Browsing by Subject "Texas"
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Item Open Access Aortic dissection and ruptures in adult congenital heart disease in Texas from 2009 to 2019.(European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2022-01) Well, Andrew; Mizrahi, Michelle; Johnson, Gregory; Patt, Hanoch; Fraser, Charles D; Mery, Carlos M; Beckerman, ZivObjectives
Acute thoracic aortic dissection and rupture (TADR) has an incidence of 5-7 per 100 000-person years. Today, most children with congenital heart disease (CHD) survive to become adults with congenital heart disease (ACHD). This study evaluates TADR in patients with ACHD in a large, hospitalized patient population over 11 years to evaluate the incidence, risk factors and outcomes associated with TADR.Methods
This was a retrospective review of the Texas Inpatient Discharge Data Set from 1 January 2009 to 31 December 2019. All non-trauma discharges of patients ≥18 years were included. ACHD discharges were identified by International Classification of Diseases, 9th edition (ICD-9)/10 diagnosis codes. TADR were identified using 2 definitions: TADR1 is an ICD-9/10 code for TADR, and TADR2 is TADR1 with an ICD-9/10 procedure code for aortic intervention. Descriptive, univariate and logistic regression statistics were used.Results
A total of 22 154 664 eligible discharges were identified, of which 12 584 (0.06%) were TADR1 and a subgroup of 5699 (0.03%) were TADR2. CHD was more prevalent in TADR1 (0.2% vs 0.05%; P < 0.001) and TADR2 (0.3% vs 0.04%; P < 0.001). Adjusting for known TADR risk factors, CHD had an odds ratio of 1.69 (95% confidence interval: 1.09-2.63; P = 0.020) for TADR1 and an odds ratio of 1.69 (95% confidence interval: 0.99-2.88; P = 0.056) for TADR2. No in-hospital deaths were found in patients with CHD with TADR.Conclusions
ACHD discharges had a higher frequency of TADR versus the general population (0.9-1.2 vs 0.3-0.6 per 1000 discharges). There is an indication that CHD confers an increased adjusted odds of TADR. As the ACHD population continues to grow in number as well as age, it will be important to continue to assess the risk of TADR from CHD and how traditional risk factors impact this risk.Item Open Access Copy Number Variants of Undetermined Significance Are Not Associated with Worse Clinical Outcomes in Hypoplastic Left Heart Syndrome.(The Journal of pediatrics, 2018-11) Dailey-Schwartz, Andrew L; Tadros, Hanna J; Azamian, Mahshid Sababi; Lalani, Seema R; Morris, Shaine A; Allen, Hugh D; Kim, Jeffrey J; Landstrom, Andrew POBJECTIVE:To determine the prevalence, spectrum, and prognostic significance of copy number variants of undetermined significance (cnVUS) seen on chromosomal microarray (CMA) in neonates with hypoplastic left heart syndrome (HLHS). STUDY DESIGN:Neonates with HLHS who presented to Texas Children's Hospital between June 2008 and December 2016 were identified. CMA results were abstracted and compared against copy number variations (CNVs) in ostensibly healthy individuals gathered from the literature. Findings were classified as normal, consistent with a known genetic disorder, or cnVUS. Survival was then compared using Kaplan-Meier analysis. Secondary outcomes included tracheostomy, feeding tube at discharge, cardiac arrest, and extracorporeal membrane oxygenation (ECMO). RESULTS:Our study cohort comprised 105 neonates with HLHS, including 70 (66.7%) with normal CMA results, 9 (8.6%) with findings consistent with a known genetic disorder, and 26 (24.7%) with a cnVUS. Six of the 26 (23.0%) neonates with a cnVUS had a variant that localized to a specific region of the genome seen in the healthy control population. One-year survival was 84.0% in patients with a cnVUS, 68.3% in those with normal CMA results, and 33.3% in those with a known genetic disorder (P = .003). There were no significant differences in secondary outcomes among the groups, although notably ECMO was used in 15.7% of patients with normal CMA and was not used in those with cnVUS and abnormal results (P = .038). CONCLUSIONS:Among children with HLHS, cnVUSs detected on CMA are common. The cnVUSs do not localize to specific regions of the genome, and are not associated with worse outcomes compared with normal CMA results.Item Open Access Costs and Emissions Reductions from the Competitive Renewable Energy Zones (CREZ) Wind Transmission Project in Texas(2011-04-29) Kwok, Gabriel; Greathouse, TylerWind power has the potential to significantly reduce air emissions from the electric power sector, but the best wind sites are located far from load centers and will require new transmission lines. Texas currently has the largest installed wind power capacity in the U.S., but a lack of transmission capacity between the western part of the state, where most wind farms are located, and the major load centers in the east has led to frequent wind curtailments. State policymakers have addressed this issue by approving a $5 billion transmission project, the Competitive Renewable Energy Zones (CREZ), which will expand the transmission capacity to 18,456 MW by 2014. In this paper, we examine the impacts of large-scale wind power in ERCOT, the power market that serves 85% of the state’s load, after the completion of the CREZ project. We assess the generation displaced and the