Recent Research Articles from UNTHSC

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

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NCBI: db=pubmed; Term="University of North Texas Health Science Center"[All Fields] OR "Univ. of North Texas Health Science Center"[All Fields] OR "UNT Health Science Center"[All Fields] OR "Osteopathic Research Center"[All Fields] OR "University of North Texas System College of Pharmacy"[All Fields] OR "UNT System College of Pharmacy"[All Fields] OR "College of Pharmacy, University of North Texas System"[All Fields]
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Modeling the Cost-Effectiveness of Interventions to Reduce Suicide Risk Among Hospital Emergency Department Patients.

Fri, 05/10/2019 - 06:35
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Modeling the Cost-Effectiveness of Interventions to Reduce Suicide Risk Among Hospital Emergency Department Patients.

Psychiatr Serv. 2018 01 01;69(1):23-31

Authors: Denchev P, Pearson JL, Allen MH, Claassen CA, Currier GW, Zatzick DF, Schoenbaum M

Abstract
OBJECTIVE: This study estimated the expected cost-effectiveness and population impact of outpatient interventions to reduce suicide risk among patients presenting to general hospital emergency departments (EDs), compared with usual care. Several such interventions have been found efficacious, but none is yet widespread, and the cost-effectiveness of population-based implementation is unknown.
METHODS: Modeled cost-effectiveness analysis compared three ED-initiated suicide prevention interventions previously found to be efficacious-follow-up via postcards or caring letters, follow-up via telephone outreach, and suicide-focused cognitive-behavioral therapy (CBT)-with usual care. Primary outcomes were treatment costs, suicides, and life-years saved, evaluated over the year after the index ED visit.
RESULTS: Compared with usual care, adding postcards improved outcomes and reduced costs. Adding telephone outreach and suicide-focused CBT, respectively, improved outcomes at a mean incremental cost of $4,300 and $18,800 per life-year saved, respectively. Monte Carlo simulation (1,000 repetitions) revealed the chance of incremental cost-effectiveness to be a certainty for all three interventions, assuming societal willingness to pay ≥$50,000 per life-year. These main findings were robust to various sensitivity analyses, including conservative assumptions about effect size and incremental costs. Population impact was limited by low sensitivity of detecting ED patients' suicide risk, and health care delivery inefficiencies.
CONCLUSIONS: The highly favorable cost-effectiveness found for each outpatient intervention provides a strong basis for widespread implementation of any or all of the interventions. The estimated population benefits of doing so would be enhanced by increasing the sensitivity of suicide risk detection among individuals presenting to general hospital EDs.

PMID: 28945181 [PubMed - indexed for MEDLINE]

Non-fluorescent filters for fluorescence detection with in-line geometry.

Thu, 05/09/2019 - 06:25
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Non-fluorescent filters for fluorescence detection with in-line geometry.

Methods Appl Fluoresc. 2019 May 08;:

Authors: Kimball J, Chavez J, Ceresa L, Shah S, Gryczynski I, Gryczynski Z

Abstract
Intrinsic emission from typical filters can unexpectedly contribute to the total measured signal in a fluorescence system. This emission becomes even more problematic for in-line geometry measurements where the excitation light can directly excite the emission filter. Potassium dichromate has minimal intrinsic fluorescence even with ultra-violet (UV) excitation. We show that a liquid sample can be tuned for its transmission properties by adding a base to the solution. This makes it attractive for use as an optical filter. In addition, when embedded in poly (vinyl alcohol) (PVA) film, potassium dichromate is even less fluorescent. These films can be cut and molded into practically any size or shape. Thus non-fluorescent, modular and cheap filters composed of potassium dichromate embedded in a PVA film is proposed to eliminate this unwanted emission and is suitable for a wide variety of devices and applications.

PMID: 31067513 [PubMed - as supplied by publisher]

A Didactic Community Pharmacy Course to Improve Pharmacy Students' Clinical Skills and Business Management Knowledge.

