Texas Tech University Health Sciences Research Articles

Impact of Depression in Teenage Pregnancy [17K

INTRODUCTION: Teenage pregnancy remains a public health concern. Maternal complications include increased C-section and instrumental deliveries. Infant complications include preterm births and neonatal death. Societal implications seen in teenage mothers include increased financial burden, unemployment, poor academic achievement, and physical abuse. In this study, we investigated a correlation between a diagnosed adolescent depression and pregnancy during adolescence (<20 years old). METHODS: We conducted a retrospective review of female patients, under the age of 20, diagnosed with depression and/or adolescent pregnancy at Texas Tech University Health Sciences Center clinics (including Obstetrics and Gynecology, Pediatric, and Family Medicine clinics) in Amarillo, Texas from January 1, 2013 to December 31, 2016 and conducted Z-test to analyze the statistical significance. IRB approval was obtained. RESULTS: Of the 490 teenage girls identified, 171 (34.9%) were pregnant but not depressed, 220 (44.9%) were depressed but not pregnant, and 99 (20.2%) were both depressed and pregnant. Of the 99 teenage girls, 35 (35.4%) of the patients had depression prior to pregnancy, 29 (29.3%) had PPD (postpartum depression), 19 (19.2%) had depression after conception without PPD, and 16 (16.2%) had depression after conception with unknown PPD. CONCLUSION: Research suggests that childbearing does not necessarily cause psychological distress among teenagers. However, after filtering out the data for PPD and those with indeterminate history, the result showed that teens were, on average, depressed first, and became pregnant after. This research shows that depression remains an important risk factor for teen pregnancy. Public policy and medical management should be encouraged to address this.

Overcoming multidrug resistance in cancer cells: Biochemical evaluation of new lead drug candidates

P‐glycoprotein (P‐gp) overexpression is often correlated with multidrug‐resistance (MDR) of cancer cells due to its role in the transport of chemotherapeutic drugs out of the cells in an ATP‐dependent process. To search for P‐gp inhibitors as co‐therapeutics to combat MDR, we previously used high‐throughput in silico ligand docking studies to identify drug‐like compounds. To assess functionality of the hit compounds we measured their effects on P‐gp ATPase hydrolysis activity. Some of the compounds inhibited ATP hydrolysis of purified P‐gp and successfully reversed the MDR in prostate and ovarian cancer cell lines. We subsequently used computational approaches and structure‐based design to produce variants of one of the hit compounds with predicted higher affinity to P‐gp. The efficacy of these variants in reversing MDR in cell culture as well as the biochemical evaluation of inhibition was assessed. High expression of human P‐gp in the yeast Pichia pastoris in a biologically active form was previously reported and the purified P‐gp was used on our recent assays. Currently, reconstitution of P‐gp into nanodiscs allowed for human P‐gp to be solubilized in its active form with ATPase activity enhanced by 2–3 fold as well as increased stability. Here we report the evaluation of the potential of our previously discovered drug‐like compounds to serve as inhibitors of human P‐gp ATP hydrolysis activity.Support or Funding InformationThis work was supported by NIH NIGMS [R15GM094771‐02] to PDV and JGW, SMU University Research Council, SMU Hamilton Undergraduate Research Scholars and Undergraduate Research Assistantship Programs, the SMU Center for Drug Discovery, Design and Delivery, the Communities Foundation of Texas, and private gifts from Ms. Suzy Ruff of Dallas, Texas, and Ms. Myra Williams, Ph.D. of Naples Florida. The authors would like to thank Dr. Ina L. Urbatsch, Texas Tech University Health Science Center, for providing the P. pastoris cells expressing the human wild‐type MDR1 used in this work.

Formative Assessments Predict Performance and Promote a Positive Learning Environment