resulting emissions reductions. We then examine the public costs of wind to estimate the CO2 abatement cost. We develop an economic dispatch model of ERCOT to quantify the generation displaced by wind power and the emissions reductions in 2014. Since there is uncertainty about the amount of new wind developed between now and 2014, three wind penetration scenarios were assessed that correspond to wind supplying 9%, 14% and 21% of ERCOT’s total generation. In the 21% wind energy penetration scenario, the CREZ transmission capacity is fully utilized, and wind displaces natural gas 74% of the time and coal 26% of the time. This results in CO2, NOX, SO2 and Hg emissions reductions of 19%, 17%, 13%, and 15%, and a CO2 abatement cost of $60 per ton of CO2. Lower wind penetrations result in gas being displaced more frequently, lower emissions reductions and an abatement cost up to $91 per ton of CO2. Our results should be compared with other technologies and policies so that policymakers can cost-effectively reduce emissions.Item Open Access DRILLING FOR GREEN CAPITAL: A Policy Study on Stimulating a Green Economy in the State of Texas(2009-04-24T18:44:03Z) Young, KristinePolicy at the state level plays a vital role in shaping economic growth. Some states, such as Pennsylvania, have actively enacted policy to stimulate a green economy. This report is a comparative case study of existing policy mechanisms for economic development in Pennsylvania and Texas. Pennsylvania has focused on economic opportunities in environmental initiatives, such as brownfield redevelopment and the cleantech industry. The Keystone Principles and Keystone Green Investment Strategy are examples of key policy tools utilized in Pennsylvania to stimulate the economy and conserve natural resources. Texas has a very strong economy, but relies heavily on energy intensive industries. The state has a strong policy agenda of economic development and business recruitment. The date collected for this case focuses on these strengths. Policy mechanisms that have built the state’s economy include the Industry Cluster Initiative, the Economic Development Bank and the Texas Enterprise Fund. The Pennsylvania case study data is used to develop recommendations on how to design and deploy incentive structures for green businesses in the State of Texas. The policy study discovers existing programs in Texas correlate with Pennsylvania’s policy mechanisms. A key element in Pennsylvania’s programs is environmental criterion to conserve natural resources, a ‘green criteria’ or ‘green objective.’ The purpose of green criteria is to weigh in on the environmental impacts of economic activities. Three recommendations are presented for Texas: 1. Incorporate a green objective in the Industry Cluster Initiative. 2. Target business services to address critical needs in green sectors. 3. Create an Energy Office in Texas’ environmental protection agency. These recommendations incorporate green objectives as enhancement strategies into existing programs. Instituting a green objective economic development will an important direction for Texas to maintain its competitive advantage on the global market in recruiting green businesses.Item Open Access Functional Variants in Notch Pathway Genes NCOR2, NCSTN, and MAML2 Predict Survival of Patients with Cutaneous Melanoma.(Cancer Epidemiol Biomarkers Prev, 2015-07) Zhang, Weikang; Liu, Hongliang; Liu, Zhensheng; Zhu, Dakai; Amos, Christopher I; Fang, Shenying; Lee, Jeffrey E; Wei, QingyiBACKGROUND: The Notch signaling pathway is constitutively activated in human cutaneous melanoma to promote growth and aggressive metastatic potential of primary melanoma cells. Therefore, genetic variants in Notch pathway genes may affect the prognosis of cutaneous melanoma patients. METHODS: We identified 6,256 SNPs in 48 Notch genes in 858 cutaneous melanoma patients included in a previously published cutaneous melanoma genome-wide association study dataset. Multivariate and stepwise Cox proportional hazards regression and false-positive report probability corrections were performed to evaluate associations between putative functional SNPs and cutaneous melanoma disease-specific survival. Receiver operating characteristic curve was constructed, and area under the curve was used to assess the classification performance of the model. RESULTS: Four putative functional SNPs of Notch pathway genes had independent and joint predictive roles in survival of cutaneous melanoma patients. The most significant variant was NCOR2 rs2342924 T>C (adjusted HR, 2.71; 95% confidence interval, 1.73-4.23; Ptrend = 9.62 × 10(-7)), followed by NCSTN rs1124379 G>A, NCOR2 rs10846684 G>A, and MAML2 rs7953425 G>A (Ptrend = 0.005, 0.005, and 0.013, respectively). The receiver operating characteristic analysis revealed that area under the curve was significantly increased after adding the combined unfavorable genotype score to the model containing the known clinicopathologic factors. CONCLUSIONS: Our results suggest that SNPs in Notch pathway genes may be predictors of cutaneous melanoma disease-specific survival. IMPACT: Our discovery offers a translational potential for using genetic variants in Notch pathway genes as a genotype score of biomarkers for developing an improved prognostic assessment and personalized