Texas Medical Board

Abstract Background: Latin American (LA) women are more likely to be diagnosed with aggressive early-stage breast cancer (EBC) compared to Non-Hispanic White (NHW) women, yet population-specific tumor biology remains underexplored. Previously, we reported elevated immune gene expression in BluePrint® (BP) Luminal B tumors in LA patients (pts) with EBC and obesity compared to Black and NHW cohorts. Here, we present updated clinical comparisons between LA, NHW and Black pts with EBC and whole transcriptome analysis (WTA) between BP Luminal B and Basal BC in pts with obesity. Methods: Clinical and WT data were analyzed from 15,577 EBC pts self-identified as LA, Black, or NHW enrolled in FLEX (NCT03053193), a prospective observational study with MammaPrint® risk of recurrence and BP molecular subtyping assays, and WT profiles. ImPrint, 53-gene immune signature, results (+/-) were generated for pts with hormone receptor positive (HR+) EBC. Chi-square and t-tests were conducted on clinical groups using arsenal R package. For WT comparisons, 215 obese LA pts with BP Luminal B and 77 with BP Basal EBC were matched to corresponding NHW and Black pts by age, T and N status. Differentially expressed genes (DEGs) were evaluated using limma, and pathway enrichment was performed using gene set enrichment analysis with Hallmark gene sets. Significant results were reported with adjusted p < 0.05. Results: Compared to Black and NHW pts, LA pts were younger and more often premenopausal (Table). Both LA and Black pts had statistically significantly higher rates of obesity compared to NHW pts. Significantly higher rates of MP High Risk 2, BP Basal and ImPrint+ tumors were observed in LA and Black pts vs NHW. WT comparisons among the obese subpopulations revealed that metabolic pathways, including adipogenesis, angiogenesis, epithelial-mesenchymal transition, and oxidative phosphorylation were significantly downregulated in EBC in LA pts vs NHW and Black cohorts. Conversely, immune-related pathways such as allograft rejection and interferon gamma response were enriched among LA pts with Basal cancers compared to NHW and Black groups. These coordinated pathway alterations suggest unique metabolic and immune profiles in LA EBC subtypes with a median absolute fold change of 1.3 among DEGs. Conclusion: The data suggest that signals from metabolic pathway alterations from modest immune-related gene upregulation may contribute to more aggressive tumor behavior in obese LA pts with EBC. Clinical and transcriptomic analyses demonstrated differences in Luminal B and Basal EBC biology among self-identified LA pts compared to NHW and Black cohorts, consistent with prior research. With further research, these findings may offer treatment targets which may enhance outcomes and reflect the importance of including racially and ethnically diverse pts in clinical trials to characterize population-specific differences in EBC outcomes. Citation Format: M. Mazo Canola, A. Santillan, J. Alberty-Oller, E. Dias, V. Kaklamani, A. Elkhanany, K. Hoskins, M. Habibi, R. Hampton, J. L. Barone, N. M. Johnson, N. Gordon, N. Sookhan, T. Bah, P. John, E. Aponte, S. Diab, V. Klimberg, N. Stivers, C. Page, S. Uygun, W. Audeh, J. O'Shaughnessy. Distinct Immune and Metabolic profiles in Latin American breast cancer patients with obesity enrolled in FLEX [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS4-09-09.

This study aims to analyze the effect of incentives and job satisfaction on employee performance, with work enthusiasm as an intervening variable at PT. Keaj Beaute Group. The research employs a quantitative approach using descriptive methods. Data were collected through questionnaires distributed to 30 employees and analyzed using multiple linear regression and path analysis. The results show that incentives do not have a significant effect on either work enthusiasm or employee performance. Job satisfaction significantly influences work enthusiasm but has no direct impact on performance. Work enthusiasm has a significant positive effect on employee performance and serves as a mediating variable between job satisfaction and employee performance, but does not mediate the relationship between incentives and performance. These findings highlight the importance of enhancing work enthusiasm through effective management of job satisfaction to achieve optimal employee performance.