Thu, 05/09/2019 - 06:25
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A Didactic Community Pharmacy Course to Improve Pharmacy Students' Clinical Skills and Business Management Knowledge.

Am J Pharm Educ. 2019 Apr;83(3):6581

Authors: Bullock KC, Horne S

Abstract
Objective. To create, implement and evaluate a Doctor of Pharmacy (PharmD) course on clinical services in community pharmacy settings. Methods. A 2-credit hour elective course was offered to second- and third-year pharmacy (P2 and P3) students. The course was developed using integrated course design principles. Community pharmacists were featured prominently in the course. Student performance on quizzes was evaluated and compared between groups (2014 and 2015 cohort). A survey with a pretest posttest design was used to assess students' self-rated knowledge and self-efficacy. Results. Twenty students enrolled in the elective course and 18 students completed the pre/post survey. There was no difference in performance scores on each of the three quizzes between students in the 2014 and 2015 courses. There was a significant increase seen for knowledge of the majority of course competencies. Students indicated improvement in their confidence to perform a variety of clinical services after course completion. Conclusion. Participation in this elective course allowed students to improve their knowledge of community pharmacy practice competencies and increased their ability to deliver clinical services in community pharmacy settings.

PMID: 31065158 [PubMed - in process]

Levels of α-2 Macroglobulin in cognitively normal Mexican- Americans with Subjective Cognitive Decline: A HABLE Study.

Wed, 05/08/2019 - 06:19
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Levels of α-2 Macroglobulin in cognitively normal Mexican- Americans with Subjective Cognitive Decline: A HABLE Study.

Curr Neurobiol. 2019 Apr;10(1):22-25

Authors: Hall JR, Wiechmann AR, Johnson LA, Edwards ML, O'Bryant SE

Abstract
Background: The presence of Subjective Cognitive Decline (SCD) in the absence of objective change and the inflammatory biomarker Alpha 2 Macroglobulin (A2M) have both been implicated in preclinical Alzheimer's disease. Mexican Americans are population with high rates of cardiovascular and inflammatory disorders.
Objectives: The current study investigated the levels of A2M in cognitively normal Mexican Americans with and without complaints of cognitive decline.
Method: 293 (243 females, 50 males) community-based cognitively normal older Mexican Americans from the ongoing Health and Aging Brain among Latino Elders (HABLE) study were grouped based on subjective cognitive decline and blood samples were assayed by electrochemiluminescence to determine levels of A2M.
Results: Participants with SCD had significantly higher levels of A2M than those without SCD. Females with SCD had a significantly higher level of A2M.
Conclusions: Results suggest that higher levels of A2M, a marker of neuronal injury, may be involved in subtle changes in cognitive functioning recognizable to persons reporting SCD but too subtle to be objectively measured. Longitudinal research is needed to assess the impact of SDC and A2M in progression to MCI and dementia in Mexican Americans.

PMID: 31061568 [PubMed]

The Value of Home Health Physical Therapy.

Tue, 05/07/2019 - 06:08

The Value of Home Health Physical Therapy.

Home Healthc Now. 2019 May/Jun;37(3):145-151

Authors: Collins TL, Yong KW, Marchetti MT, Miller KL, Booths B, Falvey JR

Abstract
The purpose of the Triple Aim is to improve population health, reduce healthcare costs, and improve the patient experience. These goals-to reduce cost while improving health outcomes and patient experiences have shifted utilization of services from other postacute care settings to the home. The purpose of this perspective article is to discuss how home healthcare services, and home physical therapy (PT) specifically, provide value to patients, caregivers, and payers to meet the goals of the Triple Aim. This article will substantiate the value of home PT and provide healthcare professionals with evidence-based information on the value of home PT.

PMID: 31058732 [PubMed - in process]

Origin and bioactivities of thiosulfinated FK228.

Tue, 05/07/2019 - 06:08

Origin and bioactivities of thiosulfinated FK228.

