Recent Research Articles from UNTHSC

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

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Novel Investigation of the Deep Band of the Lateral Plantar Aponeurosis and Its Relationship With the Lateral Plantar Nerve.

Thu, 08/08/2019 - 07:31
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Novel Investigation of the Deep Band of the Lateral Plantar Aponeurosis and Its Relationship With the Lateral Plantar Nerve.

Foot Ankle Int. 2019 Aug 06;:1071100719864352

Authors: Beck CM, Dickerson AR, Kadado KJ, Cohen ZA, Blair SE, Motley TA, Holcomb JC, Fisher CL

Abstract
BACKGROUND: We describe a thick fascial band arising from the medial aspect of the lateral plantar aponeurosis diving deep into the forefoot crossing over a branch of the lateral plantar nerve. Because a review of current literature resulted in limited and outdated sources, we sought to first determine the frequency of this fascial band and the location where it crosses the lateral plantar nerve and, second, discuss the clinical applications these anatomical findings could have.
METHODS: 50 pairs of cadaveric feet (n = 100) were dissected to investigate for presence of the fascial band and its interaction with the lateral plantar nerve. Images were taken of each foot with the fascial band. ImageJ was used to take 2 measurements assessing the relationship of the tuberosity of the base of the fifth metatarsal to where the nerve crossed deep to the fascial band.
RESULTS: Overall, 38% of the feet possessed the fascial band. It was found unilaterally in 10 pairs and bilaterally in 14 pairs. On average, the point at which the lateral plantar nerve passed deep to the fascial band was 2.0 cm medial and 1.7 cm anterior to the tuberosity of the base of the fifth metatarsal.
CONCLUSION: When present, the deep band of the lateral plantar aponeurosis (PA) was consistently found to be crossing the lateral plantar nerve. The discovery of the location where this most commonly occurs has not been previously reported and adds an interesting dimension that elevates an anatomical study to one that has clinical potential.
CLINICAL RELEVANCE: The established target zone gives a precise location for where the relationship between the deep band of the lateral PA and the lateral plantar nerve exists when evaluating the foot. The target zone provides a potential springboard for future investigations concerning said relationship clinically.

PMID: 31387386 [PubMed - as supplied by publisher]

Soft robotic devices for hand rehabilitation and assistance: a narrative review.

Thu, 08/08/2019 - 07:31
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Soft robotic devices for hand rehabilitation and assistance: a narrative review.

J Neuroeng Rehabil. 2018 02 17;15(1):9

Authors: Chu CY, Patterson RM

Abstract
INTRODUCTION: The debilitating effects on hand function from a number of a neurologic disorders has given rise to the development of rehabilitative robotic devices aimed at restoring hand function in these patients. To combat the shortcomings of previous traditional robotics, soft robotics are rapidly emerging as an alternative due to their inherent safety, less complex designs, and increased potential for portability and efficacy. While several groups have begun designing devices, there are few devices that have progressed enough to provide clinical evidence of their design's therapeutic abilities. Therefore, a global review of devices that have been previously attempted could facilitate the development of new and improved devices in the next step towards obtaining clinical proof of the rehabilitative effects of soft robotics in hand dysfunction.
METHODS: A literature search was performed in SportDiscus, Pubmed, Scopus, and Web of Science for articles related to the design of soft robotic devices for hand rehabilitation. A framework of the key design elements of the devices was developed to ease the comparison of the various approaches to building them. This framework includes an analysis of the trends in portability, safety features, user intent detection methods, actuation systems, total DOF, number of independent actuators, device weight, evaluation metrics, and modes of rehabilitation.
RESULTS: In this study, a total of 62 articles representing 44 unique devices were identified and summarized according to the framework we developed to compare different design aspects. By far, the most common type of device was that which used a pneumatic actuator to guide finger flexion/extension. However, the remainder of our framework elements yielded more heterogeneous results. Consequently, those results are summarized and the advantages and disadvantages of many design choices as well as their rationales were highlighted.
CONCLUSION: The past 3 years has seen a rapid increase in the development of soft robotic devices for hand rehabilitative applications. These mostly preclinical research prototypes display a wide range of technical solutions which have been highlighted in the framework developed in this analysis. More work needs to be done in actuator design, safety, and implementation in order for these devices to progress to clinical trials. It is our goal that this review will guide future developers through the various design considerations in order to develop better devices for patients with hand impairments.

PMID: 29454392 [PubMed - indexed for MEDLINE]

Impact of an electronic medium delivery of warfarin education in a low income, minority outpatient population: a pilot intervention study.

