Comparative Study of Risk Factors Associated with Normal Cognition and Cognitive Impairment in Rural West Elderly Texans.

Background: Alzheimer's disease (AD) is related to one or more chronic illnesses, which may develop cognitive decline and dementia. Cognitive impairment is increasing, and public health officials must address risk factors for AD to improve the health of rural West Texas communities. Objective: The purpose of this study was to explore the sociodemographic and chronic disease risk factors related to cognitive impairment among elderly adults living in Cochran, Parmer, and Bailey counties in rural West Texas. Methods: Statistical methods such as Pearson's chi-squared, proportion tests, univariate binary logistic regression, and a multivariable logistic regression were utilized to analyze data. SPSS software was used to detect the significant relationship between cognitive impairment and risk factors. Results: Summary statistics were obtained for sociodemographic and chronic diseases by using cross-tabulation analysis and comparing the county respondents with proportion tests. A univariate binary logistic regression method was utilized and found that age group 60-69, anxiety, depression, diabetes, hypertension, and cardiovascular disease were significantly associated with cognitive impairment. Using a multivariable logistic regression approach, it was found that Bailey County (age group 60-69) had a higher likelihood (p = 0.002) of cognitive impairment than Parmer (p = 0.067) and Cochran counties (p = 0.064). The risk of females (p = 0.033) in Parmer County was 78.3% lower compared to males in developing AD. Conclusions: Identifying significant risk factors for cognitive impairment are important in addressing issues of geographic variations and integrating such factors may guide relevant policy interventions to reduce cognitive impairment incidence in rural communities within West Texas.

Caring for Individuals with Alzheimer's Disease: A Spotlight on Hispanic Caregivers.

 A caregiver is a constantly evolving role that an individual most likely undertakes at some point in their lifetime. With discoveries and research in increasing life expectancy, the prevalence of neurological-related diseases, such as Alzheimer's disease (AD) and dementia, is certainly likely to require more caregivers. The demand for AD caregivers is escalating as the prevalence of the disease continues to rise. The projected rise in AD within the Hispanic population in the United States over the next few decades is expected to be the most significant among all ethnic groups. The Hispanic population faces unique dementia risks due to cultural factors like language barriers, lower education, and limited healthcare access. Higher rates of conditions such as diabetes and cardiovascular disease further elevate dementia risk. Family dynamics and caregiving responsibilities also differ, affecting dementia management within Hispanic households. Addressing these distinct challenges requires culturally sensitive approaches to diagnosis, treatment, and support for Hispanic individuals and their family's facing dementia. With AD and other dementia becoming more prevalent, this article will attempt to expand upon the status of caregivers concerning their economic, health, and cultural statuses. We will attempt to focus on the Hispanic caregivers that live in Texas and more specifically, West Texas due to the lack of current literature that applies to this area of Texas. Lastly, we discuss the ramifications of a multitude of factors that affect caregivers in Texas and attempt to provide tools that can be readily available for Hispanics and others alike.

Effects of sleep deprivation on brain atrophy in individuals with mild cognitive impairment and Alzheimer's disease.

Dementia, a prevalent condition in the United States, affecting millions of individuals and their families, underscores the importance of healthy cognitive ageing, which involves maintaining cognitive function and mental wellness as individuals grow older, promoting overall well-being and quality of life. Our original research study investigates the correlation between lifestyle factors and brain atrophy in individuals with mild cognitive impairment (MCI) or Alzheimer's disease (AD), as well as healthy older adults. Conducted over six months in West Texas, the research involved 20 participants aged 62-87. Findings reveal that sleep deprivation in MCI subjects and AD patients correlate with posterior cingulate cortex, hippocampal atrophy and total brain volume, while both groups exhibit age-related hippocampal volume reduction. Notably, fruit/vegetable intake negatively correlates with certain brain regions' volume, emphasizing the importance of diet. Lack of exercise is associated with reduced brain volume and hippocampal atrophy, underlining the cognitive benefits of physical activity. The study underscores lifestyle's significant impact on cognitive health, advocating interventions to promote brain health and disease prevention, particularly in MCI/AD cases. While blood profile data showed no significant results regarding cognitive decline, the study underscores the importance of lifestyle modifications in preserving cognitive function.

Saving Hearts in Rural West Texas: The Impact of Critical Care Access on Mortality Rates.