Medchemcomm. 2019 Apr 01;10(4):538-542

Authors: Liu X, Currens GC, Xue L, Cheng YQ

Abstract
During a large laboratory-scale purification of FK228 from the fermentation broth of Burkholderia thailandensis MSMB43, a small amount of thiosulfinated FK228 (TS-FK228) was unexpectedly purified only after the broth was mixed with silica gel. Evidence supports the postulations that TS-FK228 was derived from FK228 through spontaneous chemical reaction with silica gel, and TS-FK228 existed as two isomers 1 and 2. TS-FK228 demonstrated similar inhibitory activity and profile against human class I histone deacetylases but exhibited a much higher antiproliferative activity against representative human cancer cell lines when compared to FK228.

PMID: 31057733 [PubMed]

Longitudinal Changes in Allostatic Load during a Randomized Church-based, Lifestyle Intervention in African American Women.

Tue, 05/07/2019 - 06:08

Longitudinal Changes in Allostatic Load during a Randomized Church-based, Lifestyle Intervention in African American Women.

Ethn Dis. 2019;29(2):297-308

Authors: Tan M, Mamun A, Kitzman H, Dodgen L

Abstract
Introduction: African American (AA) women have disproportionately higher risk of cardiovascular disease than White women, which may be explained by the uniquely higher allostatic load (AL) found in AA women. No studies have tested the effect of lifestyle interventions on AL in AA women. Our objectives were to assess the change in allostatic load following a lifestyle intervention and explore the roles of lifestyle behaviors and socioeconomic factors on allostatic load change.
Methods: Participants were non-diabetic (mean age and SD: 48.8±11.2 y) AA women (n=221) enrolled in a church-based, cluster randomized trial testing a standard diabetes prevention program (DPP) and a faith-enhanced DPP with 4-months of follow-up. We assessed the relationships of changes in diet, physical activity, neighborhood disadvantage, individual socioeconomic factors, and other lifestyle variables to changes in AL at 4-months using a multilevel multinomial logistic regression model.
Results: Average AL decreased (-.13±.99, P=.02) from baseline to 4-months. After adjusting for other variables, a high school education or less (OR:.1, CI:.02-.49) and alcohol use (OR: .31, CI: .09-.99) contributed to increased AL. Living in a disadvantaged neighborhood was responsible for increased AL, though it was not statistically significant. There were no statistically significant associations between AL and other health behavior changes.
Conclusions: Lower education levels may dampen the benefits of lifestyle interventions in reducing AL. Although a significant reduction in AL was found after participation in a lifestyle intervention, more research is needed to determine how lifestyle behaviors and socioeconomic factors influence AL in AA women.

PMID: 31057315 [PubMed - in process]

Authors' Reply to Letter to the Editor.

Tue, 05/07/2019 - 06:08
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Authors' Reply to Letter to the Editor.

J Foot Ankle Surg. 2018 Sep - Oct;57(5):1052-1053

Authors: Schneider HP, Baca J, Carpenter B, Dayton P, Fleischer AE, Sachs BD

PMID: 29779993 [PubMed - indexed for MEDLINE]

Glucocorticoid Receptor Transactivation Is Required for Glucocorticoid-Induced Ocular Hypertension and Glaucoma.

Mon, 05/06/2019 - 12:01
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Glucocorticoid Receptor Transactivation Is Required for Glucocorticoid-Induced Ocular Hypertension and Glaucoma.

