Recent Research Articles from UNTHSC

Recent research articles indexed in PubMed from authors affiliated with the UNT Health Science Center.

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Updated: 1 hour 4 min ago

Daily fruit and vegetable consumption and diabetes status in middle-aged females in the general US population.

Fri, 08/02/2019 - 06:37
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Daily fruit and vegetable consumption and diabetes status in middle-aged females in the general US population.

SAGE Open Med. 2019;7:2050312119865116

Authors: Julius JK, Fernandez CK, Grafa AC, Rosa PM, Hartos JL

Abstract
Objectives: Fruit and vegetable consumption may impact development of diabetes, but limited research has addressed whether daily consumption of fruits and vegetables differs by those with and without diabetes, especially within high-risk groups. Thus, the purpose of this study was to determine whether daily fruit and vegetable consumption differs by diabetes status in middle-aged females in the general US population.
Methods: This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance System data for females ages 45-64 years old in Arizona (n = 2609), Florida (n = 3768), Georgia (n = 1018), and Texas (n = 2092). Multiple logistic regression analysis by state assessed the relationship between the daily consumption of fruit (fruit, 100% fruit juice) and vegetables (green leafy or lettuce salad, potatoes, other vegetables) and diabetes status, while controlling for health status, health behaviors, demographic factors, and socioeconomic status.
Results: Across states, relatively similar proportions of participants with and without diabetes reported daily fruit consumption (with: 58%-63%; without: 61%-68%) and daily vegetable consumption (with: 58%-63%; without: 61%-68%). The results of adjusted analyses indicated that daily fruit and vegetable consumption did not differ by diabetes status across states.
Conclusion: Across states, daily fruit and vegetable consumption did not differ by diabetes status in middle-aged females. In the primary care setting, providers should educate all females ages 45-64 on the importance of eating fresh fruits and vegetables and may consider sharing information about flavonoid-rich fruit and vegetable consumption for diabetes.

PMID: 31367380 [PubMed]

Diversity in the Era of Precision Medicine - From Bench to Bedside Implementation.

Fri, 08/02/2019 - 06:37
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Diversity in the Era of Precision Medicine - From Bench to Bedside Implementation.

Ethn Dis. 2019;29(3):517-524

Authors: Mamun A, Nsiah NY, Srinivasan M, Chaturvedula A, Basha R, Cross D, Jones HP, Nandy K, Vishwanatha JK

Abstract
Recent evidence shows how patients' unique genetic makeup can affect disease outcomes and the increasing availability of targeted treatments promises a future in health care, whereby treatments will be tailored to individual needs. This article reports on the topics discussed at the 13th Annual Texas Conference on Health Disparities, organized by the Texas Center for Health Disparities at the University of North Texas Health Science Center; the meeting focused on the theme, "Diversity in the Era of Precision Medicine" and was held during June 2018 in Fort Worth, Texas. The primary focus of this conference, which brought together clinical and basic scientists, was on the inclusion of diversity in precision medicine to bridge the gap in health disparities. Here, we present the highlights of the conference that include the potential application of precision medicine at the population level, the effects of precision medicine and direct-to-consumer testing on health disparities, genetic basis of health disparities, pharmacogenomics, and strategies to enhance participation of under-represented populations in precision medicine. Furthermore, we conclude with recommendations for future implementation, including how to mitigate disparities in genomics services and enhance participation of diverse groups in clinical trials.

PMID: 31367173 [PubMed - in process]

Complementing T Regulatory Cells to Combat Hypertension.

Fri, 08/02/2019 - 06:37
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Complementing T Regulatory Cells to Combat Hypertension.

Circ Res. 2018 03 30;122(7):911-912

Authors: Mathis KW

PMID: 29599271 [PubMed - indexed for MEDLINE]

Structural and functional insights into the bona fide catalytic state of Streptococcus pyogenes Cas9 HNH nuclease domain.

