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Short report: The role of oral hypersensitivity in feeding behaviors of young autistic children
No full textFeeding problems are common among autistic children and are linked to negative health consequences. Therefore, understanding feeding problems and factors that influence these behaviors is important for developing supports for children and families. While certain sensory processing patterns are commonly associated with feeding problems, less is known about the link between sensory processing and feeding behaviors in autism, as well as how parent behaviors and feelings during mealtime differ based on child sensory preferences. This research examined two groups of young autistic children who were reported to be picky eaters by their parents: those with and those without oral hypersensitivity. Children with oral hypersensitivity had more difficulty with food acceptance, and their parents reported more negative feelings around feeding their child. However, the two groups of children (oral hypersensitive and not) did not differ in their medical/oral motor symptoms, mealtime behavior, or parent use of strategies at mealtimes. This research supports the need for personalized treatment strategies based on the child’s sensory preferences to support both the child and parent in managing mealtimes
Evidence-based practice models and frameworks in the healthcare setting: a scoping review
Get PDFA grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Objectives The aim of this scoping review was to identify and review current evidence-based practice (EBP) models and frameworks. Specifically, how EBP models and frameworks used in healthcare settings align with the original model of (1) asking the question, (2) acquiring the best evidence, (3) appraising the evidence, (4) applying the findings to clinical practice and (5) evaluating the outcomes of change, along with patient values and preferences and clinical skills.
Design A Scoping review.
Included sources and articles Published articles were identified through searches within electronic databases (MEDLINE, EMBASE, Scopus) from January 1990 to April 2022. The English language EBP models and frameworks included in the review all included the five main steps of EBP. Excluded were models and frameworks focused on one domain or strategy (eg, frameworks focused on applying findings).
Results Of the 20 097 articles found by our search, 19 models and frameworks met our inclusion criteria. The results showed a diverse collection of models and frameworks. Many models and frameworks were well developed and widely used, with supporting validation and updates. Some models and frameworks provided many tools and contextual instruction, while others provided only general process instruction. The models and frameworks reviewed demonstrated that the user must possess EBP expertise and knowledge for the step of assessing evidence. The models and frameworks varied greatly in the level of instruction to assess the evidence. Only seven models and frameworks integrated patient values and preferences into their processes.
Conclusion Many EBP models and frameworks currently exist that provide diverse instructions on the best way to use EBP. However, the inclusion of patient values and preferences needs to be better integrated into EBP models and frameworks. Also, the issues of EBP expertise and knowledge to assess evidence must be considered when choosing a model or framework
Evaluation of Latex Immunoturbidimetric Assay Thresholds and HIT in Cardiothoracic Surgery
Get PDFBackground
Heparin-induced thrombocytopenia (HIT) is a common differential diagnosis in cardiothoracic surgery. The latex immunoturbidimetric assay (LIA) is an enhanced immunoassay that has recently been introduced for the detection of total HIT immunoglobulin and retains a higher specificity of 95% compared to the enzyme-linked immunosorbent assay.
Objectives
To investigate if a semiquantitative relationship exists between increasing LIA levels beyond the current positivity threshold and its correlation to positive serotonin release assay results in cardiothoracic surgery.
Methods
This was a multicenter, observational cohort of cardiothoracic surgery patients initiated on anticoagulation with heparin-based products. To conduct sensitivity and specificity analysis of LIA values, HIT positive was defined as a LIA value ≥1 unit/mL and HIT negative was defined as a LIA level <1 unit/mL. A receiver operating characteristic (ROC) analysis was utilized to evaluate the predictive performance of the LIA.
Results
At manufactures’ cutoffs of ≥1.0 unit/mL, LIA sensitivity and specificity was 93.8% and 22%, respectively, yielding a false positive rate of 78%. At a higher cutoff of 4.5 units/mL, LIA sensitivity and specificity was 75% and 71%, respectively, yielding a false positive rate of 29% and an area under the ROC curve of 0.75 (P = .01; 95% confidence interval: 0.621-0.889). Bivalirudin was initiated in 84.6% of false positive LIA results.