At Texas Tech University Health Sciences Center School of Medicine, our curriculum begins with a rigorous and fast‐paced Clinically Oriented Anatomy course. Over the past four years, we have increased and improved the use of formative quizzes and exams to promote higher learning and performance outcomes, clarify examination expectations, and reduce student stress. Prior to starting our curriculum students are offered the opportunity to take a 25 question comprehensive formative pre‐test that previews examination content and USMLE vignette style questions. In the past year, we found that 93% of the incoming class utilized this voluntary resource. An average score of 23% on this pre‐test is consistent with a lack of familiarity of incoming students with human anatomy. To evaluate the effectiveness of our curriculum to bridge this informational gap, we provide students with two formative assessments (practice practical and practice written exam) prior to each summative exam. Computer based laboratory practice exams use digital images of prosected cadavers while didactic exams encompass a range of first, second and third order questions. Post‐assessment question/answer rationales provide students with immediate feedback to help identify areas of strength and weakness. Using this formative assessment approach, we have investigated the ability of formative assessments to predict exam performance and identify “at risk” students early in the course (i.e. after taking the first formative practice exam). Analysis of formative assessment data revealed a strong correlation with graded exam performance (p values ranging from 0.01–0.001 and r values from 0.44–0.70). Furthermore, overall graded summative exams correlate strongly with NBME performance (p = 0.001 and r = 0.92). Indicative of a successful educational experience, students scored an average of 233% higher on the repeat post‐course formative exam. Furthermore, the student’s perception of these formative assessments is very favorable and increases each year. In the past year, we had significantly fewer “at risk” students, and NBME performance was a record high. Thus, we find that formative assessments improve the educational experience, boost exam performance, and reduce student stress.Support or Funding Information(Sponsored by the Department of Medical Education at the TTUHSC SOM.)This study is approved by TTUHSC‐QIRB (approval#17008)

Optimizing Protein Function for Screening of Novel Inhibitors that Target Multi‐Drug Resistance in Cancers

P‐glycoprotein (P‐gp) belongs to the ATP‐Binding Cassette (ABC) transporter family of proteins and is strongly linked with multidrug resistance (MDR) in tumors where overexpression often abolishes the effects of chemotherapeutics by removing the therapeutics from the cells. In hopes of creating co‐therapeutics to re‐sensitize tumors to chemotherapeutics, we previously used high‐throughput in silico ligand docking studies and identified drug‐like compounds that reversed MDR in human cancer cells in culture. To evaluate the mechanism of inhibition in human P‐gp, we have isolated human P‐gp from the yeast Pichia pastoris using mixed detergent micelles. In order to effectively assess the potential inhibitors, we must be able to sufficiently stimulate our protein and have a high enough activity to see the inhibitory effects of the potential inhibitors. In previous work, we found that the activity of P‐gp assembled into membrane nanodiscs had significantly higher basal activity in the absence of transport substrate than P‐gp in detergent micelles. However, significant increase in activity in the presence of the substrate verapamil was not observed in micelles or nanodiscs. Here, we report methods of protein purification and nanodisc assembly modified to have optimally functional human P‐gp. The resulting purified P‐gp will be used to evaluate the inhibition mechanism of lead compounds that were shown to reverse MDR in cancer cell culture.Support or Funding InformationThis work was supported by NIH NIGMS [R15GM094771‐02] to PDV and JGW, SMU Hamilton Undergraduate Research Scholars and Undergraduate Research Assistantship Programs, the SMU Center for Drug Discovery, Design and Delivery, the Communities Foundation of Texas, and private gifts from Ms. Suzy Ruff of Dallas, Texas, and Ms. Myra Williams, Ph.D. of Naples, Florida. The authors would like to thank Dr. Ina L. Urbatsch, Texas Tech University Health Science Center, for providing the P. pastoris cells expressing the human wild‐type MDR1 used in this work.

Implementation of a pilot medical student mentoring program for premedical students and its effects on premedical student attitudes

As the medical school admissions process becomes increasingly competitive, there is an increased mental and emotional burden on undergraduate premedical students due to uncertainty about acceptance. Mentors in Medicine is a mentoring program between Texas Tech University Health Sciences Center and Texas Tech University students; the data demonstrate that this program can alleviate some negative emotional aspects faced by premedical students on their journey to medical school. The program interventions include establishing mentor-mentee relationships between medical students and premedical students, hosting various events to encourage dialogue, and promoting communication efforts from medical mentors. These interventions were found to significantly decrease feelings of anxiety or nervousness, as well as feelings of doubt or insecurity. These results may provide a framework for similar medical-premedical mentoring programs at other institutions.

Into the Weeds: High-volume Weeding at the Texas Tech University Health Sciences Center

ABSTRACT As print usage continues to shrink while the demand for student space grows, many academic libraries have felt the pressure to weed more aggressively. While not a new trend, much of the discussion surrounding weeding draws on the implicit assumption of some occasional weeding as collection maintenance. This article describes an aggressive weeding project at Texas Tech University Health Sciences Center, which had previously adhered to a no-weeding policy. It outlines the library’s development of selection criteria and methods where none had previously existed as well as the challenges encountered and the outcomes achieved.