Wed, 08/07/2019 - 07:22
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Impact of an electronic medium delivery of warfarin education in a low income, minority outpatient population: a pilot intervention study.

BMC Public Health. 2019 Aug 05;19(1):1050

Authors: Heinrich K, Sanchez K, Hui C, Talabi K, Perry M, Qin H, Nguyen H, Tatachar A

Abstract
BACKGROUND: Warfarin is classified as a high-alert medication for ambulatory healthcare and safe guards for high-alert medications are necessary, including the practice of mandatory patient education. The high cost of hospitalizations related to adverse events combined with the average bleeding event rate of 7-8% in spite of routine patient education, suggests the importance of new approaches to standardized health education on warfarin. We sought to evaluate the impact of a warfarin educational video using an electronic tablet on patient knowledge and to determine patients' satisfaction with the use of an electronic tablet for educational purposes in outpatient clinics serving a low income, minority population.
METHODS: A warfarin educational video delivered on an electronic tablet (iPad) was delivered at two pharmacist-managed anticoagulation clinics to uninsured patients whose annual income is equal or less than two hundred percent below the poverty level were offered. Patients (n = 18) completed a pre-video and post-video knowledge test on warfarin before and after viewing the warfarin educational video on an electronic tablet and a follow-up test to measure the retention of knowledge and a patient satisfaction survey at 60 days. The primary outcome was change in knowledge test scores. Other outcome measures included adherence rates, adverse events, time in therapeutic INR range, and patient-reported satisfaction scores.
RESULTS: The majority of patients were uninsured men taking warfarin for atrial fibrillation (n = 5). The median scores at post-video knowledge test and follow-up knowledge test were significantly higher than that for the pre-knowledge test (12 (11-12) vs. 10(8-11), p < 0.001). The study group had a 'time in therapeutic INR' range of 56.3%, a rate of adverse events of 24.5%, and a self-reported adherence rate to warfarin of 94.1%. The majority of patients also had positive responses to the patient satisfaction survey.
CONCLUSIONS: Patient education delivered via iPad to facilitate knowledge of medication can serve as a useful tool for educating patients about warfarin and warfarin therapy. Use of an electronic medium may be a unique way to provide standard medication education to patients.
TRIAL REGISTRATION: The study was retrospectively registered with: NCT03650777 ; 9/18/18.

PMID: 31382942 [PubMed - in process]

Tyrosine Hydroxylase Inhibition in Substantia Nigra Decreases Movement Frequency.

Wed, 08/07/2019 - 07:22
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Tyrosine Hydroxylase Inhibition in Substantia Nigra Decreases Movement Frequency.

Mol Neurobiol. 2019 Apr;56(4):2728-2740

Authors: Salvatore MF, McInnis TR, Cantu MA, Apple DM, Pruett BS

Abstract
Reduced movement frequency or physical activity (bradykinesia) occurs with high prevalence in the elderly. However, loss of striatal tyrosine hydroxylase (TH) in aging humans, non-human primates, or rodents does not reach the ~ 80% loss threshold associated with bradykinesia onset in Parkinson's disease. Moderate striatal dopamine (DA) loss, either following TH inhibition or decreased TH expression, may not affect movement frequency. In contrast, moderate DA or TH loss in the substantia nigra (SN), as occurs in aging, is of similar magnitude (~ 40%) to nigral TH loss at bradykinesia onset in Parkinson's disease. In aged rats, increased TH expression and DA in SN alone increases movement frequency, suggesting aging-related TH and DA loss in the SN contributes to aging-related bradykinesia or decreased physical activity. To test this hypothesis, the SN was targeted with bilateral guide cannula in young (6 months old) rats, in a within-subjects design, to evaluate the impact of nigral TH inhibition on movement frequency and speed. The TH inhibitor, α-methyl-p-tyrosine (AMPT) reduced nigral DA (~ 40%) 45-150 min following infusion, without affecting DA in striatum, nucleus accumbens, or adjacent ventral tegmental area. Locomotor activity in the open-field was recorded up to 3 h following nigral saline or AMPT infusion in each test subject. During the period of nigra-specific DA reduction, movement frequency, but not movement speed, was significantly decreased. These results indicate that DA or TH loss in the SN, as observed in aging, contributes as a central mechanism of reduced movement frequency.

PMID: 30056575 [PubMed - in process]

Evaluation of mitogenome sequence concordance, heteroplasmy detection, and haplogrouping in a worldwide lineage study using the Precision ID mtDNA Whole Genome Panel.

Tue, 08/06/2019 - 07:14

Evaluation of mitogenome sequence concordance, heteroplasmy detection, and haplogrouping in a worldwide lineage study using the Precision ID mtDNA Whole Genome Panel.