Invest Ophthalmol Vis Sci. 2019 May 01;60(6):1967-1978

Authors: Patel GC, Millar JC, Clark AF

Abstract
Purpose: Glucocorticoid (GC)-induced ocular hypertension (GC-OHT) is a serious side effect of prolonged GC therapy that can lead to glaucoma and permanent vision loss. GCs cause a plethora of changes in the trabecular meshwork (TM), an ocular tissue that regulates intraocular pressure (IOP). GCs act through the glucocorticoid receptor (GR), and the GR regulates transcription both through transactivation and transrepression. Many of the anti-inflammatory properties of GCs are mediated by GR transrepression, while GR transactivation largely accounts for GC metabolic effects and side effects of GC therapy. There is no evidence showing which of the two mechanisms plays a role in GC-OHT.
Methods: GRdim transgenic mice (which have active transrepression and impaired transactivation) and wild-type (WT) C57BL/6J mice received weekly periocular dexamethasone acetate (DEX-Ac) injections. IOP, outflow facilities, and biochemical changes to the TM were determined.
Results: GRdim mice did not develop GC-OHT after continued DEX treatment, while WT mice had significantly increased IOP and decreased outflow facilities. Both TM tissue in eyes of DEX-treated GRdim mice and cultured TM cells isolated from GRdim mice had reduced or no change in the expression of fibronectin, myocilin, collagen type I, and α-smooth muscle actin (α-SMA). GRdim mouse TM (MTM) cells also had a significant reduction in DEX-induced cytoskeletal changes, which was clearly seen in WT MTM cells.
Conclusions: We provide the first evidence for the role of GR transactivation in regulating GC-mediated gene expression in the TM and in the development of GC-OHT. This discovery suggests a novel therapeutic approach for treating ocular inflammation without causing GC-OHT and glaucoma.

PMID: 31050723 [PubMed - in process]

Author Correction: Magnesium intake and mortality due to liver diseases: Results from the Third National Health and Nutrition Examination Survey Cohort.

Fri, 05/03/2019 - 14:29
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Author Correction: Magnesium intake and mortality due to liver diseases: Results from the Third National Health and Nutrition Examination Survey Cohort.

Sci Rep. 2019 May 01;9(1):6983

Authors: Wu L, Zhu X, Fan L, Kabagambe EK, Song Y, Tao M, Zhong X, Hou L, Shrubsole MJ, Liu J, Dai Q

Abstract
A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

PMID: 31043638 [PubMed - in process]

Real-world data on antiviral treatments for hepatitis C virus infections: Can we define intention to treat or per protocol analyses?

Fri, 05/03/2019 - 14:29
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Real-world data on antiviral treatments for hepatitis C virus infections: Can we define intention to treat or per protocol analyses?

J Hepatol. 2018 08;69(2):551-553

Authors: Ojha RP, Steyerberg EW

PMID: 29843905 [PubMed - in process]

Reiteration of the Statistical Basis of DNA Source Attribution Determinations in View of the Attorney General's Directive on "Reasonable Scientific Certainty" Statements.

Thu, 05/02/2019 - 08:12
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Reiteration of the Statistical Basis of DNA Source Attribution Determinations in View of the Attorney General's Directive on "Reasonable Scientific Certainty" Statements.

J Forensic Sci. 2017 07;62(4):1114-1115

Authors: Moretti TR, Budowle B

PMID: 28508395 [PubMed - indexed for MEDLINE]

What is the most durable construct for a forefoot amputation, traditional transmetatarsal amputation or a medial ray sparing procedure?

Tue, 04/30/2019 - 07:52
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What is the most durable construct for a forefoot amputation, traditional transmetatarsal amputation or a medial ray sparing procedure?

Ann Transl Med. 2019 Mar;7(Suppl 1):S47

Authors: Lavery LA, Crisologo PA, Yavuz M

PMID: 31032326 [PubMed]

Cognitive Training and Transcranial Direct Current Stimulation in Mild Cognitive Impairment: A Randomized Pilot Trial.

Tue, 04/30/2019 - 07:52
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Cognitive Training and Transcranial Direct Current Stimulation in Mild Cognitive Impairment: A Randomized Pilot Trial.

