University of North Texas Health Science Center

Dementia frequently goes undetected in community settings, particularly among socially disadvantaged populations. Here, we estimated the prevalence of underdiagnosed dementia across diverse sociodemographic determinants of health in the Health and Aging Brain Study-Health Disparities (HABS-HD), a community-based cohort of adults recruited through community outreach in Fort Worth, Texas. We estimated age-specific probabilities of underdiagnosis using Poisson regression models with a log link, including age and sex as covariates. Robust (sandwich) variance estimators were used to obtain standard errors and 95% confidence intervals (CI). Group differences or trends for continuous measures were assessed using robust variance estimates. The prevalence of underdiagnosed dementia was higher among individuals without physician access (98.1% vs. 78.1%, p<.0001), non-English speakers (97.9% vs. 76.8%, p<.0001), and the uninsured (91.5% vs. 79.5%, p=.03). Black and Hispanic participants also showed higher prevalence (85.8% and 90.9%) compared to non-Hispanic White participants (64.9%; p=.02 and p=.002, respectively). Each additional year of education was associated with a 2.5% lower risk of underdiagnosis (p<.0001). No differences were observed by sex, marital status, income or social support. Our results highlight that several sociodemographic factors contribute to the likelihood of living with undiagnosed dementia.

Testicular cancer is one of the most common solid malignancies among men aged 15-35 years and is associated with excellent outcomes when identified early. Ultrasound is the first-line imaging modality for evaluation of scrotal pathology; however, access to timely imaging may be limited in low-resource primary care settings. This case describes a young male who initially presented with asymptomatic microscopic hematuria and later disclosed unilateral scrotal swelling. Initial urologic evaluation and computed tomography (CT) imaging failed to identify testicular pathology. Subsequent point-of-care scrotal ultrasound performed in a primary care clinic revealed a large complex cystic mass, prompting immediate escalation of care. Further evaluation confirmed a primary testicular malignancy, and the patient underwent definitive surgical management with radical orchiectomy. This case highlights the critical role of point-of-care ultrasound in facilitating early recognition and timely referral for testicular malignancy in low-resource settings. Primary care physicians should remain vigilant for atypical presentations and be proficient in identifying concerning sonographic features to reduce delays in diagnosis and intervention, thereby improving patient outcomes.

Purpose The purpose of this study is to inform special collections and archives professionals about the perceptions and needs of a previously understudied group – members of the general public who are not already actively using archives and special collections. Survey methods are used to capture societal values and public expectations about archival outreach, processing metrics and care for culturally sensitive materials. Design/methodology/approach A survey was utilized to quantify public sentiment on archival practice, with two blocks of experimental randomized questions fielded to determine the effect of two treatments on members of the general public in the United States (N = 800). Block one was used to determine perceptions on resource expenditures, while block two gauged attitudes regarding archival outreach. Findings Results show a strong preference among the public for the preservation of cultural heritage items over business records, as well as an overwhelming willingness by the public to engage in archival outreach if provided the opportunity. Originality/value Despite paradigm shifts that realigned institutional archives with public engagement and outreach, there have been few, if any, empirical studies of perceptions of archives by members of the public who are not already engaged with archives. In order for archival institutions to truly engage and serve the public, archival professionals and scholars need to understand how the public actually views archives and their work. While this survey study cannot provide nuanced insights into individual user needs and experiences, it quantifies questions asked in past qualitative studies on archival participation and provides new paths for future research.

Stroke triggers a rapid and complex immune response that is not yet fully understood, especially within hours after an ischemic infarct. Our previous study in stroke patients revealed a significant increase in interferon-gamma (IFN-γ) immediately (hyperacute) and downstream of the ischemic ictus, within the arterial compartment. The present study investigated the source, inciting factors, and role of IFN-γ in a preclinical murine model. Stroke was produced using transient middle cerebral artery occlusion, and immune cells within the arterial vasculature distal to the occlusion (pre- and post-occlusion) were characterized using flow cytometry. Compared with the control samples, the post-occlusion samples presented an increase in IFN-γ+ and CD69+ cells, whereas no significant increase was detected in IL17+, IL4+, and CD25+ cells. Further analysis of the IFN-γ+ population revealed two novel attributes. First, interrogation of the identity of these IFN-γ+ cells revealed that the increase in IFN-γ production was largely driven by CD14+ myeloid cells in the post-occlusion sample, with negligible contributions from other canonical IFN-γ-producing cells (CD4, CD8, NK). Second, the IFN-γ+ cells exhibited two distinct clusters, an IFN-γlow and an IFN-γhi population. Further analysis revealed that the IFN-γ low population was largely composed of CD14+ myeloid cells, whereas the IFN-γhi population was dominated by CD4+ T-cells. To explore the conditions driving IFN-γ production, an in vitro ischemia model involving oxygen-glucose deprivation (OGD) was employed. Co-culturing of naïve splenocytes with OGD-treated CNS cells and OGD-derived supernatant resulted in a significant increase in IFN-γ+CD14+ cells, as compared to normoxic controls, an effect that coincided with marked loss of DAPI+ and NeuN+DAPI+ cells in mixed cortical (neuronal and glial) cultures. In summary, this study identified intra-arterial CD14+ myeloid cells as novel early sources of IFN-γ in the hyperacute phase of stroke, a role traditionally attributed to adaptive immune cells. Using in vivo and in vitro ischemia models, the findings reveal that injury-associated signals from CNS cells are sufficient to directly induce IFN-γ production in CD14+ myeloid cells, redefining early stroke immunopathology and uncovering a potential target for timely immunomodulation.