management of cutaneous melanoma patients.Item Open Access Labor, Civil Rights, and the Struggle for Democracy in Mid-Twentieth Century Texas(2011) Krochmal, MaximilianWhat happens when the dominant binary categories used to describe American race relations--either "black and white," or "Anglo and Mexican"--are examined contemporaneously, not comparatively, but in relation to one another? How do the long African American and Chicano/a struggles for racial equality and economic opportunity look different? And what role did ordinary people play in shaping these movements? Using oral history interviews, the Texas Labor Archives, and the papers of dozens of black, brown, and white activists, this dissertation follows diverse labor, civil rights, and political organizers from the mid-1930s to the mid-1960s.
Tracing their movements revealed a startling story. Beginning in the mid-1930s, African American and ethnic Mexican working people across Texas quietly and tentatively approached one another as well as white laborers for support in their efforts to counter discrimination at work, in their unions, and in the cities in which they lived. Such efforts evolved in different ways due to the repression of the early Cold War, but most organizers simply redirected their activism into new channels. By the close of the 1950s, new forms of multiracial alliances were beginning to take hold. Mutual suspicion slowly gave way to mutual trust, especially in San Antonio. There, and increasingly statewide, black and brown activists separately developed robust civil rights movements that encompassed demands not only for integration but also equal economic opportunities and the quest for independent political power.
The distinct civil rights and labor movements overlapped, especially in the realm of electoral politics. By the mid-1960s, what began as inchoate collaboration at the local level had gradually expanded from its origins in the barrios, ghettos, union halls, and shop floors to become a broad-based, state-wide coalition in support of liberal politicians and an expansive civil rights agenda. At the same time, African American and ethnic Mexican activists were engaged in new waves of organizing for both political power and civil rights, but they encountered opposition from members of their own ethnic groups. Thus the activists' efforts to forge inter-ethnic coalitions coexisted with protracted intra-ethnic conflict. In many cases distinctions of class and political philosophy and tactics mattered at least as much as did ties of ethnicity. Activists learned this lesson experientially: in the trenches, through countless small conflicts over several decades, they slowly separated themselves from their more conservative counterparts and looked to multiracial coalitions as their primary strategy for outflanking their intra-ethnic opponents. Meanwhile, organized labor and white liberals had been searching for allies in their efforts to wrest control of the Democratic Party away from its conservative wing. In the early 1960s, they reached the conclusion that black and brown voters would prove key to their own success, so they gradually transitioned toward civil rights organizing in order to build a coalition with the black and brown civil rights movements.
After decades of fighting separately and dabbling in experimental partnerships, veteran ethnic Mexican, African American, and white labor and liberal activists finally came together into a powerful statewide Democratic Coalition. Between 1962 and 1964, their collaborative campaign for civil rights, economic opportunity, and political power reached a fever pitch, resulting in the state's largest ever direct action protests, massive door-to-door electoral initiatives, and an ever-deepening commitment by labor to putting boots on the ground for community organizing. In the late 1960s the statewide multiracial coalition reached its apex and began to lose steam. At the same time, local multiracial coalitions continued to thrive, underpinning both the African American and Chicano/a urban electoral mobilizations and the rising Black and Brown Power movements. At the local level and in the short term, black, brown, and white working-class civil rights activists won--they achieved a degree of economic and political democracy in Texas that was scarcely imaginable in the age of Jim Crow just a few decades earlier. But as they won local battles they also lost the larger war.
Working-class civil rights organizers thus failed in the end to democratize Texas and America. Their goals remain distant to this day. Yet they were themselves transformed by their experiences in the struggle. Most transitioned from near-complete political and economic exclusion to having a voice. Their collective story indicates that scholars have much to gain from studying organized labor, electoral politics, and the African American and ethnic Mexican civil rights movements simultaneously. Doing so not only adds to the emerging historical sub-field of black-brown relations but also makes each of the individual movements look different. It reconnects class to the black freedom struggle, militancy to the ethnic Mexican civil rights movement, organized labor to community activism, and all three movements to the creation of today's urban politics.