Front Neurosci. 2019;13:307

Authors: Das N, Spence JS, Aslan S, Vanneste S, Mudar R, Rackley A, Quiceno M, Chapman SB

Abstract
Background: Transcranial direct current stimulation (tDCS), a non-invasive stimulation, represents a potential intervention to enhance cognition across clinical populations including Alzheimer's disease and mild cognitive impairment (MCI). This randomized clinical trial in MCI investigated the effects of anodal tDCS (a-tDCS) delivered to left inferior frontal gyrus (IFG) combined with gist-reasoning training (SMART) versus sham tDCS (s-tDCS) plus SMART on measures of cognitive and neural changes in resting cerebral blood flow (rCBF). We were also interested in SMART effects on cognitive performance regardless of the tDCS group.
Methods: Twenty-two MCI participants, who completed the baseline cognitive assessment (T1), were randomized into one of two groups: a-tDCS + SMART and s-tDCS + SMART. Of which, 20 participants completed resting pCASL MRI scan to measure rCBF. Eight SMART sessions were administered over 4 weeks with a-tDCS or s-tDCS stimulation for 20 min before each session. Participants were assessed immediately (T2) and 3-months after training (T3).
Results: Significant group × time interactions showed cognitive gains at T2 in executive function (EF) measure of inhibition [DKEFS- Color word (p = 0.047)], innovation [TOSL (p = 0.01)] and on episodic memory [TOSL (p = 0.048)] in s-tDCS + SMART but not in a-tDCS + SMART group. Nonetheless, the gains did not persist for 3 months (T3) after the training. A voxel-based analysis showed significant increase in regional rCBF in the right middle frontal cortex (MFC) (cluster-wise p = 0.05, k = 1,168 mm3) in a-tDCS + SMART compared to s-tDCS + SMART. No significant relationship was observed between the increased CBF with cognition. Irrespective of group, the combined MCI showed gains at T2 in EF of conceptual reasoning [DKEFS card sort (p = 0.033)] and category fluency [COWAT (p = 0.055)], along with gains at T3 in EF of verbal fluency [COWAT (p = 0.009)].
Conclusion: One intriguing finding is a-tDCS to left IFG plus SMART increased blood flow to right MFC, however, the stimulation seemingly blocked cognitive benefits of SMART on EF (inhibition and innovation) and episodic memory compared to s-tDCS + SMART group. Although the sample size is small, this paper contributes to growing evidence that cognitive training provides a way to significantly enhance cognitive performance in adults showing memory loss, where the role of a-tDCS in augmenting these effects need further study.

PMID: 31031581 [PubMed]

Chronic benzodiazepine suppresses translocator protein and elevates amyloid β in mice.

Tue, 04/30/2019 - 07:52
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Chronic benzodiazepine suppresses translocator protein and elevates amyloid β in mice.

Pharmacol Biochem Behav. 2018 09;172:59-67

Authors: Tan S, Metzger DB, Jung ME

Abstract
Benzodiazepine (BZD) is a commonly prescribed anxiolytic and sedation aid medication, especially in elderly women. However, long-term use of BZD provokes adverse nontherapeutic effects that include movement deficit. Here, we investigated motoric deficit and molecular changes in cerebellum associated with the chronic use of BZD (cBZD) in female mice. We measured neuroprotective translocator protein (TSPO), neurotoxic amyloid β (Aβ), Aβ-producing presenilin-1 (PS1), and Aβ-degrading neprilysin. We also tested whether cBZD treatment damages mitochondrial membranes by measuring mitochondrial membrane swelling and mitochondrial respiration. Young and old mice received BZD (lorazepam) for 20 days, were tested for motoric function using Rotarod, and then euthanized to collect cerebellum. The major methods were immunoblot and RT-PCR for TSPO, PS1, and neprilysin expressions; ELISA for Aβ level; spectrometry for mitochondrial membrane swelling; XF-respirometry for mitochondrial respiration. cBZD-treated old mice showed poorer motoric function than old control or young cBZD-treated mice. Old mice treated with cBZD showed a decrease in TSPO and neprilysin and an increase in Aβ and PS1 production compared to old control mice. Old cBZD-mice also showed an increase in mitochondrial membrane swelling and a decrease in mitochondrial respiration. These data suggest that cBZD exacerbates motoric aging in a manner that involves diminished TSPO, elevated Aβ, and mitochondrial damage.

PMID: 30030126 [PubMed - indexed for MEDLINE]

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