Wed, 07/31/2019 - 06:17
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Structural and functional insights into the bona fide catalytic state of Streptococcus pyogenes Cas9 HNH nuclease domain.

Elife. 2019 Jul 30;8:

Authors: Zuo Z, Zolekar A, Babu K, Lin VJ, Hayatshahi HS, Rajan R, Wang YC, Liu J

Abstract
The CRISPR-associated endonuclease Cas9 from Streptococcus pyogenes (SpyCas9), along with a programmable single-guide RNA (sgRNA), has been exploited as a significant genome-editing tool. Despite the recent advances in determining the SpyCas9 structures and DNA cleavage mechanism, the cleavage-competent conformation of the catalytic HNH nuclease domain of SpyCas9 remains largely elusive and debatable. By integrating computational and experimental approaches, we unveiled and validated the activated Cas9-sgRNA-DNA ternary complex in which the HNH domain is neatly poised for cleaving the target DNA strand. In this catalysis model, the HNH employs the catalytic triad of D839-H840-N863 for cleavage catalysis, rather than previously implicated D839-H840-D861, D839-H840-N854, D837-D839-H840, or D839-H840-D861-N863. Our study contributes critical information to defining the catalytic conformation of the HNH domain and advances the knowledge about the conformational activation underlying Cas9-mediated DNA cleavage.

PMID: 31361218 [PubMed - as supplied by publisher]

Assessment of Demographic and Socio-Behavioral Factors on Adherence to HIV Pre-Exposure Prophylaxis Using a Markov Modeling Approach.

Tue, 07/30/2019 - 06:00

Assessment of Demographic and Socio-Behavioral Factors on Adherence to HIV Pre-Exposure Prophylaxis Using a Markov Modeling Approach.

Front Pharmacol. 2019;10:785

Authors: Mallayasamy S, Chaturvedula A, Fossler MJ, Sale ME, Hendrix CW, Haberer JE

Abstract
Purpose: Adherence is important for the effectiveness of human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP). The objective of the current work is to assess the impact of multiple demographic and socio-behavioral factors on the adherence to tenofovir-based PrEP among HIV serodiscordant couples in East Africa using Markov mixed-effects modeling approach. Methods: The Partners Demonstration Project was a prospective, open-label, implementation science-driven study of HIV PrEP among heterosexual HIV serodiscordant couples in Kenya and Uganda. The uninfected partner received oral PrEP according to the "bridge to antiretroviral therapy [ART]" strategy (i.e., until the infected partner had been on ART for ≥6 months). Adherence was monitored electronically; demographic and socio-behavioral data were collected during study visits. Analyzed data reflect 12 months of follow-up per participant. A two-state, first-order, discrete time Markov model was developed with longitudinal adherence data characterized by "dose taking (1)" and "dose missing (0)." Covariate effects were linearly added in the logit domain of transition probability parameters (P01 and P10) in the model. The full covariate model was initially developed, followed by backward elimination process to reduce the model. All significant covariates reported by a prior primary statistical analysis of the same data were included in the full covariate model. Results: The model included data from 920 participants, who were predominantly male (65%). Significant covariates associated with higher adherence were 25 years or older [odds ratio (OR) for P10, 0.61], female sex (OR for P10, 0.67), participant wanting the relationship with the partner to succeed (OR for P10, 0.79; OR for P01, 1.45), and sex with partner either with 100% or <100% condom use compared to those reported no sex (OR for P10, 0.84; OR for P01, 1.21). Significant covariates associated with lower adherence were partner on ART >6 months (OR for P01, 0.86; OR for P10, 1.34), subject in the study for >6 months (OR for P01, 0.8; OR for P10, 1.25), and problematic alcohol use (OR for P01, 0.63; OR for P10, 1.16). Conclusion: The developed Markov model provides a mechanistic understanding of relationship between demographic, socio-behavioral covariates, and PrEP adherence, by indicating the pattern of adherence influenced by each factor over time. Such data can be used for further intervention development to promote PrEP adherence.