Background The Critical Access Hospital (CAH) designation program was created in 1997 by the US Congress to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping fundamental services in rural communities. Methods This is a retrospective observational study. Information on CAHs in West Texas in rural counties was extrapolated from the Flex Monitoring Team between 2010 and 2020. The study population included adults aged ≥25 years with a known heart failure (HF) diagnosis who were identified using ICD-10 codes. Mortality rates were obtained from the CDC Wide-ranging ONline Data for Epidemiologic Research (WONDER) database. The HF population was categorized by age, sex, and ethnicity. Mortality differences among these groups were analyzed using a two-sample t-test. The significance level was considered to be p < 0.05. Results The total study population analyzed was 1,348,001. A statistically significant difference in age-adjusted mortality rate (AAMR) was observed between the study and control groups, with a value of 3.200 (95% CI: 3.1910-3.2090, p < 0.0001) in favor of a lower mortality rate in rural counties with CAHs. When comparing gender-related differences, males and females had lower AAMRs in rural counties with CAHs. Among each gender, statistically significant differences were noted between males (95% CI: 2.181-2.218, p < 0.001) and females (95% CI: 3.382-3.417, p < 0.001). When examining the data by ethnicity, the most significant difference in mortality rate was observed within the Hispanic population, 6.400 (95% CI: 6.3770-6.4230, p < 0.0001). When adjusted to age, the crude mortality rate was calculated, which favored CAH admission in the younger population (10.200 (95% CI: 10.1625-10.2375, p < 0.001) and 11.500 (95% CI: 11.4168-11.5832, p < 0.001) in the 55-64 and 65-74 age groups, respectively). Conclusion The data clearly showed that West Texas rural county hospitals that received CAH designation performed better in terms of mortality rates in the HF population compared to non-CAH.

Avian haemosporidians of breeding birds in the Davis Mountains sky-islands of west Texas, USA.

Avian haemosporidians are protozoan parasites transmitted by insect vectors that infect birds worldwide, negatively impacting avian fitness and survival. However, the majority of haemosporidian diversity remains undescribed. Quantifying this diversity is critical to determining parasite­host relationships and host-switching potentials of parasite lineages as climate change induces both host and vector range shifts. In this study, we conducted a community survey of avian haemosporidians found in breeding birds on the Davis Mountains sky islands in west Texas, USA. We determined parasite abundance and host associations and compared our results to data from nearby regions. A total of 265 birds were screened and infections were detected in 108 birds (40.8%). Most positive infections were identified as Haemoproteus (36.2%), followed by Plasmodium (6.8%) and Leucocytozoon (0.8%). A total of 71 haemosporidian lineages were detected of which 39 were previously undescribed. We found that regional similarity influenced shared lineages, as a higher number of lineages were shared with avian communities in the sky islands of New Mexico compared to south Texas, the Texas Gulf Coast and central Mexico. We found that migratory status of avian host did not influence parasite prevalence, but that host phylogeny is likely an important driver.

Impact of Access to Breast Care For West Texas Program on Early Detection and Regional Breast Cancer Mortality.

INTRODUCTION: This study aimed to assess whether the Access to Breast Care for West Texas (ABC4WT) program impacted regional breast cancer detection and mortality in the Texas Council of Governments (COG)1 region. METHODS: Interrupted time series analyses were utilized to evaluate the impact of the intervention. Spearman's rank correlation and cross-orrelation analyses were performed to assess the relationship between the total number of screenings and (i) the total number of breast cancer detected and (ii) the proportion of early-stage cancer detected and the (pre-whitened) residuals. A three-way interaction model compared pre-and post-intervention mortality in COG 1 with the COG 9 region (control). RESULTS: Increased screening rate was associated with increased breast and early-stage cancer incidences (P = .001 and P = .002, respectively). There were significant positive cross-correlations between the total number of screenings and the total number of breast cancer detected (r = .996) and the proportion of early-stage cancer detected (r = .709) without a lag even after pre-whitening. Univariate analysis showed that regional mortality decreased with time (P < .001) and after intervention (P = .001). Multivariate analysis did not show any significant difference in time (P = .594), intervention (P = .453), and time and intervention interaction (P = .273). The three-way interaction model showed no difference in the baseline mortality and pre-intervention trend difference in COG 1 and COG 9 regions. However, there was a significant pre-post intervention trend difference in mortality COG 1 compared to the COG 9 region (P = .041). CONCLUSION: Implementing the ABC4WT program was associated with the early detection of breast cancer and reducing regional mortality in the COG 1 region.

