IMPACT OF OPEN ENROLLMENT IN COURSE-BASED UNDERGRADUATE RESEARCH EXPERIENCES WITH AT-RISK STUDENT POPULATIONS.

Participation in authentic research activities, particularly mentored undergraduate research experiences, at the University of Texas at El Paso has long been associated with student success measures such as graduation and matriculation to strong graduate programs in STEM. However, these opportunities typically are available to upper division students, despite evidence suggesting that the first (Freshman) year at university is determinant for individuals to complete STEM degrees. To expand the number of research opportunities and to extend them preferentially to new, entering students, we established the Freshman Year Research Intensive Sequence (FYRIS) in 2015, a course sequence consisting of a research foundations course and one or two laboratory courses redesigned by faculty into small, special topic Course-based Undergraduate Research Experiences (CUREs). CUREs provide authentic research experiences with similar early-, middle-, and late-term benefits to those found in traditional mentored experiences. Several of these benefits can be conceptualized as "hubs", which derive from earlier benefits, while facilitating later positive outcomes. Self-efficacy is one such hub, while retention and persistence in science enrollment represent late-phase positive outcomes. In this report, we examined self-efficacy of FYRIS participants in surveys administered at the start and end of each course to assess their confidence in conducting fundamental and specific research activities in the foundations and research driven courses, respectively. Specific items from a validated survey were used in addition to items developed for each course based on specific learning objectives. Retention was measured across three years of assessment of participants and non-participants, controlling for key scholastic characteristics. Results on retention rates after FYRIS vary depending on whether students fully or partially participated in the course-sequence. Results will be presented for three cohorts of students: 2015-16, 2016-17, and 2017-18.

A prospective long-term study of external trigeminal nerve stimulation for drug-resistant epilepsy.

BACKGROUND: External trigeminal nerve stimulation (eTNS) is an emerging noninvasive therapy for drug-resistant epilepsy (DRE). We report the long-term safety and efficacy of eTNS after completion of a phase II randomized controlled clinical trial for drug-resistant epilepsy. METHODS: This was a prospective open-label long-term study. Subjects who completed the phase II randomized controlled trial of eTNS for DRE were offered long-term follow-up for 1year. Subjects who were originally randomized to control settings were crossed over to effective device parameters (30s on, 30s off, pulse duration of 250s, frequency of 120Hz). Efficacy was assessed using last observation carried forward or parametric imputation methods for missing data points. Outcomes included change in median seizure frequency, RRATIO, and 50% responder rate. RESULTS: Thirty-five of 50 subjects from the acute double-blind randomized controlled study continued in the long-term study. External trigeminal nerve stimulation was well tolerated. No serious device-related adverse events occurred through 12months of long-term treatment. At six and twelve months, the median seizure frequency for the original treatment group decreased by -2.39 seizures per month at 6 months (-27.4%) and -3.03 seizures per month at 12 months (-34.8%), respectively, from the initial baseline (p<0.05, signed-rank test). The 50% responder rates at three, six, and twelve months were 36.8% for the treatment group and 30.6% for all subjects. CONCLUSION: The results provide long-term evidence that external trigeminal nerve stimulation is a safe and promising long-term treatment for drug-resistant epilepsy.

Randomized controlled trial of trigeminal nerve stimulation for drug-resistant epilepsy.