PMID: 31354496 [PubMed]

Examining the Influence of Religious and Spiritual Beliefs on HPV Vaccine Uptake Among College Women.

Mon, 07/29/2019 - 05:54

Examining the Influence of Religious and Spiritual Beliefs on HPV Vaccine Uptake Among College Women.

J Relig Health. 2019 Jul 27;:

Authors: Best AL, Thompson EL, Adamu AM, Logan R, Delva J, Thomas M, Cunningham E, Vamos C, Daley E

Abstract
The human papillomavirus (HPV) vaccine is an effective mechanism to prevent HPV-associated cancers; however, uptake is low among women aged 18-26. Religiosity/spirituality is associated with sexual health decision-making. This study examined the role of religious/spiritual beliefs on HPV vaccination among college women (N = 307) using logistic regression and mediation analyses. Findings indicate that sexual activity is the main factor associated with HPV vaccination; and sexual activity fully mediates the relationship between religious/spiritual beliefs and HPV vaccination. Health promotion efforts should highlight the importance of HPV vaccination regardless of current sexual activity and may benefit from partnerships with religious/spiritual organizations.

PMID: 31352665 [PubMed - as supplied by publisher]

Hybrid Compound SA-2 is Neuroprotective in Animal Models of Retinal Ganglion Cell Death.

Sun, 07/28/2019 - 05:47
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Hybrid Compound SA-2 is Neuroprotective in Animal Models of Retinal Ganglion Cell Death.

Invest Ophthalmol Vis Sci. 2019 Jul 01;60(8):3064-3073

Authors: Stankowska DL, Dibas A, Li L, Zhang W, Krishnamoorthy VR, Chavala SH, Nguyen TP, Yorio T, Ellis DZ, Acharya S

Abstract
Purpose: Determine the toxicity, bioavailability in the retina, and neuroprotective effects of a hybrid antioxidant-nitric oxide donor compound SA-2 against oxidative stress-induced retinal ganglion cell (RGC) death in neurodegenerative animal models.
Methods: Optic nerve crush (ONC) and ischemia reperfusion (I/R) injury models were used in 12-week-old C57BL/6J mice to mimic conditions of glaucomatous neurodegeneration. Mice were treated intravitreally with either vehicle or SA-2. Retinal thickness was measured by spectral-domain optical coherence tomography (SD-OCT). The electroretinogram and pattern ERG (PERG) were used to assess retinal function. RGC survival was determined by counting RBPMS-positive RGCs and immunohistochemical analysis of superoxide dismutase 1 (SOD1) levels was carried out in the retina sections. Concentrations of SA-2 in the retina and choroid were determined using HPLC and MS. In addition, the direct effect of SA-2 treatment on RGC survival was assessed in ex vivo rat retinal explants under hypoxic (0.5% O2) conditions.
Results: Compound SA-2 did not induce any appreciable change in retinal thickness, or in a- or b-wave amplitude in naive animals. SA-2 was found to be bioavailable in both the retina and choroid after a single intravitreal injection (2% wt/vol). An increase in SOD1 levels in the retina of mice subjected to ONC and SA-2 treatment, suggests an enhancement in antioxidant activity. SA-2 provided significant (P < 0.05) RGC protection in all three of the tested RGC injury models in rodents. PERG amplitudes were significantly higher in both I/R and ONC mouse eyes following SA-2 treatment (P ≤ 0.001) in comparison with the vehicle and control groups.
Conclusions: Compound SA-2 was effective in preventing RGC death and loss of function in three different rodent models of acute RGC injury: ONC, I/R, and hypoxia.

PMID: 31348824 [PubMed - in process]

Examining the effect of weight conscious drinking on binge drinking frequency among college freshmen.