Background In vivo mechanical behaviour of the abdominal wall has been poorly characterised and important details are missing regarding the occurrence and post-operative recurrence rate of hernias which can be as high as 30 %. This study aimed to assess the correlation between abdominal wall displacement and intra-abdominal pressure, as well as abdominal compliance. Methods Eighteen healthy participants performed audio-guided passive (breathing) and active (coughing, Valsalva maneuver) exercises. Axial dynamic changes of abdominal muscles and visceral area were measured using MRI, and intra-abdominal pressure with ingested pressure sensor. Findings Correlations between abdominal wall displacement and intra-abdominal pressure were specific to participant, exercise, and varying between rectus abdominis and lateral muscles. Strong correlations were found between rectus abdominis displacement and intra-abdominal pressure during breathing (r = 0.92 $\pm$ 0.06), as well as lateral muscles displacement with intra-abdominal pressure during coughing and Valsalva maneuver (r = --0.98 $\pm$ 0.03 and -- 0.94 $\pm$ 0.05 respectively). The abdominal pseudo-compliance varied greatly among participants during muscular contraction, the coefficient of variation reaching up to 70 %. Interpretation The combination of intra-abdominal pressure and dynamic MRI measurements enables the identification of participant-specific behaviour pattern. Intra-abdominal pressure and abdominal wall dynamic undergo consistent and predictable interactions. However, this relationship is subject-specific and may not be extrapolated to other individuals. Therefore, both intra-abdominal pressure and abdominal wall motion must be measured in the same participant in order to accurately characterise the abdominal wall behaviour. These results are of great importance for mesh design, surgical decision-making, and personalised healthcare.

We prove the linear and nonlinear asymptotic stability of small amplitude one-dimensional solitary waves submitted to small localized irrotational perturbations in the three dimensional Euler-Poisson system describing the dynamics of ions. In particular, in this regime, we obtain the existence of global smooth solutions and describe their asymptotic behavior.

This study aims to examine the effect of capital intensity and firm size on tax aggressiveness, with profitability as a moderating variable. The research objects are mining companies listed on the Indonesia Stock Exchange (IDX) during the period from 2019 to 2023, with an observation span of five years. A total of 17 companies were selected as samples using purposive sampling. The data were analyzed using multiple linear regression analysis. The results show that, partially, capital intensity has a positive but insignificant effect on tax aggressiveness, and firm size also has a positive but insignificant effect on tax aggressiveness. Simultaneously, capital intensity and firm size have a positive and significant effect on tax aggressiveness. Based on the moderated regression analysis (MRA), profitability is able to strengthen the influence of capital intensity but is unable to strengthen the influence of firm size on tax aggressiveness.

A new frontier for payments is emerging where the ‘traditional’ world of machine-to-machine and automated payments intersects with the rapidly evolving world of artificial intelligence (AI). As the bots evolve from simple chatbots to intelligent agents, known as Agentic AI, they will evolve from machines (in the most general sense) under our control into robots capable of making their own decisions and, by implication, their own payments. This is where we see an emerging demand for robot-to-robot (R2R) payments and the commensurate need for a strategic response from the payments sector to meet this need. While early experiments in machine payments have used existing mechanisms (eg blockchain and payment cards) it is not clear that these mechanisms can satisfy the needs of the emerging sector. This paper extends a taxonomy of payment types to include AI and looks at the specific needs of the R2R subsector. It presents some of the opportunities for FinTechs to create new products and services to complement the offerings of the ‘traditional’ players at the intersection of AI, machine payments and financial services. It concludes that the smart wallet (ie a digital wallet that can be operated by a robot) will be the central orchestration mechanism. We see the potential for a new payments infrastructure emerging to both re-energise past propositions (eg micropayments) and create entirely new ones (supply-chain currencies). New transactions and new trade mean new prosperity. With the right governance in place, the payments industry can explore this entirely new frontier to the great benefit of the economy as a whole.

Abstract Glutamate decarboxylase (Gad), a pyridoxal 5'-phosphate (PLP)-dependent enzyme, catalyses the conversion of glutamate to γ-aminobutyric acid (GABA), consuming a proton in the process and contributing to intracellular pH homeostasis in bacteria. The presence and function of the Gad-dependent mechanism in mycobacteria remain largely unexplored. Our study aimed to characterize Gad activity in Mycobacterium tuberculosis (Mtb). We detected Gad enzymatic activity and protein expression in mycobacterial cells, observing activity in live cells of both Mtb and Mycobacterium smegmatis (MS). Gad activity and GABA production were also detected in cell lysates of Mtb and MS. The gadB gene from Mtb was cloned, expressed, and purified under native conditions using MS as an expression host. Initial attempts to express Gad in Escherichia coli (E. coli) resulted in the protein being insoluble and inactive when purified under denaturing conditions. Therefore, an acetamide-inducible expression system was used for overexpression in MS. Recombinant GadB was purified using immobilized metal affinity chromatography, and its molecular weight was determined to be 51.2 kDa via SDS-PAGE. The purified GadB enzyme was active at both neutral and acidic pH. Its activity was found to be PLP-dependent, with optimal activity at pH 7.2 and 50°C. These findings suggest that Gad is expressed in Mtb at both normal as well as acidic pH, indicating the possible existence of a Gad-dependent acid resistance mechanism in Mtb.