Item Open Access Novel long QT syndrome-associated missense mutation, L762F, in CACNA1C-encoded L-type calcium channel imparts a slower inactivation tau and increased sustained and window current.(International journal of cardiology, 2016-10) Landstrom, AP; Boczek, NJ; Ye, D; Miyake, CY; De la Uz, CM; Allen, HD; Ackerman, MJ; Kim, JJBACKGROUND:Mutations in the CACNA1C-encoded L-type calcium channel have been associated with Timothy syndrome (TS) with severe QT prolongation, syndactyly, facial dysmorphisms, developmental delay, and sudden death. Recently, patients hosting CACNA1C mutations with only long QT syndrome (LQTS) have been described. We sought to identify novel variants in CACNA1C associated with either TS or LQTS, and to determine the impact of the mutation on channel function. METHODS/RESULTS:Two probands were identified with mutations in CACNA1C, one with a TS-associated mutation, G406R, and a second with genotype-negative LQTS. Illumina HiSeq 2000 whole exome sequencing on the genotype-negative LQTS proband revealed a novel variant, CACNA1C-L762F, that co-segregated within a multi-generational family. The missense mutation localized to the DII/DIII intracellular interlinker segment of the channel in a highly conserved region in close proximity to the 6th transmembrane segment of domain II (DIIS6). Whole cell patch clamp of heterologously expressed CACNA1C-L762F in TSA201 cells demonstrated slower inactivation tau and increased sustained and window current. Comprehensive review and topological mapping of all described CACNA1C mutations revealed TS-specific hotspots localizing to the cytoplasmic aspect of 6th transmembrane segment of respective domains. Probands hosting TS mutations were associated with elevated QTc, higher prevalence of 2:1 AV block, and a younger age at presentation compared to LQTS. CONCLUSIONS:The CACNA1C-L762F mutation is associated with development of LQTS through slower channel inactivation and increased sustained and window current. TS-associated mutations localize to specific areas of CACNA1C and are associated with a younger age at presentation, higher QTc, and 2:1 AV block than isolated LQTS-associated mutations.Item Open Access R.E.A.C.H. All Our Students: Considerations for Ethnic Studies Advocacy(2023-04-27) Lindsey, TimothyItem Open Access Syllabic Heirlooms(2017-12) Hooks, ChloeSyllabic Heirlooms is a collection steeped in lyricism, myth and Southwestern idiom as it explores inherited speech, feminine self-possession and the journey from love to liberation. An abbreviated version of the collection won Duke's 2017 Academy of American Poets Prize (First Place) and went on to win Duke English's Anne Flexner Award for Poetry in 2018, and it contributed to Hooks' reception of the inaugural Council for the Arts Award for Excellence. Selections of the collection have been published by APSU's Red Mud Review and by Z Publishing's North Carolina's Best Emerging Poets. The work is heavily influenced both by thesis advisor Dr. Joseph Donahue and by Dr. Nathaniel Mackey.Item Open Access Trajectory of systolic blood pressure in a low-income, racial-ethnic minority cohort with diabetes and baseline uncontrolled hypertension.(Journal of clinical hypertension (Greenwich, Conn.), 2017-07) Zullig, Leah L; Liang, Yuanyuan; Vale Arismendez, Shruthi; Trevino, Aron; Bosworth, Hayden B; Turner, Barbara JIn two primary care clinics in Texas serving low-income patients, systolic blood pressure (SBP) trajectory was examined during 2 years in patients with diabetes mellitus (mean SBP ≥140 mm Hg: 152 mm Hg±11.2 in the baseline year). Among 860 eligible patients, 62.0% were women, 78.8% were Hispanic, and 41.2% were uninsured. Overall, SBP dropped 0.56 mm Hg per month or 13.4 mm Hg by 24 months. For patients with mean glycated hemoglobin ≥9% in year 1, SBP declined 4.8 mm Hg less by 24 months vs those with glycated hemoglobin <7% (P=.03). Compared with white women, SPB declined 7.2 mm Hg less by 24 months in Hispanic women (P=.03) and 9.6 mm Hg less by 24 months in black men (P=.04). SBP also declined 9.1 mm Hg less by 24 months for patients taking four or more blood pressure drug classes at baseline vs one drug class. In this low-income cohort, clinically complex patients and racial-ethnic minorities had clinically significantly smaller declines in SBP.