Sun, 07/28/2019 - 05:47
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Examining the effect of weight conscious drinking on binge drinking frequency among college freshmen.

J Am Coll Health. 2019 Jul 26;:1-8

Authors: Castañeda G, Colby SE, Barnett TE, Olfert MD, Zhou W, Leite WL, El Zein A, Mathews AE

Abstract
Objective: To examine the effect of weight-conscious drinking and compensatory behavior temporality on binge drinking frequency of college freshmen. Participants: Freshmen (n = 1149) from eight US universities, Fall 2015. Methods: Participants completed the Compensatory Eating Behaviors in Response to Alcohol Consumption Scale and Alcohol Use Disorders Identification Test-Consumption. Structural equation modeling was used to model the effect of weight-conscious drinking constructs on binge drinking frequency. Results: Bulimia, Dietary Restraint and Exercise, Restriction, proactive Alcohol Effects, during Alcohol Effects, and proactive Dietary Restraint and Exercise factors significantly predicted binge drinking frequency. Conclusion: Weight-conscious drinking among this cohort of college students comprises temporal factors significantly associated with binge drinking frequency. Relationships between Bulimia, Dietary Restraint and Exercise, and Restriction compensatory behaviors and binge drinking should be considered in interventions to address binge drinking among college students.

PMID: 31348733 [PubMed - as supplied by publisher]

Androgens modulate chronic intermittent hypoxia effects on brain and behavior.

Sun, 07/28/2019 - 05:47
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Androgens modulate chronic intermittent hypoxia effects on brain and behavior.

Horm Behav. 2018 11;106:62-73

Authors: Snyder B, Duong P, Trieu J, Cunningham RL

Abstract
Sleep apnea is associated with testosterone dysregulation as well as increased risk of developing neurodegenerative diseases, such as Alzheimer's disease (AD) and Parkinson's disease (PD). A rodent model of the hypoxemic events of sleep apnea, chronic intermittent hypoxia (CIH), has been previously documented to impair cognitive function and elevate oxidative stress in male rats, while simultaneously decreasing testosterone. Therefore, androgens may modulate neuronal function under CIH. To investigate the role of androgens during CIH, male rats were assigned to one of four hormone groups: 1) gonadally intact, 2) gonadectomized (GDX), 3) GDX + testosterone (T) supplemented, or 4) GDX + dihydrotestosterone (DHT) supplemented. Each group was exposed to either normal room air or CIH exposure for one week, followed by memory and motor task assessments. Brain regions associated with AD and PD (entorhinal cortex, dorsal hippocampus, and substantia nigra) were examined for oxidative stress and inflammatory markers, key characteristics of AD and PD. Gonadally intact rats exhibited elevated oxidative stress due to CIH, but no significant memory and motor impairments. GDX increased memory impairments, regardless of CIH exposure. T preserved memory function and prevented detrimental CIH-induced changes. In contrast, DHT was not protective, as evidenced by exacerbated oxidative stress under CIH. Further, CIH induced significant spatial memory impairment in rats administered DHT. These results indicate androgens can have both neuroprotective and detrimental effects under CIH, which may have clinical relevance for men with untreated sleep apnea.

PMID: 30268884 [PubMed - indexed for MEDLINE]

Mutation of CEP72 Gene May Predispose Patients to Hepatotoxicity.

Fri, 07/26/2019 - 05:23

Mutation of CEP72 Gene May Predispose Patients to Hepatotoxicity.

J Pediatr Hematol Oncol. 2019 Jul 23;:

Authors: Pham R, Hoeft A, Roberts C, Hamby T, Maloy C, Ray A

Abstract
Drug toxicities during treatment of acute lymphoblastic leukemia play a pivotal role in influencing the outcome as certain toxicities may impair treatment compliance. Polymorphisms in CEP72 have been linked to increased incidence of vincristine-induced toxicities, namely peripheral neuropathy. We hypothesize that polymorphisms in the same gene may increase a patient's risk of developing hepatotoxicity when receiving potentially hepatotoxic agents during chemotherapy. This report describes hepatotoxicity that first developed during consolidation in a patient homozygous for the CEP72 risk alleles. Bilirubin levels normalized following dose reduction of 6-mercaptopurine. The patient continues to tolerate maintenance therapy at a reduced dose of 6-mercaptopurine.

