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UNTHSC Scholar is an open access repository of the intellectual output and publicly available materials of the university. UNTHSC Scholar provides stable access to data, highlights community partnerships and engagement, and enables discovery of these works by the international scientific community. It preserves the history, growth and innovation of the University of North Texas Health Science Center as an institution.

 

Recent Submissions

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Design and Synthesis of D(3)R Bitopic Ligands with Flexible Secondary Binding Fragments: Radioligand Binding and Computational Chemistry Studies
(MDPI, 2024-01-11) Tian, Gui-Long; Hsieh, Chia-Ju; Taylor, Michelle; Lee, Ji Youn; Luedtke, Robert R.; Mach, Robert H.
A series of bitopic ligands based on Fallypride with a flexible secondary binding fragment (SBF) were prepared with the goal of preparing a D(3)R-selective compound. The effect of the flexible linker ((R,S)-trans-2a-d), SBFs ((R,S)-trans-2h-j), and the chirality of orthosteric binding fragments (OBFs) ((S,R)-trans-d, (S,R)-trans-i, (S,S)-trans-d, (S,S)-trans-i, (R,R)-trans-d, and (R,R)-trans-i) were evaluated in in vitro binding assays. Computational chemistry studies revealed that the interaction of the fragment binding to the SBF increased the distance between the pyrrolidine nitrogen and ASP110(3.32) of the D(3)R, thereby reducing the D(3)R affinity to a suboptimal level.
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Quantifying Musculoskeletal and Biomechanical Symmetry to Identify Injury and Fall Risks in Individuals Who Use Unilateral Lower-Limb Prostheses
(2022-12) Finco, Malaka G.; Menegaz, Rachel A.; Patterson, Rita M.
Individuals who use lower-limb prostheses have increased risks of developing overuse injuries and experiencing falls compared to the general population. This is often attributed to individuals loading, or weighting, their prosthetic limb less than their intact limb. Quantifying musculoskeletal and biomechanical symmetry between prosthetic and intact limbs could help clinicians evaluate risks of developing overuse injuries and experiencing falls. However, these relationships have not been determined. The objective of this dissertation is to quantify musculoskeletal and biomechanical symmetry and determine their relationships to overuse injuries and falls in individuals with unilateral lower-limb loss. This objective has two specific aims: 1) evaluate musculoskeletal symmetry associated with risks of developing overuse injuries, and 2) determine the relationship between wearable sensor-derived walking symmetry values and falls. Musculoskeletal symmetry was quantified in skeletal properties (e.g. fracture risk via dual x-ray absorptiometry), hip and knee joint space (e.g. osteoarthritis via x-rays), and thigh muscle architecture (e.g. atrophy via cross-sectional area) in four anatomical donors and thirty post-mortem CT scans. Biomechanical symmetry was quantified in twenty-two individuals who use unilateral lower-limb prostheses. Wearable sensors called inertial measurement units were compared to the gold standard of motion capture in the first five individuals. The relationship between number of falls, clinical outcome measures, and gait symmetry will be assessed to determine if gait symmetry could supplement clinical outcome measures to evaluate fall risk. Impaired musculoskeletal symmetry suggests amputated limbs, particularly those with diabetes, had higher indications of distal femur fracture risk and more thigh muscle atrophy compared to intact limbs. Compared to healthy and diabetic control groups, individuals with amputation had higher indications of osteoarthritis and muscle atrophy bilaterally. Biomechanical studies suggest data derived from inertial measurement units were comparable to motion capture, and the Four Square Step test was associated with 12-month retrospective falls. Findings could help clinicians proactively evaluate overuse injury and fall risks in this population.
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The influence of race/ethnicity and social determinants of health and HPV vaccination in vaccine-eligible adults in the U.S.
(2022-08) Garg, Ashvita; Thompson, Erika; Nguyen, Uyen-Sa D.T.; Luningham, Justin M.
Background: Human Papillomavirus (HPV) vaccination is an essential primary prevention measure against HPV-related cancers, currently approved for catch-up for inadequately vaccinated adults by age 26 and for mid-adults aged 27-45 with shared clinical decision-making. Although HPV vaccination rates have been gradually increasing, racial/ethnic disparities and low catch-up among adults persist. Examining the Social Determinants of Health (SDOH) associated with HPV vaccination in different racial groups may help explain these disparities in lower vaccine uptake. Previous studies using national datasets have found differences in estimated prevalence of HPV vaccine uptake across datasets for racial/ethnic minorities, especially for Asian Americans, when compared to non-Hispanic White, with results varying from lower