Into the Weeds: High-volume Weeding at the Texas Tech University Health Sciences Center

Into the Weeds: High-volume Weeding at the Texas Tech University Health Sciences Center

HISTORY OF DEPRESSION AS A RISK FACTOR FOR THE DIAGNOSIS OF DEMENTIA: A RETROSPECTIVE CASE-CONTROL STUDY

Introduction This study aims to explore whether a documented history of depression posses additional risk of being diagnosed with dementia in a sample of community-dwelling elderly seen at outpatient geriatric psychiatry clinic, and whether marital status and living situation modify this association. A secondary outcome is to evaluate depression outcome before the age of 50. Methods The purpose of this study was to assess if patients with a history of depression are more likely to develop dementia (all-cause). A secondary outcome is to evaluate depression outcome before the age of 50. This is a retrospective case-control study using chart reviews evaluated at Texas Tech Health Sciences Center El Paso. Continuous variables were summarized using mean, standard deviation (SD), minimum, and maximum. Categorical variables were summarized using frequency and percentages. Outcomes “History of Dementia” and “Onset of Dementia before the Age of 50” were assessed using a logistic regression analysis. Unadjusted and adjusted models were developed for both outcomes. A stepwise selection procedure was implemented (entry = 0.15 and stay = 0.20) to determine the final model for each outcome. All associations and relationships were considered statistically significant at 5%. Data management and logistic regression analysis was conducted using SAS v.9.4. Results A total of 264 patients were recruited after considering all inclusion and exclusion criteria. The participant population had an average age of 76 (SD=7.08) years. 36% of the sample had reported a history of dementia while 81% of the population had reported a history of depression. 14% had reported an onset of depression before the age of 50. The binary variable “History of Dementia” was analyzed using a logistic regression analysis. The unadjusted logistic regression found several associations with “History of Dementia” (Table 3.1). Specifically, Hispanic patients had 1.8?times more odds of having dementia as opposed to those who were not Hispanic (P=0.038). Those who had a family history of dementia had 4.5?times more odds of having dementia themselves as opposed to those who did not have a family history (P=0.002). Those who were currently taking medication for depression were found to have 72% less odds of having dementia (P Conclusions Age, being Hispanic, and having a diagnosis of depression significantly increased the risk of all-cause dementia. A family history of dementia increased the risk of being diagnosed with dementia five-fold. Most significantly, those who were currently taking medication for depression were now found to have 81% less odds of having dementia, meaning that antidepressant medications play an important role. This research was funded by: Texas Tech University Health Sciences Center El Paso

Qualitative Analysis of Knowledge, Attitudes, and Beliefs About Pessary Use Among Spanish-Speaking Women on the US-Mexico Border.

To explore the knowledge, attitudes, and beliefs related to pessary use in Spanish-speaking women along the US-Mexico border. Spanish-speaking women with symptoms of vaginal bulge were recruited from the urogynecology/gynecology clinics at Texas Tech University Health Sciences Center El Paso to participate in moderated focus groups. Discussion topics included knowledge of prolapse/pessaries, pros/cons of pessaries, alternatives, and prolapse surgery. Audio-recorded group discussions were transcribed verbatim, and qualitative analysis completed by independent review using grounded theory methodology. Common themes were identified and then aggregated to form consensus concepts, agreed upon by the reviewers. Twenty-nine Spanish-speaking women participated in 6 focus group discussions. Approximately half of women reported little or no prior knowledge about pessaries. Three main themes were identified from analysis: knowledge/perceptions, misinformation/misconceptions, and surgery-related concerns. Concepts identified from common themes included limited knowledge of pessaries, confusing "pessary" with "mesh," willingness to try pessaries in order to avoid surgery, desire to try pessary if it was recommended by physician, limited efficacy or complications of surgery, and mesh-related concerns. Interestingly, some women reported that pessaries appear to be a treatment more often offered in the United States rather than in Mexico. Most participants showed a willingness to try a pessary for symptoms of pelvic organ prolapse in an effort to avoid surgery, despite expressing limited knowledge about this treatment. Physician recommendations and risks of pessary use influence their likelihood of trying a pessary. These concepts serve as focus points for effective pessary counseling to help improve education and informed decision making in this patient population.