Gender differences in prevalence of myocardial infarction in rural West Texans.

Background: Heart disease is the leading cause of death in the United States. Incidence rates of myocardial infarction (MI) in rural West Texas signify a lack of effective, risk-specific prevention programs. The purpose of this study was to identify gender-specific risk factors for MI in rural West Texans. Subjects and methods: Hospital patient data for those with and without a history of MI were obtained from the Project FRONTIER database for rural West Texas counties. We used statistical software, such as SPSS, R, and WinBUGS to detect and understand the nature of MI risk factors. Statistical methods including t-tests, Chi-squared, logistic regression, and a Bayesian approach were utilized to analyze data. Results: MI significant risk factors obtained for females were systolic blood pressure (p = 0.002), diastolic blood pressure (p = 0.004), pulse (p = 0.015), and smoking (p = 0.002). For males, these were glucose (p = 0.022), age (p = 0.050), body fat (p = 0.034), and smoking (p = 0.017). The mean risk parameter followed a normal distribution, while the precision parameter depicted skew for both sexes. Conclusions: Gender-specific differences in MI risk factors exist, and incorporating such variables can guide relevant policymaking to reduce MI incidence in rural West Texans.

Time to Fix the Damage of Weakened Chemical Disaster Prevention Regulations.

The Trump administration weakened regulations through changes on rules that have been improved during the Obama years. An example is the reversal in 2019 of the improvements to the U.S. Environmental Protection Agency Risk Management Program, Chemical Disaster Prevention Rule. In 2013 a catastrophic explosion of ammonium nitrate in West, Texas, provided the impetus to improve the original regulations after an investigation of its consequences. The justification for reversing the improvements was provided by one of the three federal investigations conducted by the U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives which alleged, without proof, that the West, Texas explosion was caused by arson and thus nonpreventable. This commentary reviews the details of this reversal and recommends that the U.S. Environmental Protection Agency, now under the Biden Administration, resurrect its 2016 Risk Management Program chemical disaster rule in order to prevent future chemical facility catastrophes.

Disparities in Breast Cancer Survivors in Rural West Texas.

OBJECTIVES: Breast cancer is the second highest female mortality rate in Texas for all races and ethnicities, except for Hispanics. Interestingly, Hale County is a rural underserved county in West Texas which experiences a lower rate of cancer, has higher age-adjusted mortality rates (26.2/100 000), on average, compared to all of Texas (23.1/100 000). The purpose of this study was to determine the relationship between sociodemographic variables and breast cancer outcomes in underserved Hale County which contributed to the highest mortality rate in Texas. METHODS: Hale County breast cancer data (1995-2014) were obtained from the Texas Cancer Registry. Statistical methods independent samples t-test, Kaplan-Meier curve, and Cox proportional hazard were used to describe the significant relationship between survival time, sociodemographic, and prognostic variables. RESULTS: Women with breast cancer in Hale County were more likely to be White non-Hispanics (n = 266, 65.5%) and had the highest longevity (2753.6 ± 2073.5 days). White Hispanics experienced the worst survival (2369.6 ± 2060.2 days) and were more likely to develop a serious grade of cancer. Significant relationships were found between the stage of cancer and insurance status with survival time for both White non-Hispanics and White Hispanics (P < .001). Patients in grades II and III were found to be significantly (P < .01) associated with breast cancer death, and grades II and III which had around five-fold and eleven-fold increased risk of death, respectively, compared with the referent group, grade I. CONCLUSION: Determining the impact of sociodemographic variables on breast cancer outcome is essential to addressing issues of geographic disparities and integrating such variables may guide relevant policy interventions to reduce breast cancer's incidence in rural underserved communities in West Texans.

A Retrospective Analysis and Comparison of Prisoners and Community-Based Patients with COVID-19 Requiring Intensive Care During the First Phase of the Pandemic in West Texas.