In 2018, the National Institutes of Health (NIH) launched the Helping to End Addiction Long-Term ® (HEAL) Initiative to advance addiction and pain research and clinical practice. The NIH-HEAL Initiative supports investigator-initiated research across diverse focus areas, allowing scientists discretion in selecting research topics, methodologies, and outcomes while still remaining subject to NIH's peer review process. This study aims to answer the research question: what do investigators of NIH-HEAL funded studies define as important knowledge, particularly in relation to growth in empirical studies and clinical policy? By examining how pain and addiction researchers define what knowledge is important to produce, this study offers novel insight into how research priorities take shape and why this matters for science and clinical practice. To answer this research question, we conducted a directed content analysis of 1,068 NIH-HEAL funded study abstracts published on the NIH RePORTER website. Our findings suggest that while the scope of the NIH-HEAL funded studies is broad, there are common identifiable patterns that exist within the funded research portfolio such as a preference for treating pain and addiction conditions with prescription medication (33.80% of pain studies, 34.17% of opioid use disorder studies) and a narrow focus on intervention efficacy (43.21% of pain studies, 39.22% of opioid use disorder studies). This analysis is important for the scientific enterprise and clinical practice as prior literature has painted research as inherently influenced by the values of a scientist and of their discipline. By identifying what social and empirical problems NIH-HEAL funded investigators identify, their proposed solutions, and the outcomes they prioritize, this study carries important implications for grant-funding agencies, scientists, and the people who need and receive treatment for pain and addiction conditions.

Background: Chlamydia infections during pregnancy are associated with adverse outcomes such as preterm birth, low birth weight, perinatal death, and miscarriage. Many professional organizations have evidence-based guidelines recommending chlamydia screening during pregnancy, but little is known regarding the factors influencing the adoption of these guidelines into practice. This study assessed the awareness, adoption, and acceptability of prenatal chlamydia screening guidelines among physicians. Methods: Prenatal providers in the United States (MD/DO; n = 201) were recruited via an online survey platform. Items assessed provider awareness about prenatal chlamydia and STI screening guidelines, current practice behaviors, and risk factors considered when screening pregnant patients for STIs. Guideline characteristics including acceptability, feasibility, relative advantage, and evidence source were assessed. Descriptive and bivariate comparisons were analyzed using SAS v9.4. Results: Over 12% of providers were unaware of prenatal STI screening recommendations from their professional organizations, and almost 8% were unaware of chlamydia screening guidelines. Most providers reported using the prenatal chlamydia screening guideline from the American College of Obstetricians and Gynecologists (70%). Those selecting this guideline were significantly more likely to describe this guideline as clear ( P = 0.004) and report that guideline source was important ( P = 0.006) compared to other organization guidelines. Conclusions: Awareness of professional organization guidelines about prenatal chlamydia screening guidelines was high among providers. However, women are not screened adequately during their pregnancies suggesting that there are other factors contributing to the underutilization of screening. Future studies should focus on how these organizations can improve guideline dissemination to increase implementation of chlamydia screening during pregnancy.

Extracellular vesicles (EVs) are increasingly recognized as programmable bioactive carriers in non-viral gene delivery and adaptable bioengineering platforms. Beyond their roles as natural nanocarriers in intercellular communication, EVs can promote ocular surface repair and retinal neuroprotection with potential for low immunogenicity and high biocompatibility. Bioengineering now enables cargo encapsulation, surface targeting, and integration of EVs with biomaterial platforms to enhance tissue penetration, retention, and precision delivery. The emergence of induced pluripotent stem cell-derived EVs (iMSC-EVs) offers improved batch uniformity and potential for personalized therapy. However, progress hinges on resolving knowledge gaps in ocular EV biology, standardizing isolation and storage, scaling reproducible manufacturing, and executing focused clinical trials. We synthesize the current developments and outline how EVs are moving from biological mediators to engineered therapeutics to accelerate the translation of EV diagnostics and therapeutics for eye diseases.

Forensic human identification relies on length-based differences in short tandem repeats (STRs) across autosomal and Y chromosomes, which require separate reactions and provide limited resolution. While next-generation sequencing offers greater discriminatory power, most platforms are expensive and restricted to traditional lab settings. Nanopore sequencing has the potential to change this with the real-time, portable MinION sequencer. However, forensic-specific tools that generate STR profiles compatible with established length-based databases are lacking. To address this, we developed STRspy2.0, which simultaneously profiles autosomal and Y-STRs using nanopore reads. STRspy2.0 produced accurate profiles for 54 multiplexed control libraries and 41 mock casework samples (blood, swab, bone), achieving overall F1-scores of 100% and 99.75%, respectively. It maintains compatibility with existing forensic databases while providing higher resolution than traditional profiles. Our updated method and comprehensive database, along with the MinION's small size and price, make sequence-based STR profiling more accessible to forensic laboratories and resource-limited settings.