Sleep Patterns and Health Behaviors in Healthcare Students

Personal health behavior can influence the academic development of healthcare students. This study was designed to evaluate the personal health behavior, including sleep time, of healthcare students at a large health sciences center. An anonymous online survey based on standardized questionnaires about sleep, insomnia, depression, alcohol use, and exercise was sent to all of the healthcare students (including medical, nursing, pharmacy, graduate biomedical science, and allied health students) in the Texas Tech University Health Sciences Center graduate education programs in Lubbock. In total, 412 students replied to this survey. Their mean sleep duration during the weekday was 7.5 ± 1.2 hours; 16.5% were short sleepers (<7 hours) during weekdays; 33% of the students woke up "feeling tired or worn out" >15 days during the last month. Many students were either moderately or severely bothered by "the lack of energy" because of poor sleep, and 56.6% of students rated their sleep as either fair or poor. Approximately 35% of students had drinking patterns that qualified as hazardous drinking, 6.3% of students smoked, and 23% of students did not do even mild exercise during the week. Eighty-nine percent of students reported stress in their life, including family stress, job stress, financial stress, legal stress, and other stress. Thirty-five percent of students considered their health as either poor or fair. Approximately 50% of students did not expect any change in their situation during the next 3 to 6 months. Although most healthcare students report adequate sleep times, more than half of them rate their sleep as fair or poor. In addition, some have poor health habits, including excessive alcohol use. Health science centers should introduce programs to promote healthy behaviors and reduce stress in healthcare students.

Actions of annatto-extracted tocotrienol supplementation on obese postmenopausal women: study protocol for a double-blinded, placebo-controlled, randomised trial

IntroductionObesity is a major health concern in postmenopausal women, and chronic low-grade inflammation contributes to the development of obesity. Cellular studies and high-fat-diet-induced obese mouse model mimicking obesity show the...

Abstract P5-12-12: Prospective evaluation of adherence to adjuvant aromatase inhibitor (AI) therapy among Hispanic/Latino women with breast cancer (BC) living in the border city of El Paso, Texas

Abstract Background: Adjuvant therapy with AI improve survival and is recommended to all postmenopausal women with hormone receptor-positive BC. A typical duration of the therapy is from 5 to 10 years. Despite clinically proven efficacy early discontinuation rate approaching 10% per year. The purpose of this study was to determine the adherence level through the Morisky Medication Adherence Scale (MMAS-8) among women with breast cancer treated at Texas Tech University Health Sciences Center El Paso (TTUHSC EP). Methods: Institutional review board approval was obtained prior to initiating this prospective study. 133 postmenopausal women were consented and participated in this study. Patients seen at the TTUHSC EP who was diagnosed with stage I-III breast cancer and who were on adjuvant AIs, were given the MMAS-8 questionnaire, and a demographics questionnaire. In order to identify reasons for non-adherence to AIs, all patients were also asked to identify the reason why they did not take their medication if applicable.Results: One hundred thirty-three patients were enrolled, median age 64 (range 41 - 89), 110 (90.2%) identified themselves as Hispanic/Latino. 58.2% have an income of 15K or less. 39% completed eighth grade or less, 34.5% completed high school, and 12% obtained a technical degree. Mean duration of AI therapy was 6.5 years. The majority of patients have high or intermediate levels of adherence 88%. Only 12 % had a low level of adherence. 7 (5.6%) patients scored two or below in the intentional adherence scale, and 18 (13.5%) scored two or below in the unintentional adherence scale (maximum scale is four). Conclusions: Our results indicate that the majority of patients treated at TTUHSC EP have a high or intermediate level of adherence to AI therapy. The main reason listed for non-adherence were mostly unintentional: forgetfulness and missing getting refills on time. Citation Format: Alexander Philipovskiy, Aleli Campbell, Brenda Castillo, Rosalinda Heydarian, Sumit Gaur, Alok Dwivedi, Zeina Nahleh. Prospective evaluation of adherence to adjuvant aromatase inhibitor (AI) therapy among Hispanic/Latino women with breast cancer (BC) living in the border city of El Paso, Texas [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-12-12.

Adherence to Adjuvant Aromatase Inhibitor Therapy Among Postmenopausal Hispanic/Latino Women With Breast Cancer.