PMID: 31343483 [PubMed - as supplied by publisher]

Antiretroviral Adherence Level Necessary for HIV Viral Suppression using Real-World Data.

Fri, 07/26/2019 - 05:23

Antiretroviral Adherence Level Necessary for HIV Viral Suppression using Real-World Data.

J Acquir Immune Defic Syndr. 2019 Jul 18;:

Authors: Byrd KK, Hou JG, Hazen R, Kirkham H, Suzuki S, Clay PG, Bush T, Camp NM, Weidle PJ, Delpino A, Patient-centered HIV Care Model Team

Abstract
BACKGROUND: A benchmark of near-perfect adherence (≥95%) to antiretroviral therapy (ART) is often cited as necessary for HIV viral suppression. However, given newer, more effective ART medications the threshold for viral suppression might be lower. We estimated the minimum ART adherence level necessary to achieve viral suppression.
SETTINGS: The Patient-centered HIV Care Model demonstration project.
METHODS: Adherence to ART was calculated using the Proportion of Days Covered (PDC) measure for the 365-day period prior to each viral load test result, and grouped into five categories (<50%, 50%-<80%, 80%-<85%, 85%-<90%, and ≥90%). Binomial regression analyses were conducted to determine factors associated with viral suppression (HIV RNA <200 copies/mL); demographics, PDC category and ART regimen type were explanatory variables. Generalized estimating equations with an exchangeable working correlation matrix accounted for correlation within subjects. In addition, probit regression models were used to estimate adherence levels required to achieve viral suppression in 90% of HIV viral load tests.
RESULTS: The adjusted odds of viral suppression did not differ between persons with an adherence level of 80%-<85% or 85%-<90% and those with an adherence level of ≥90%. Additionally, the overall estimated adherence level necessary to achieve viral suppression in 90% of viral load tests was 82% and varied by regimen type; integrase inhibitor- and non-nucleoside reverse transcriptase inhibitor-based regimens achieved 90% viral suppression with adherence levels of 75% and 78%, respectively.
CONCLUSIONS: The ART adherence level necessary to reach HIV viral suppression may be lower than previously thought and may be regimen dependent.

PMID: 31343455 [PubMed - as supplied by publisher]

A blood-based biomarker panel indicates IL-10 and IL-12/23p40 are jointly associated as predictors of β-amyloid load in an AD cohort.

Thu, 07/25/2019 - 05:15
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A blood-based biomarker panel indicates IL-10 and IL-12/23p40 are jointly associated as predictors of β-amyloid load in an AD cohort.

Sci Rep. 2017 10 25;7(1):14057

Authors: Pedrini S, Gupta VB, Hone E, Doecke J, O'Bryant S, James I, Bush AI, Rowe CC, Villemagne VL, Ames D, Masters CL, Martins RN, AIBL Research Group

Abstract
Alzheimer's Disease (AD) is the most common form of dementia, characterised by extracellular amyloid deposition as plaques and intracellular neurofibrillary tangles of tau protein. As no current clinical test can diagnose individuals at risk of developing AD, the aim of this project is to evaluate a blood-based biomarker panel to identify individuals who carry this risk. We analysed the levels of 22 biomarkers in clinically classified healthy controls (HC), mild cognitive impairment (MCI) and Alzheimer's participants from the well characterised Australian Imaging, Biomarker and Lifestyle (AIBL) study of aging. High levels of IL-10 and IL-12/23p40 were significantly associated with amyloid deposition in HC, suggesting that these two biomarkers might be used to detect at risk individuals. Additionally, other biomarkers (Eotaxin-3, Leptin, PYY) exhibited altered levels in AD participants possessing the APOE ε4 allele. This suggests that the physiology of some potential biomarkers may be altered in AD due to the APOE ε4 allele, a major risk factor for AD. Taken together, these data highlight several potential biomarkers that can be used in a blood-based panel to allow earlier identification of individuals at risk of developing AD and/or early stage AD for which current therapies may be more beneficial.