OBJECTIVE: To explore the safety and efficacy of external trigeminal nerve stimulation (eTNS) in patients with drug-resistant epilepsy (DRE) using a double-blind randomized controlled trial design, and to test the suitability of treatment and control parameters in preparation for a phase III multicenter clinical trial. METHODS: This is a double-blind randomized active-control trial in DRE. Fifty subjects with 2 or more partial onset seizures per month (complex partial or tonic-clonic) entered a 6-week baseline period, and then were evaluated at 6, 12, and 18 weeks during the acute treatment period. Subjects were randomized to treatment (eTNS 120 Hz) or control (eTNS 2 Hz) parameters. RESULTS: At entry, subjects were highly drug-resistant, averaging 8.7 seizures per month (treatment group) and 4.8 seizures per month (active controls). On average, subjects failed 3.35 antiepileptic drugs prior to enrollment, with an average duration of epilepsy of 21.5 years (treatment group) and 23.7 years (active control group), respectively. eTNS was well-tolerated. Side effects included anxiety (4%), headache (4%), and skin irritation (14%). The responder rate, defined as >50% reduction in seizure frequency, was 30.2% for the treatment group vs 21.1% for the active control group for the 18-week treatment period (not significant, p = 0.31, generalized estimating equation [GEE] model). The treatment group experienced a significant within-group improvement in responder rate over the 18-week treatment period (from 17.8% at 6 weeks to 40.5% at 18 weeks, p = 0.01, GEE). Subjects in the treatment group were more likely to respond than patients randomized to control (odds ratio 1.73, confidence interval 0.59-0.51). eTNS was associated with reductions in seizure frequency as measured by the response ratio (p = 0.04, analysis of variance [ANOVA]), and improvements in mood on the Beck Depression Inventory (p = 0.02, ANOVA). CONCLUSIONS: This study provides preliminary evidence that eTNS is safe and may be effective in subjects with DRE. Side effects were primarily limited to anxiety, headache, and skin irritation. These results will serve as a basis to inform and power a larger multicenter phase III clinical trial. CLASSIFICATION OF EVIDENCE: This phase II study provides Class II evidence that trigeminal nerve stimulation may be safe and effective in reducing seizures in people with DRE.

Premenstrual dysphoric disorder in women with epilepsy: relationships to potential epileptic, antiepileptic drug, and reproductive endocrine factors.

The purpose of this prospective observational investigation was to determine whether the frequency of premenstrual dysphoric disorder (PMDD) and the severity of PMDD symptoms differ between women with epilepsy and controls without epilepsy and whether there exists a relationship between the severity of PMDD symptoms and some epileptic, antiepileptic drug, and reproductive endocrine features. The results suggest that epilepsy, antiepileptic drug levels, ovulatory status, and hormone levels and ratios may all influence PMDD in women with epilepsy. PMDD severity scores may be greater in people with right-sided than in those with left-sided epilepsy, and in people with temporal than in those with nontemporal epileptic foci. PMDD severity scores may be greater with anovulatory cycles, and scores may correlate negatively with midluteal serum progesterone levels and positively with midluteal estradiol/progesterone ratios. Mood score may vary with particular antiepileptic drugs, favoring carbamazepine and lamotrigine over levetiracetam. PMDD severity scores may correlate directly with carbamazepine levels, whereas they correlate inversely with lamotrigine levels.

Factores sociosanitarios y prevalencia del síndrome del intestino irritable según los criterios diagnósticos de Roma III en una población general de Colombia / Prevalence of irritable bowel syndrome and associated factors according to the Rome III diagnostic criteria in a general population in Colombia

Introducción: El síndrome del intestino irritable (SII) es un trastorno gastrointestinal funcional de diagnóstico clínico. La prevalencia y los factores asociados se desconocen en la población colombiana. El diagnóstico del SII hoy se hace por medio de la aplicación de los criterios de Roma III y se debe descartar otra condición médica antes de realizar el diagnóstico. Objetivo: Determinar la prevalencia del SII y sus factores sociosanitarios asociados en una población de entre 18 y 60 años de Bucaramanga, Colombia. Métodos: Estudio de corte transversal. Se realizó un cuestionario autoaplicado que investigó variables sociodemográficas, tipo de alimentos consumidos, identificación del SII por medio de los criterios de Roma III, SDS (Self-Rating Depression Scale escala autoaplicada para depresión ) de Zung, test de STAI (State-Trait Anxiety Inventory inventario de ansiedad estado-rasgo ) y autoinforme del uso de servicios médicos en una muestra aleatorizada de la población adulta del municipio de Bucaramanga. Se usó el análisis bivariado y la regresión logística para establecer asociaciones. Resultados: De un total de 615 individuos seleccionados, 558 se incluyeron en el estudio. La edad promedio fue de 36,4 años y el 62,4% fueron mujeres. La prevalencia de SII fue del 19,9%. El análisis de regresión logística mostró asociación a los síntomas depresivos y al sexo femenino independiente de los síntomas de la ansiedad y de la edad. Conclusión: El SII presenta una prevalencia alta y se asocia con síntomas depresivos y al sexo femenino en una población adulta de Colombia. Su presencia genera mayor utilización del sistema sanitario, incapacidad médica y restricción en las actividades de la vida diaria (AU)