The purpose of this study was to determine the level of adherence to adjuvant aromatase inhibitor (AI) therapy and factors associated with non-adherence among Hispanic/Latino women with hormonal receptor-positive breast cancer (BC) treated at an academic center at the American-Mexican border city of El Paso, TX. Institutional Review Board approval was obtained in this cross-sectional study using the validated Morisky Medication Adherence Scale to assess patient adherence to AI therapy. Patients diagnosed with stage I-III hormonal receptor-positive, human epidermal growth factor receptor 2-negative BC who were on adjuvant AIs therapy were recruited from the Texas Tech University Health Sciences Center El Paso breast clinic. Between September 2017 and August 2018, 122 consecutive patients were enrolled; 119 were analyzed, three were lost to follow up. The mean age was 61.6±9.4 years, and 109 (91.6%) self-identified as Hispanic/Latino. A total of 58% reported an annual income of $15,000 or less. Overall, 40.3% had completed eighth grade or less education, 31.9% high school, and 12% had obtained a technical degree. The majority of patients (56%) had either a medium (45%) or a low level of adherence (11%). High adherence was noted in 44% of participants. Seven (5.6%) patients scored 2 or below on a 4-point scale for intentional adherence, and 18 (13.5%) scored 2 or below on a 4-point scale for unintentional adherence. These data suggest that the majority of Hispanic/Latino women with breast cancer have medium or low levels of adherence to therapy with AIs. Factors associated with medium and low adherence were unintentional (forgetfulness), but also included intentional factors, such as avoidance of adverse effects and delays with obtaining refills (cost-related nonadherence).

Court rules in favor of university

Case name: Flores v. Texas Tech University Health Sciences Center, No. 18‐10438 (5th Cir. 01/28/19).

Robotic Revision Of A Post-Whipple Hepaticojejunostomy Stricture After Previous Open Pancreatoduodenectomy

Presenter: Zayne Belal | Texas Tech University Health Sciences Center Background: Hepaticojejunostomy (HJ) is one of the three anastomoses made during a pancreatoduodenectomy (Whipple) procedure. A rare complication of a HJ anastomosis is a stricture, which is often symptomatic with pain, jaundice, cholangitis and potential biliary cirrhosis. The recommended initial treatment for this complication is to first attempt percutaneous dilations of the stricture and then perform surgical stricture revision if the percutaneous dilations fail. In this video, we describe a robotic approach to a post-Whipple resection hepaticojejunostomy stricture revision. Methods: A robotic camera with 3 robotic arms and an assistant trocar were used for the procedure. The omental attachments to the free edge of the right liver were released until the hepatic hilum was exposed. The jejunal loop anastomosed to the bile duct was encountered and released from the surrounding attachments until the hepaticojejunostomy was fully identified and circumferentially dissected. The presumed bile duct portion of the HJ was grasped with robotic graspers to confirm the indwelling PTC tube and HJ. The HJ anastomosis was then opened over the PTC tube with electrosurgery until the tube was exposed. The tube was then retracted and the associated debris, stones and stricture were removed. The entire HJ was then taken down after the PTC tube was removed. The bile duct orifice was examined; it was thick-walled and measured roughly 7-8 mm in diameter. The HJ stricture scar was excised completely. The same jejunotomy was used for re-anastomosis. A new HJ was created with running posterior and anterior layers of 4-0 Vicryl sutures on RB-1 needles. The patency of the anastomosis was confirmed using a robotic grasper. The anterior and posterior sutures were then tightened and tied, completing the new HJ anastomosis. Surgical drain was placed around the HJ. Results: The procedure time was 195 minutes with an estimated blood loss around 50 mL. The patient had an uneventful recovery postoperatively, and was discharged on post-operative day 2. The patient is currently doing well at 9 months postoperatively and will be followed up as needed. Conclusion: Robotic hepaticojejunostomy stricture revision post-pancreatoduodenectomy feasible procedure. Previous open surgery should not contraindicate an attempt at minimally invasive repair if appropriate MIS/HPB skills and expertise is available.Robotic approach is had additional advantages in surgical dexterity due to increased range of motion/degrees of freedom, reduced surgeon fatigue and enhanced 3D visualization. Both access to a surgical robot and appropriately trained HPB surgeons are necessary to perform this procedure. This is often limited to large tertiary hepato-pancreato-biliary (HPB) surgery centers.