to higher uptakes. Despite Asian Americans being a very diverse racial group, most studies either combine them in one category or with other races, resulting in an incomplete picture of HPV vaccine uptake among different Asian American subgroups. Purpose: Using the SDOH framework, this study aimed to examine the racial/ethnic differences for HPV vaccination across three U.S. national databases among vaccine-eligible adults and examine the association between HPV vaccination and Asian racial subgroups. Methods: For the first aim, the study utilized 2017-2019 NHIS (n=30,788), 2017-2020 pre-pandemic NHANES (n=3,685), and 2017-2019 BRFSS (n=30,324) data, ages 18-45 years. Asian racial subgroup disparities for the second aim were assessed with 2014-2018 NHIS data (n=34,839, ages 18-38). Survey-weighted multivariable logistic regression models identified the association between HPV vaccination status (outcome) and explanatory variables: SDOH indicators, race/ethnicity, sex, nativity, and age. Results: The racial/ethnic differences in HPV vaccine uptake were not similar between the three datasets. In the NHIS dataset, compared to Non-Hispanic White, Non-Hispanic Asian and Non-Hispanic Asian males were more likely to be vaccinated. With NHANES data, Non-Hispanic Asian males were less likely to be vaccinated. While BRFSS data did not show statistically significant differences in HPV vaccination for difference races/ethnicity. However, inverse variance weighted averages indicated that compared to Non-Hispanic White, Non-Hispanic Asian individuals had higher odds of receiving HPV vaccination. Males compared to females and foreign-born compared to U.S.-born individuals were less likely to be vaccinated. Among SDOH factors, education level, time since last healthcare visit, health insurance status, and having a usual place of healthcare were significantly associated with HPV vaccination. Compared to White individuals, Asian Indian were less likely to be vaccinated while Filipino and individuals from other Asian subgroups were more likely to be vaccinated. Additionally, foreign-born Asian Indian compared to foreign-born White individuals and Asian Indian females compared to White females were less likely to be vaccinated. Regarding SDOH factors, education level, insurance status, and time since last healthcare were significantly associated with HPV vaccination. Conclusion: This study identified racial/ethnic differences in HPV vaccine uptake and SDOH indicators associated with HPV vaccination. Findings indicate that more studies are needed to assess the differences in these three surveillance systems that led to the conflicting findings and to explore the reasons for lower vaccination uptake among the Asian Indian population. Finally, tailoring HPV vaccine awareness campaigns and improving vaccination access for males, foreign-born, individuals lacking health insurance, or those failing to have regular healthcare visits could help promote HPV vaccination and reduce HPV-associated cancers.
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Lessons Learned from the Design and Implementation of a Health Promotion Intervention for African American Women
(2022-08) Dodgen, Leilani, A.; Spence-Almaguer, Emily
The purpose of this dissertation is to explore how intervention design can be enhanced to influence the health of African American women through examining the processes and methods related to health behavior theory, cultural adaptation, and participatory approaches. Data from African American women who participated in the Better Me Within (BMW)Trial, as well as, formative data from focus groups with African American women were used to investigate these intervention planning approaches through the following aims: Aim 1 addressed the question how do theoretical constructs of behavior change help to explain health outcomes in the BMW trial? This was quantitatively explored by examining theoretical constructs with outcomes of weight, diet and physical activity. Aim 2 explored the perspectives of African American women through qualitative analysis of focus groups for cultural and contextual elements that may influence the approach to intervention design, increase knowledge about cultural adaptations, and contribute methods to enhance weight management. Aim 3 critically examined how the community-based participatory research (CBPR) approach with African American faith communities in the BMW Trial aligned with the CBPR conceptual model through a case study. Understanding how processes, operations, and decisions in intervention design contribute to health improvements is imperative for ensuring programs are relevant and effective in specific populations. One size does not fit all. The current state of health inequities and chronic conditions in African American women require thoughtful intervention strategies that center community knowledge, culture, and context. This dissertation seeks to arrive at intervention strategies that are relevant to African American women, and influence how public health professionals approach intervention development for meaningful, community-identified health improvements.