BACKGROUND: COVID-19 is a highly infectious disease which usually presents with respiratory symptoms. This virus is disseminated through respiratory droplets, and, therefore, individuals residing in close quarters are at a higher risk for the acquisition of infection. The prison population is at a significantly increased risk for infection. METHODS: Prisoners from the Montford Correctional facility in Lubbock, Texas, hospitalized in the medical intensive care unit at University Medical Center between March 1, 2020 and May 15, 2020 were compared to community-based patients hospitalized in the same medical intensive care unit. Clinical information, laboratory results, radiographic results, management requirements, and outcomes were compared. RESULTS: A total of 15 community-based patients with a mean age of 67.4 ± 15.5 years were compared to 5 prisoners with a mean age of 56.0 ± 9.0 years. All prisoners were men; 10 community-based patients were men. Prisoners presented with fever, dyspnea, and GI symptoms. The mean number of comorbidities in prisoners was 2.4 compared to 1.8 in community-based patients. Prisoners had significantly lower heart rates and respiratory rates at presentation than community-based patients. The mean length of stay in prisoners was 12.6 ± 8.9 days; the mean length of stay in community-based patients was 8.6 ± 6.5. The case fatality rate was 60% in both groups. CONCLUSIONS: Prisoners were younger than community-based patients but required longer lengths of stay and had the same mortality rate. This study provides a basis for comparisons with future studies which could involve new treatment options currently under study.

Prevalence of monarch (Danaus plexippus) and queen (Danaus gilippus) butterflies in West Texas during the fall of 2018.

BACKGROUND: The monarch butterfly (Danaus plexippus) is a conspicuous insect that has experienced a drastic population decline over the past two decades. While there are several factors contributing to dwindling monarch populations, habitat loss is considered the most significant threat to monarchs. In the United States, loss of milkweed, particularly in the Midwest, has greatly reduced the available breeding habitat of monarchs. This has led to extensive efforts to conserve and restore milkweed resources throughout the Midwest. Recently, these research and conservation efforts have been expanded to include other important areas along the monarch's migratory path. RESULTS: During the fall of 2018, we conducted surveys of monarch eggs and larvae through West Texas. We documented monarch and queen butterfly (Danaus gilippus) reproduction throughout the region and used the proportion of monarch and queen larva to estimate the number of monarch eggs. Peak egg densities for monarchs were as high as 0.78 per milkweed ramet after correction for the presence of queens. Despite our observations encompassing only a limited sample across one season, the peak monarch egg densities we observed exceeded published reports from when monarch populations were higher. CONCLUSIONS: To our knowledge, this is the first study to correct for the presence of queens when calculating the density of monarch eggs. This research also provides insight into monarch utilization of less well-known regions, such as West Texas, and highlights the need to expand the scope of monarch monitoring and conservation initiatives. While the importance of monarch research and conservation in the Midwest is unquestionable, more comprehensive efforts may identify new priorities in monarch conservation and lead to a more robust and effective overall strategy, particularly given the dynamic and rapidly changing global environment.

Detection of the Amphibian Pathogens Chytrid Fungus (Batrachochytrium dendrobatidis) and Ranavirus in West Texas, USA, Using Environmental DNA.

Environmental DNA (eDNA) methods provide novel options for the detection of pathogens. The amphibian pathogens Batrachochytrium dendrobatidis (Bd) and Ranavirus have been relatively understudied in Texas, US, so we applied eDNA assays for the surveillance of these pathogens in the upper Brazos River basin near the Texas panhandle. We collected water samples from five urban playa lakes and one reservoir in and around Lubbock, Texas. Quantitative PCR detected both Bd and Ranavirus at one playa lake, representing novel detection of both pathogens in the region. Based on these results, we recommend increased monitoring for the pathogens and symptoms of amphibian disease throughout the region.

Investigating the culturable atmospheric fungal and bacterial microbiome in West Texas: implication of dust storms and origins of the air parcels.

Individuals often experience ailments such as allergies, asthma and respiratory tract infections throughout the year. Weather reports often include estimations of common allergens that can affect these individuals. To describe the local 'atmospheric microbiome' in Lubbock, Texas, USA, we examined the culturable fungal and bacterial microbiome present in the air on calm and dust storm days using internal transcribed spacer (ITS)-1 and 16S rRNA amplicon sequencing, respectively. While some types of airborne fungi were frequently present throughout the year, distinct differences were also observed between calm and dust storm days. We also observed the influence of the origin of air parcels and wind elevation of the air trajectory. The most abundant genera of fungi identified during the study period were Cryptococcus, Aureobasidium, Alternaria, Cladosporium and Filobasidium. This observation was not surprising considering the agricultural intensive environment of West Texas. Interestingly, Cladosporium, a common allergenic mold, was increased during days with dust storm events. The predominant bacterial genera observed were Bacillus, Pseudomonas, Psychrobacter, Massilia and Exiguobacterium. The relative abundance of the psychrophiles, Psychrobacter and Exiguobacterium, was surprising, given the semi-aridity of West Texas. Coupling our observations with back trajectories of the wind (Hybrid Single-Particle Lagrangian Integrated Trajectory models) demonstrated that dust storms, regional anthropogenic activity and origin of air parcels are important influences on the diversity and temporal presence of the atmospheric microbiome.