Forensic Sci Int Genet. 2019 Jul 23;42:244-251

Authors: Strobl C, Churchill Cihlar J, Lagacé R, Wootton S, Roth C, Huber N, Schnaller L, Zimmermann B, Huber G, Lay Hong S, Moura-Neto R, Silva R, Alshamali F, Souto L, Anslinger K, Egyed B, Jankova-Ajanovska R, Casas-Vargas A, Usaquén W, Silva D, Barletta-Carrillo C, Tineo DH, Vullo C, Würzner R, Xavier C, Gusmão L, Niederstätter H, Bodner M, Budowle B, Parson W

Abstract
The emergence of Massively Parallel Sequencing technologies enabled the analysis of full mitochondrial (mt)DNA sequences from forensically relevant samples that have, so far, only been typed in the control region or its hypervariable segments. In this study, we evaluated the performance of a commercially available multiplex-PCR-based assay, the Precision ID mtDNA Whole Genome Panel (Thermo Fisher Scientific), for the amplification and sequencing of the entire mitochondrial genome (mitogenome) from even degraded forensic specimens. For this purpose, more than 500 samples from 24 different populations were selected to cover the vast majority of established superhaplogroups. These are known to harbor different signature sequence motifs corresponding to their phylogenetic background that could have an effect on primer binding and, thus, could limit a broad application of this molecular genetic tool. The selected samples derived from various forensically relevant tissue sources and were DNA extracted using different methods. We evaluated sequence concordance and heteroplasmy detection and compared the findings to conventional Sanger sequencing as well as an orthogonal MPS platform. We discuss advantages and limitations of this approach with respect to forensic genetic workflow and analytical requirements.

PMID: 31382159 [PubMed - as supplied by publisher]

Characterization of the Neurochemical and Behavioral Effects of Solriamfetol (JZP-110), a Selective Dopamine and Norepinephrine Reuptake Inhibitor.

Tue, 08/06/2019 - 07:14
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Characterization of the Neurochemical and Behavioral Effects of Solriamfetol (JZP-110), a Selective Dopamine and Norepinephrine Reuptake Inhibitor.

J Pharmacol Exp Ther. 2018 08;366(2):367-376

Authors: Baladi MG, Forster MJ, Gatch MB, Mailman RB, Hyman DL, Carter LP, Janowsky A

Abstract
Excessive sleepiness (ES) is associated with several sleep disorders, including narcolepsy and obstructive sleep apnea (OSA). A role for monoaminergic systems in treating these conditions is highlighted by the clinical use of US Food and Drug Administration-approved drugs that act on these systems, such as dextroamphetamine, methylphenidate, modafinil, and armodafinil. Solriamfetol (JZP-110) is a wake-promoting agent that is currently being evaluated to treat ES in patients with narcolepsy or OSA. Clinical and preclinical data suggest that the wake-promoting effects of solriamfetol differ from medications such as modafinil and amphetamine. The goal of the current studies was to characterize the mechanism of action of solriamfetol at monoamine transporters using in vitro and in vivo assays. Results indicate that solriamfetol has dual reuptake inhibition activity at dopamine (DA; IC50 = 2.9 μM) and norepinephrine (NE; IC50 = 4.4 μM) transporters, and this activity is associated in vivo with increased extracellular concentration of DA and NE as measured by microdialysis. Solriamfetol has negligible functional activity at the serotonin transporter (IC50 > 100 μM). Moreover, the wake-promoting effects of solriamfetol are probably owing to activity at DA and NE transporters rather than other neurotransmitter systems, such as histamine or orexin. The dual activity of solriamfetol at DA and NE transporters and the lack of significant monoamine-releasing properties of solriamfetol might explain the differences in the in vivo effects of solriamfetol compared with modafinil or amphetamine. Taken together, these data suggest that solriamfetol may offer an important advancement in the treatment of ES in patients with narcolepsy or OSA.

PMID: 29891587 [PubMed - indexed for MEDLINE]

Safety and Effectiveness of CyPass Supraciliary Micro-Stent in Primary Open-Angle Glaucoma: Five-Year Results from the COMPASS XT Study.

Mon, 08/05/2019 - 07:04
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Safety and Effectiveness of CyPass Supraciliary Micro-Stent in Primary Open-Angle Glaucoma: Five-Year Results from the COMPASS XT Study.