PMID: 29070909 [PubMed - indexed for MEDLINE]

Management of Bilateral Ureteral Obstruction After Transplantation of Pediatric En Bloc Kidneys, a Case Report and Review of Available Literature.

Wed, 07/24/2019 - 11:08
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Management of Bilateral Ureteral Obstruction After Transplantation of Pediatric En Bloc Kidneys, a Case Report and Review of Available Literature.

Transplant Direct. 2019 Jul;5(7):e466

Authors: Allam SR, Iyamu I, Pan G, Martinez E, Sankarapandian B, Fayek S, Rofaiel G

PMID: 31334340 [PubMed]

Brain Delivery of Thyrotropin-Releasing Hormone via a Novel Prodrug Approach.

Sun, 07/21/2019 - 10:33
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Brain Delivery of Thyrotropin-Releasing Hormone via a Novel Prodrug Approach.

Pharmaceutics. 2019 Jul 18;11(7):

Authors: Prokai-Tatrai K, De La Cruz DL, Nguyen V, Ross BP, Toth I, Prokai L

Abstract
Using thyrotropin-releasing hormone (TRH) as a model, we explored whether synergistic combination of lipoamino acid(s) and a linker cleaved by prolyl oligopeptidase (POP) can be used as a promoiety for prodrug design for the preferential brain delivery of the peptide. A representative prodrug based on this design principle was synthesized, and its membrane affinity and in vitro metabolic stability, with or without the presence of a POP inhibitor, were studied. The in vivo formation of TRH from the prodrug construct was probed by utilizing the antidepressant effect of the peptide, as well as its ability to increase acetylcholine (ACh) synthesis and release. We found that the prototype prodrug showed excellent membrane affinity and greatly increased metabolic stability in mouse blood and brain homogenate compared to the parent peptide, yet a POP inhibitor completely prevented prodrug metabolism in brain homogenate. In vivo, administration of the prodrug triggered antidepressant-like effect, and microdialysis sampling showed greatly increased ACh release that was also antagonized upon a POP inhibitor treatment. Altogether, the obtained promising exploratory data warrant further investigations on the utility of the prodrug approach introduced here for brain-enhanced delivery of small peptides with neurotherapeutic potential.

PMID: 31323784 [PubMed]

Enhanced interrogation of degraded DNA from human skeletal remains: Increased genetic data recovery using the expanded CODIS loci, multiple sex determination markers, and consensus testing.

Sat, 07/20/2019 - 07:19
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Enhanced interrogation of degraded DNA from human skeletal remains: Increased genetic data recovery using the expanded CODIS loci, multiple sex determination markers, and consensus testing.

Anthropol Anz. 2019 Jul 19;:

Authors: Ambers A, Zeng X, Votrubova J, Vanek D

Abstract
Skeletal remains are among the most difficult types of samples encountered in forensic DNA casework and historical investigations due to prolonged exposure to environmental insults. DNA extracted from bone often is degraded, in low quantities, and contains co-purified inhibitors from the surrounding soil and/or burial vault material. When sexually dimorphic skeletal elements are not recovered, determining the sex of a decedent can be challenging. With unidentified human skeletal remains, genetic data often are evaluated in concert with anthropological analyses, as well as other types of metadata, to improve confidence in making associations or for positive identifications. This study evaluated a multi-faceted molecular genetic approach to increasing the amount of data that can be recovered from degraded skeletal remains. Results demonstrate that using a newer-generation multiplex (GlobalFiler™) with an expanded set of highly discriminatory DNA markers - combined with co-amplification of three different sex-determining loci, one additional PCR cycle, and testing multiple cuttings from the same bone or multiple regions within a skeleton - can improve reliability and accuracy in skeletal remains identifications by providing data concordance.