Minimally invasive pancreatectomies and hepatectomies for the elderly. Safety and outcomes

Presenter: Elizabeth De La Rosa | Texas Tech University Health Sciences Center Background: Minimally invasive pancreatectomies and hepatectomies are gaining popularity. Their outcomes in the elderly are not established. We hypothesized that with the increased use of minimally invasive surgery (MIS) for pancreas and liver surgery perioperative outcomes are maintained in the elderly (≥80yo). Methods: The National Cancer Database (2010-2016) was utilized to assess perioperative outcomes of minimally invasive pancreatectomies and hepatectomies. Results: Data from 45375 pancreatectomies and 10526 hepatectomies were analyzed. Median age was 66 for the pancreatectomies (range:18-90) and 64 for the hepatectomies (range:18-90) whereas 8.9% of patients who underwent pancreatectomy and 6.3% of patients who underwent hepatectomy were ≥80yo. The utilization of MIS surgery for patients ≥80yo increased from 2010 to 2016 (for pancreatectomies: robotic: increase from 1.4% to 8%; laparoscopic: increase from 14.1% to 23.6%; hepatectomies: robotic: increase from 0.9% to 4.3%, laparoscopic: increase from 18.8% to 26.4%). Most common MIS pancreatectomies were partial pancreatectomies/distals (42%) and Whipples (29%) whereas MIS hepatectomies were partial lobectomies (69%). MIS pancreatectomies and hepatectomies for the elderly had lower 90 day mortality rates compared to open which reached significance for pancreatectomies (pancreatectomies MIS: 8 vs 13.3%; p<0.001; hepatectomies MIS 8.9% vs 11.3%; p=0.3). The Charlson Comorbidity Index (CCI) didn’t correlate with 90 day mortality for the elderly who underwent MIS surgery (pancreatectomies: mortality 12.6%, 11.1%, 8.6% and 13% for CCI scores 0,1,2,3; hepatectomies: mortality 4.7%, 12.8%, 11.1%, 21.4% for CCI scores 0,1,2,3; p=0.1). Conclusion: With appropriate patient selection there is increase utilization of minimally invasive pancreatectomies and hepatectomies for the elderly with improved outcomes compared to open surgery. Elderly patients should not be excluded from clinical trials on minimally invasive surgery. The development of preoperative comprehensive geriatric assessment tools more sensitive than comorbidity indexes may allow for better patient selection for minimally invasive surgery.

Current Status of Healthy Aging and Dementia Research: A Symposium Summary.

The purpose of the 'First Regional Healthy Aging and Dementia Research Symposium' was to discuss the latest research in healthy aging and dementia research, public health trends related to neurodegenerative diseases of aging, and community-based programs and research studying health, nutrition, and cognition. This symposium was organized by the Garrison Institute on Aging (GIA) of the Texas Tech University Health Sciences Center (TTUHSC), and was held in Lubbock, Texas, October 24-25, 2018. The Symposium joined experts from educational and research institutions across the United States. The two-day Symposium included all GIA staff and researchers. Students, postdoctoral fellows, and faculty members involved in dementia research presented at the Symposium. Healthcare professionals, from geriatricians to social workers working with patients with neurodegenerative diseases, also presented. In addition, experts traveled from across the United States to participate. This event was comprised of multiple sessions, each with several oral presentations, followed by questions and answers, and discussion.

Lifestyle and Risk Factors of Dementia in Rural West Texas

In October 2018, the Texas Tech University Health Sciences Center (TTUHSC) held its first annual Healthy Aging and Dementia Research Symposium. The symposium was conceived and organized by the TTUHSC Garrison Institute on Aging. Its overall objective was to bring together scientists, healthcare professionals, interns, graduate students, postdoctoral fellows, faculty members, and NIH officials in order to share research results on aging and dementia associated with Alzheimer's disease and to discuss possible lines of research that may be productive in reducing dementia associated with Alzheimer's disease and, ultimately, associated with other neurological diseases. Another objective of the symposium was to share information, through formal and informal presentations, on whether and how unmodifiable factors, such as aging, and modifiable lifestyle factors, such diet and physical activity, impact dementia specifically and other chronic and neurological diseases, including diabetes and Alzheimer's disease. Discussions of the relationship across aging, dementia, and chronic and neurological diseases, and of the impact of lifestyles on these diseases mainly focused on populations living in the rural areas of West Texas counties since these areas are known to have populations of extremely different lifestyles. This introduction gives background on research of dementia associated with Alzheimer's disease, on populations and lifestyles of persons in rural West Texas, and on lifestyle factors known to affect progression of dementia and neurological diseases.

Court rules in favor of university

Case name: Flores v. Texas Tech University Health Sciences Center, No. 18‐10438 (5th Cir. 01/28/19).

Court rules in favor of university

Case name: Flores v. Texas Tech University Health Sciences Center, No. 18‐10438 (5th Cir. 01/28/19).