Blasting is an essential operation in mining and construction for breaking hard rock, but it inherently risks the dangerous phenomenon of flyrock, which can cause injury to personnel and damage to nearby infrastructure. Consequently, the accurate prediction of flyrock type (e.g., fractured, mid-wall (MW), or fresh) during mine blasting is critical for safety in construction areas. This study addresses this need by implementing eight different Supervised Machine Learning (SML) models—including Decision Tree (DT), Random Forest (RF), K-Nearest Neighbor (KNN), and Support Vector Machine (SVM)—to precisely forecast flyrock type based on real-time blasting parameters and rock mass properties. The models were trained and evaluated using a dataset comprising 152 blasting events recorded across three open-pit granite mines in Johor, Malaysia. The performance of the constructed SML models was rigorously assessed using standard validation metrics such as accuracy, precision, recall, and F1 Score. The results demonstrate the superior predictive capabilities of the ensemble models, with the Decision Tree, Random Forest, and AdaBoost models all achieving 100% accuracy in flyrock type prediction with zero prediction loss, thus providing robust tools for enhancing safety management in quarry and construction operations.

Let M be a finitely generated submodule of a free module over a multivariate polynomial ring with coefficients in a discrete coherent ring. We prove that its module MLT(M ) of leading terms is countably generated and provide an algorithm for computing explicitly a generating set. This result is also useful when MLT(M ) is not finitely generated. Suppose that the base ring is strongly discrete coherent. We provide a Buchberger-like algorithm and prove that it converges if, and only if, the module of leading terms is finitely generated. We also provide a constructive version of Hilbert's syzygy theorem by following Schreyer's method.

Objectives: Spaceflight Associated Neuro-ocular Syndrome (SANS) includes an array of ophthalmic and neurologic signs and symptoms observed in a subset of astronauts after prolonged spaceflight. The etiology of these changes remains unknown. Data from spaceflight and bed rest studies provide evidence that the one-carbon (1C) metabolic pathway is involved in the risk of developing SANS. Specifically, it has been demonstrated that genetic variants of methionine synthase reductase (MTRR) A66G and serine hydroxymethyltransferase-1 (SHMT1) C1420T are associated with ophthalmic changes. Moreover, the magnitude of change in total retinal thickness (ΔTRT) in astronauts is greater for those with these genetic variants when combined with lower B-vitamin status (e.g., folate, vitamins B6 and B12, and riboflavin). Rodent research utilizing real and simulated spaceflight conditions has yet to provide a rodent model of SANS. Methods: In this study, mice with a genetic knock-out (KO) for SHMT1 are compared to age-matched WT mice fed either a folate-deficient (FD) or folate-sufficient (FS) diet. Optical coherence tomography (OCT) is performed to determine TRT. Blood is collected following OCT to assess B-vitamin status. Following the study, the mice will be euthanized, and ocular pathologies will be assessed via histological staining. Results: Preliminary analyses have indicated an effect of the diet on TRT (FS TRT = 202 μm vs. FD TRT = 243 μm). Additionally, TRT trended high in the SHMT KO fed the FD diet (TRT = 246 μm) as compared to WT on the same diet (TRT = 239 μm). Further OCT analyses are necessary before any conclusions can be drawn regarding observations as a result of diet, genetics, or a combination thereof. Conclusions: This study will evaluate the relationship between biochemical markers of disrupted one-carbon metabolism and total retinal thickness. Creating rodent models of SANS will allow us to systematically evaluate individual contributing factors of the spaceflight environment (radiation, microgravity, CO2, etc) that increase one’s risk of developing SANS and allow for the testing and/or evaluation of countermeasures. Funding Sources: This work is funded by Texas A&M Institute for Advancing Health through Agriculture.