PMID: 31322643 [PubMed - as supplied by publisher]

Linkage, recombination, and mutation rate analyses of 19 X-chromosomal STR loci in Chinese Southern Han pedigrees.

Fri, 07/19/2019 - 07:10
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Linkage, recombination, and mutation rate analyses of 19 X-chromosomal STR loci in Chinese Southern Han pedigrees.

Int J Legal Med. 2019 Jul 17;:

Authors: Yang X, Chen Y, Zeng X, Chen L, Liu C, Liu H, Xu Q, Budowle B, Liu C

Abstract
From Southern Han Chinese samples, we analyzed 19 X-STR markers for linkage, linkage disequilibrium (LD), and mutation rate. The data were collected from two- and three-generation Southern Han Chinese families. These data suggested that both linkage and linkage disequilibrium should be considered while calculating likelihood ratios with X-STR markers in relationship tests. The linkage disequilibrium of these 19 X-STR markers was calculated in our previous research study that was conducted on Southern Han Chinese population. In this study, the recombination fractions between pairs of markers and those obtained from the second-generation Rutgers combined linkage-physical map of the human genome were compared. The observed differences indicated that recombination was not homogeneous along the X chromosome. Therefore, we evaluated the effect on likelihood calculations by referring to haplotype frequencies obtained from allele distributions rather than haplotype counts of Southern Han Chinese population.

PMID: 31317316 [PubMed - as supplied by publisher]

Age- and body weight-dependent association between sleep duration and hypertension in US adults: findings from the 2014-2017 National Health Interview Survey.

Tue, 07/16/2019 - 06:36

Age- and body weight-dependent association between sleep duration and hypertension in US adults: findings from the 2014-2017 National Health Interview Survey.

Sleep Health. 2019 Jul 10;:

Authors: Okunowo O, Orimoloye HT, Bakre SA, Njesada NS, Solomon A

Abstract
OBJECTIVES: Previous studies have confirmed the relationship between sleep duration and hypertension. However, there are unanswered questions on how this relationship is affected by age and body mass index (BMI). This study examined the association between sleep duration and hypertension in US adults and evaluated interaction by age and BMI.
DESIGN: Nationwide, population-based, cross-sectional survey.
SETTING: National Health Interview Survey (NHIS), 2014 to 2017.
PARTICIPANTS: Adult participants aged 18 years or older (n = 130,139).
MEASUREMENTS: Sleep duration, hypertension, age, and BMI status were assessed based on self-reported survey responses. Odds ratios (ORs) and 95% confidence intervals (CIs) for sleep duration-hypertension associations were estimated by logistic regression, adjusting for potential confounders.
RESULTS: The proportion of participants who reported sleeping less than 7 hours (short sleepers) and more than 9 hours (long sleepers) per night was 32% and 4%, respectively. In adjusted analysis, short sleepers had higher odds of hypertension (OR: 1.54, 95% CI: 1.10-2.17). Although not statistically significant, long sleepers also had higher odds of hypertension (OR: 1.28, 95% CI: 0.80-2.05). In stratified analyses by age and BMI, the association between short sleep and hypertension was especially notable in adults aged 18-44 years (OR: 1.25, 95% CI: 1.16-1.35) and adults with normal weight (OR: 1.21, 95% CI: 1.11-1.33).
CONCLUSIONS: Short sleep is associated with increased odds of hypertension among American adults and this relationship is dependent on age and BMI.

PMID: 31302069 [PubMed - as supplied by publisher]

Applying Organizational Health Literacy to Maternal and Child Health.