Am J Ophthalmol. 2019 Aug 01;:

Authors: Reiss G, Clifford B, Vold S, He J, Hamilton C, Dickerson J, Lane S

Abstract
PURPOSE: To characterize the long-term (up to five years) safety and effectiveness of the supraciliary micro-stent implanted at the time of phacoemulsification in eyes with coexisting open-angle glaucoma (OAG) and visually significant cataract DESIGN: Three-year safety extension of a two-year randomized clinical trial.
METHODS: Patients from the multicenter COMPASS trial who underwent micro-stent implantation plus phacoemulsification (n=215) or phacoemulsification alone (n=67) were evaluated 36, 48, and 60 months postoperatively. The primary outcome measure was the occurrence of sight-threatening ocular serious adverse events. Evaluations at each time point included best-corrected visual acuity (BCVA), anterior and posterior segment examinations, tonometry, gonioscopy, pachymetry, perimetry, specular microscopy, and assessment of adverse events.
RESULTS: Three sight-threatening ocular adverse events occurred, two in the micro-stent and one in the control group, but none of these events was related to the micro-stent device. Ocular adverse events were of similar frequencies in both groups, the most common of which were BCVA loss >2 lines compared with best BCVA in COMPASS and worsening of visual field mean defect (VFMD) >2.5 dB compared with Month 24. Changes from baseline in mean BCVA, clinical examinations, pachymetry and VFMD were similar in the two groups. At 60 months, a higher proportion of subjects in the micro-stent (46%; 95% CI 38.9% -53.2%) than in the control (32.1%; 95% CI 19.9%-46.3%) group achieved ≥ 20% IOP reduction without using hypotensive medication.
CONCLUSIONS: Few sight-threatening serious ocular adverse events occurred following micro-stent implantation, and clinical evidence of corneal decompensation was minimal.

PMID: 31377287 [PubMed - as supplied by publisher]

Corneal Endothelial Cell Loss and Morphometric Changes 5 Years after Phacoemulsification With or Without CyPass Micro-Stent.

Mon, 08/05/2019 - 07:04
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Corneal Endothelial Cell Loss and Morphometric Changes 5 Years after Phacoemulsification With or Without CyPass Micro-Stent.

Am J Ophthalmol. 2019 Aug 01;:

Authors: Lass JH, Benetz BA, He J, Hamilton C, Von Tress M, Dickerson J, Lane S

Abstract
PURPOSE: To characterize long-term corneal endothelial cell changes following phacoemulsification with or without supraciliary micro-stent (CyPass, Alcon, Ft. Worth, TX) implantation in eyes with open-angle glaucoma (OAG) and visually-significant cataract.
DESIGN: Three-year safety extension of a two-year randomized clinical trial.
METHODS: Patients from the multicenter COMPASS trial who underwent micro-stent implantation plus phacoemulsification (n=282) or phacoemulsification alone (n=67) were analyzed post-hoc. Specular microscopy was used to assess endothelial cell loss (ECL), including changes from baseline in endothelial cell density (ECD), coefficient of variation, and percentage of hexagonal cells,.
RESULTS: Preoperative ECD was similar in the microstent (2432.6 cells/mm2 [95% CI: 2382.8, 2482.4]) and control (2434.5 cells/mm2 [95% CI: 2356.5, 2512.4]) groups. ECL at Months 48 and 60 was greater in the micro-stent than in the control group. At Month 60, mean percent changes in ECD were -20.4% (95% CI: -23.5%, -17.5%) in the micro-stent and -10.1% (95% CI: -13.9%, -6.3%) in the control group. No statistically significant between-group changes from baseline in cellular morphology were observed. Nine adverse events were possibly related to ECL, including three eyes with transient focal corneal edema and four eyes that required micro-stent trimming due to protrusion.
CONCLUSIONS: In eyes with OAG, ECL following phacoemulsification is acute and stabilizes after 3 months, whereas ECL following phacoemulsification plus micro-stent implantation proceeds for at least 5 years. Clinical findings associated with ECL in these eyes were uncommon (3.3% of implanted eyes), suggesting that ECL is generally a subclinical phenomenon.

PMID: 31377278 [PubMed - as supplied by publisher]

Correction: Systemically administered peptain-1 inhibits retinal ganglion cell death in animal models: implications for neuroprotection in glaucoma.

Sat, 08/03/2019 - 06:46
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Correction: Systemically administered peptain-1 inhibits retinal ganglion cell death in animal models: implications for neuroprotection in glaucoma.

Cell Death Discov. 2019;5:122

Authors: Stankowska DL, Nam MH, Nahomi RB, Chaphalkar RM, Nandi SK, Fudala R, Krishnamoorthy RR, Nagaraj RH

Abstract
[This corrects the article DOI: 10.1038/s41420-019-0194-2.].

PMID: 31372242 [PubMed - in process]

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]

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