancer potential of the FDA-approved compound Ormeloxifene (ORM), which has well-defined pharmacokinetic and pharmacodynamic properties, has been explored in a variety of cancers, its efficacy in HCC has remained unknown. Therefore, the purpose of this study was to investigate the …

Investigating The Determinants Of Frailty: The Intersection Of Genetics And Environment In Mexican Americans From South Texas, Natasha Garcia-Rodriguez, Vincent P. Diego, Marcio Almeida, Jacob Galan, Sandra Laston, Joanne E. Curran, Tom Howard, Eron Manusov, John Blangero, Sarah Williams-Blangero

Research Colloquium

Background: The projected worldwide population of people aged 65 and over is anticipated to hit 1.6 billion by 2050. Frailty, marked by increased susceptibility to adverse health outcomes, mortality, and decreased health-related quality of life (HrQoL), poses significant challenges to an aging population. The Frailty Index (FI), is the ratio of the number of accumulated health deficits to the total number of deficits considered, is used to predict frailty.

Methods: Utilizing data from the Mexican American Family Study, we investigated the heritability and gene-environment (GxE) interactions influencing frailty in 1,029 Mexican American participants. We calculated the FI using 34 variables, …

Inflammatory Breast Carcinoma In The Rio Grande Valley: A Case Report, Miguel A. Lopez, Maria Villegas, Thomas Davis

Research Colloquium

Inflammatory breast carcinoma (IBC) is a rare and aggressive subtype of invasive breast cancer found in a small percentage of patients in the United States.The Rio Grande Valley is a region of Texas with pockets of low socioeconomic status and increased rates of obesity, a large risk factor for IBC. The cutaneous presentation of IBC is a tender, erythematous patch or plaque that surrounds hair follicles (referred to as peau d’orange) and is frequently edematous. Diagnosis requires a high clinical index of suspicion supported by a thorough patient history and pathology consistent with invasive carcinoma. This case study discusses a …

Successful Typical And Atypical Atrial Flutter Ablation In A Patient With Systolic-Diastolic Heart Failure And A Recent Implantable Cardioverter Defibrillator: A Case Report, Jose J. Loayza Pintado, Michelle Lopez

Research Colloquium

Background: The prevalence of atrial fibrillation/flutter (AF) increases with the severity of chronic heart failure (HF) and is linked to worsened outcomes and higher mortality. Implantable cardiac devices, such as the implantable cardioverter-defibrillator (ICD), reduce mortality from ventricular arrhythmias in HF patients. Conversely, AF, which occurs in up to 20% of ICD patients, can limit the clinical effectiveness of ICDs. The impact of AF on prognosis, including inappropriate ICD therapy, remains debated. This case report aims to illustrate this sporadic occurrence and discuss the controversy surrounding AF's impact on the prognosis of ICD patients.

Case Presentation: A 63-year-old male …

Yb1 Modulates Sorafenib Sensitivity In Hepatocellular Carcinoma Cell Lines, Dennis Kwabiah, Yamile Abuchard Anaya, Ricardo Bracho Pequeno, Mohammed Shabir Hussain, Manish K. Tripathi

Research Colloquium

Background: Drug resistance is a leading cause of mortality in cancer, responsible for up to 90% of cancer-related deaths. Understanding the mechanisms behind drug resistance is crucial for enhancing the efficacy of cancer therapies. Hepatocellular carcinoma (HCC) is the most prevalent form of liver cancer and a major contributor to liver cancer-related fatalities. While early-stage HCC can often be cured with surgical interventions like liver transplantation or hepatectomy, advanced stages are challenging due to drug resistance. Sorafenib, an FDA-approved multi-tyrosine kinase inhibitor for treatment of advanced HCC, has shown limited effectiveness in prolonging overall survival in advanced HCC patients. …

Characterization Of Alzheimer's Disease In South Asians: Analysis Of Cardiovascular Disease Prevalence As A Risk Factor, Ramya Kunta, Luis A. Pena Marquez, Maria Sophia Z. Malbas, Astrid-Ines Foamkom, Ney Alliey Rodriguez

Research Colloquium

Background: Alzheimer’s Disease (AD), a growing public health issue affecting an estimated 6.7 million Americans, is characterized by a slow progressive decline in cognition. While there is extensive research focused on Non-Hispanic European populations, data is limited on underrepresented minorities, particularly South Asians. This study aims to analyze cardiovascular disease prevalence as a risk factor in relation to AD in South Asians.

Methods: The National Alzheimer’s Coordinating Center (NACC) Uniform Data Set was utilized for this study. The study sample consists of 47,165 participants, including 66 South Asian individuals, which represents 0.1% of the total population selected for the study. …