Introduction: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with a clinical diagnosis. The prevalence of this disorder and associated factors are unknown among the Colombian population. Nowadays, diagnosis of IBS is made by applying the Rome III criteria, and other disorders should be excluded before establishing the diagnosis. Objective: To assess the prevalence of IBS and associated factors in a population aged between 18 and 60 years old in Bucaramanga, Colombia. Methods: A cross-sectional study was performed. We applied a questionnaire that included sociodemographic variables, types of food, identification of IBS by the Rome III criteria, the Zung self-rating depression scale, the State-Trait Anxiety Inventory (STAI) test and self-reported use of medical services among a random sample of an adult population in Bucaramanga. Univariate analysis and logistic regression was used to establish associations. Results: Of the 615 individuals selected, 558 were included in the study. The mean age was 36.4 years and 62.4% was female. The prevalence of IBS was 19.9%. Logistic regression analysis showed an association with depressive symptoms and female sex independently of age and anxiety symptoms. Conclusions:The prevalence of IBS is high and is associated with depressive symptoms and female sex in an adult population in Colombia. This disorder generates substantial health system utilization and medical disability and restricts activities of daily life (AU)

[Prevalence of irritable bowel syndrome and associated factors according to the Rome III diagnostic criteria in a general population in Colombia]. / Factores sociosanitarios y prevalencia del síndrome del intestino irritable según los criterios diagnósticos de Roma III en una población general de Colombia.

INTRODUCTION: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with a clinical diagnosis. The prevalence of this disorder and associated factors are unknown among the Colombian population. Nowadays, diagnosis of IBS is made by applying the Rome III criteria, and other disorders should be excluded before establishing the diagnosis. OBJECTIVE: To assess the prevalence of IBS and associated factors in a population aged between 18 and 60 years old in Bucaramanga, Colombia. METHODS: A cross-sectional study was performed. We applied a questionnaire that included sociodemographic variables, types of food, identification of IBS by the Rome III criteria, the Zung self-rating depression scale, the State-Trait Anxiety Inventory (STAI) test and self-reported use of medical services among a random sample of an adult population in Bucaramanga. Univariate analysis and logistic regression was used to establish associations. RESULTS: Of the 615 individuals selected, 558 were included in the study. The mean age was 36.4 years and 62.4% was female. The prevalence of IBS was 19.9%. Logistic regression analysis showed an association with depressive symptoms and female sex independently of age and anxiety symptoms. CONCLUSIONS: The prevalence of IBS is high and is associated with depressive symptoms and female sex in an adult population in Colombia. This disorder generates substantial health system utilization and medical disability and restricts activities of daily life.

Deaths associated with cysticercosis. Report of three cases and review of the literature.

There is significant concern about an increased risk of death in patients with neurocysticercosis who receive antihelminthic agents. To clarify the risk factors for death associated with cysticercosis, the authors identified all cases of mortality over a 5-year period in patients in whom cysticercosis was diagnosed and who were discharged from a major metropolitan medical center. In addition, they reviewed the literature to delineate risk factors associated with cysticercosis-related death, concluding that the risk of death is highest in patients with heavy cyst burdens and those surgically treated for intracranial hypertension. Death is rare in properly selected patients with parenchymal disease in whom the cyst burden is low and intracranial hypertension is absent. The most common causes of death appear to be 1) intracranial hypertension in surgically treated patients and 2) shunt infection.