Elevated parasite burdens as a potential mechanism affecting northern bobwhite (Colinus virginianus) population dynamics in the Rolling Plains of West Texas.

Northern bobwhite quail (Colinus virginianus) are a highly sought-after game bird in the Rolling Plains of West Texas. Unfortunately, bobwhite populations in this area are subject to dramatic fluctuations and have been steadily decreasing over the past several decades. While many factors have been investigated as potential mechanisms of cyclic and declining bobwhite numbers, the effect of parasites on bobwhite populations has historically been undervalued. Between December 2017 and February 2018, we received 21 hunter-shot bobwhite from Garza and Mitchell counties in Texas and found peak caecal worm (Aulonocephalus pennula) and eyeworm (Oxyspirura petrowi) burdens averaging 599 and 44, respectively. These represent the highest average parasite loads we have documented in bobwhite from the Rolling Plains thus far and are coincident with widespread reports of declining bobwhite abundance. These elevated infections also followed a high point in bobwhite populations in the Rolling Plains, and our observations of infection dynamics during this time reflect other instances of potential parasite-induced host mortality. While the sample discussed in this communication is small, our findings highlight the need for additional research into how parasites may affect bobwhite population fluctuations in this region.

A Multicomponent Intervention Helped Reduce Sugar-Sweetened Beverage Intake in Economically Disadvantaged Hispanic Children.

PURPOSE: This study aimed to examine the effect of a multicomponent intervention program on consumption of sugar-sweetened beverages (SSBs), and lifestyle factors associated with SSB intake, in Hispanic children from low-income families. DESIGN: A five-wave longitudinal study using a quasi-experimental design was conducted. SETTING: Five elementary schools in West Texas served as the setting. SUBJECTS: Participants included 555 predominantly Hispanic children (ages 5-9 years) from low-income families and their parents (n = 525). INTERVENTION: A multicomponent intervention program was implemented. MEASURES: Children's anthropometric measures were obtained. Their weight status was determined based on body mass index for age and gender. Parents responded to a demographic questionnaire, a shelf inventory, an acculturation scale, and a family survey. ANALYSIS: Growth curve analyses were used to test differences between intervention and comparison participants' SSB intake and to examine potential covariates. RESULTS: Comparison group children's daily SSB intake significantly increased over time (B = 1.06 ± .40 ounces per month, p < .01), but this linear increase of SSB was slowed down by the intervention (B = -.29 ± .12, p < .05). More daily TV time, more fast food intake, and more types of SSBs available at home were associated with higher SSB intake. CONCLUSION: Risk factors of childhood obesity were associated with each other. The intervention program produced a modest reduction in SSB consumed by economically disadvantaged and predominantly Hispanic children.

Epidemiological characteristics, hospital course and outcome of snakebite victims in West Texas.

INTRODUCTION: Numerous snakebites are reported every spring and summer in the United States especially in the Southwestern part of the country. This is usually associated with significant morbidity but fatalities are rare. Most victims are male and the majority of bites are on the extremities. METHODS: A search for all cases coded with a discharge diagnosis of snakebite injury revealed 90 patients admitted to Northwest Texas Hospital, the trauma center in Amarillo, Texas, between January 2002 and December 2012. These charts were retrospectively reviewed and data extracted including patient demographics, severity of snakebite, treatment given, and ultimate outcome. RESULTS: Ninety patients were admitted to the hospital due to snakebite. It was a rattlesnake in 83 cases. The mean age of the victims was 29.7 years and 74 of them were male. Fifty-one bites were on the upper extremities, thirty-eight bites were on the lower extremities and one bite was on the abdominal wall. About 95% of the lower extremity bites were moderate or severe compared to 74.5% of the upper extremity bites, Cramer's coefficient 0.3, p=0.02. Thirty-one patients had complications and twenty patients required surgical intervention. Eighty-eight patients received a median of 10 vials of antivenin that was well tolerated. Median hospital length of stay was 3 days. None of the patients died. CONCLUSION: Rattlesnake bites cause significant morbidity although mortality is rare. Early administration of antivenin and appropriate supportive measures and monitoring for complications with surgical intervention when needed leads to improved patient outcomes.