Tue, 07/16/2019 - 06:36
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Applying Organizational Health Literacy to Maternal and Child Health.

Matern Child Health J. 2019 May;23(5):597-602

Authors: Vamos CA, Thompson EL, Griner SB, Liggett LG, Daley EM

Abstract
Purpose Describe the development of an innovative teaching activity that applies organizational health literacy to maternal and child health (MCH). Description Health literacy is a strong predictor of health behavior and outcomes. While the study of health literacy has traditionally been confined to skills and capacities of individuals, the significant role of the social and physical environmental contexts in facilitating or hindering one's ability to obtain, understand, and make informed decision about their health has been recognized. MCH organizations play a critical role in influencing health literacy across system levels. This teaching activity aims to equip students with knowledge and skills needed to foster organizational health literacy. Assessment The teaching activity is assembled within a toolkit which includes the following: (1) instructor lesson plan; (2) interactive PowerPoint presentation with instructor notes; (3) field assignment description; (4) health literacy attribute assessment worksheets; and (5) grading rubric. The teaching tool was pilot tested by a student research team member to assess the educational value and assignment logistics, resulting in minor edits (i.e., addition of interviewer probes, and option of a group project-format to permit triangulation of multiple organizational interviews). Conclusion The field of MCH is expanding in complexity, and the demands of health systems on women, children, and families must be mediated by conscious efforts within organizations. Through teaching the importance and function of organizational health literacy to students in MCH, educators can prepare an emerging workforce to improve health literacy, and ultimately the quality of healthcare for women, children, and families.

PMID: 30600522 [PubMed - indexed for MEDLINE]

Progressive disclosure cases: The design and evaluation of use in multiple therapeutics courses.

Tue, 07/16/2019 - 06:36
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Progressive disclosure cases: The design and evaluation of use in multiple therapeutics courses.

Curr Pharm Teach Learn. 2018 06;10(6):723-729

Authors: Howard ML, Gaviola ML

Abstract
BACKGROUND AND PURPOSE: Case-based learning is used frequently throughout pharmacy education. Although beneficial, stand-alone cases may result in segmented learning that does not simulate realistic longitudinal patient care. We report the development, implementation, and evaluation of a longitudinal progressive disclosure case surrounding a single patient spanning two different therapeutics courses.
EDUCATIONAL ACTIVITY AND SETTING: A patient case was developed surrounding topics in two third professional year therapeutics courses occurring sequentially in the same semester. Changes to the patient's status were provided to students longitudinally via "disclosures." Students were assessed via quizzes and written assessment and plans. Students completed four perceptions of confidence surveys via a four-point Likert Scale. Surveys included questions surrounding confidence in areas of the pharmacists' patient care process (PPCP) before and after courses utilizing the progressive disclosure case. Case assessment grades were used to evaluate the impact on student performance on course examinations. Students also completed a survey on final perceptions of the activity.
FINDINGS: Seventy students were enrolled in the two courses participating in the progressive disclosure case and there were 50 (71.4%) matched, completed surveys completed for analysis. Significant improvements were seen in several questions surrounding confidence in the areas of the PPCP between the beginning and conclusion of courses that contained the progressive disclosure case. No correlation between case activity grades and examination performance was found.
DISCUSSION AND CONCLUSION: Overall, student confidence in patient care skills associated with information collection, assessment, plan design, and monitoring improved with the use of progressive disclosure cases within two sequential therapeutics courses.

PMID: 30025772 [PubMed - indexed for MEDLINE]

Treatments and Preventative Measures for Trauma-Induced Heterotopic Ossification: A Review.

Tue, 07/16/2019 - 06:36
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Treatments and Preventative Measures for Trauma-Induced Heterotopic Ossification: A Review.

Clin Transl Sci. 2018 07;11(4):365-370

Authors: Juarez JK, Wenke JC, Rivera JC

PMID: 29697199 [PubMed - indexed for MEDLINE]

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