Conclusion
This study suggests that the diagnostic accuracy of the LIA can be optimized by increasing the LIA positivity threshold. Proposing a higher LIA cutoff, may mitigate unwarranted anticoagulation and bleeding outcomes
Filtration of Gene Trees From 9,000 Exons, Introns, and UCEs Disentangles Conflicting Phylogenomic Relationships in Tree Frogs (Hylidae)
Get PDFAn emerging challenge in interpreting phylogenomic data sets is that concatenation and multi-species coalescent summary species tree approaches may produce conflicting results. Concatenation is problematic because it can strongly support an incorrect topology when incomplete lineage sorting (ILS) results in elevated gene-tree discordance. Conversely, summary species tree methods account for ILS to recover the correct topology, but these methods do not account for erroneous gene trees (“EGTs”) resulting from gene tree estimation error (GTEE). Third, site-based and full-likelihood methods promise to alleviate GTEE as these methods use the sequence data from alignments. To understand the impact of GTEE on species tree estimation in Hylidae tree frogs, we use an expansive data set of ∼9,000 exons, introns, and ultra-conserved elements and initially found conflict between all three types of analytical methods. We filtered EGTs using alignment metrics that could lead to GTEE (length, parsimony-informative sites, and missing data) and found that removing shorter, less informative alignments reconciled the conflict between concatenation and summary species tree methods with increased gene concordance, with the filtered topologies matching expected results from past studies. Contrarily, site-based and full-likelihood methods were mixed where one method was consistent with past studies and the other varied markedly. Critical to other studies, these results suggest a widespread conflation of ILS and GTEE, where EGTs rather than ILS are driving discordance. Finally, we apply these recommendations to an R package named PhyloConfigR, which facilitates phylogenetic software setup, summarizes alignments, and provides tools for filtering alignments and gene trees
Othello’s Second Marriage: The Temptation Scene and the Forms of Early Modern Marriage
No full textThis thesis explores the way Iago and Othello’s binding agreement in Othello 3.3 echoes the marriage ceremony traditions of early modern England. Editors and scholars including Michael Neill, Ayanna Thompson and John Baxter have all referred to the end of the famous temptation scene in Othello as a “marriage” or “mock marriage,” but none fully explains or documents why it has the markings of a marriage. This paper attempts to fill in the gaps through a detailed explanation of marriage practices in early modern England, followed by a close reading of Othello 3.3 that focuses on repetition, the calling of witnesses, kneeling, and the language of the vows. Finally, this thesis ends by exploring the implications of reading Othello 3.3 as resemblant of a marriage scene
Changing the Paradigm in Prognostic Breast Cancer Testing Based on Extracellular Vesicles
No full textWomen with early-stage breast cancer have several options for genomic tests including Oncotype DX®, MammaPrint®, and Prosigna® that can estimate risk of distant recurrence and help determine whether they will benefit from adjuvant chemotherapy, but these tests depend on access to tumor tissue samples [1-3]. Our recently published work on “Assessing Breast Cancer Molecular Subtypes Using Extracellular Vesicles’ mRNA” was driven by a desire to develop a liquid-based biopsy approach to estimate the risk of distant recurrence for breast cancer patients receiving endocrine therapy [4].
The clinical relevance in therapeutic stratifications of different molecular subtypes of breast cancer has been demonstrated [5]. Molecular subtyping in breast cancer looks beyond the common prognostic clinical-pathological parameters (e.g., age, tumor size, presence of node metastases and histological grade) and receptor status (i.e., progesterone, estrogen, and HER2) to make sure breast cancer patients receive proper treatment. One such test is the Prosigna® Breast Cancer Prognostic Gene Signature Assay (formerly called the PAM50 test). Prosigna® is used to estimate the risk of distant recurrence for postmenopausal women within 10 years of diagnosis of early-stage, hormone-receptor-positive disease with up to three positive lymph nodes after 5 years of hormonal therapy.
Our study focused on molecular profiling and subtyping of breast cancer patients using a minimally invasive approach. We focused our attention specifically on Extracellular Vesicles (EVs) and their molecular cargo (i.e., exo-mRNA) that can be secured from a simple blood draw. The premise of our research was that EVs carry RNA cargo believed to be associated with the cell-of-origin and thus, have the potential to serve as a liquid biopsy marker for supplying molecular information to identify characteristics of the disease (i.e., precision medicine). EVs were affinity selected by targeting epithelial and mesenchymal surface markers and the harvested exo-mRNA cargo was analyzed using the PAM50® gene panel on the Nanostring nCounter. We also developed a new analysis algorithm (exo- PAM50), which aided in the examination of the exo-mRNA data. Our initial results were very encouraging and suggested that the quantitation of PAM50-based exo-mRNA transcripts collected from both epithelial and mesenchymal EVs could generate profiles with high concordance to tumor tissue-based testing.
Additional studies are required to further validate our exo-mRNA-based PAM50 assay and potentially other clinical approved prognostic tests in breast cancer patients; however, in our work we have demonstrated the feasibility of using novel methods to efficiently isolate exo-biomarkers and their analysis with the validated technologies or clinical lab-developed tests. Liquid biopsy assays will be important in the future as they can be used in the stratification and subtyping of other epithelial cancers. For example, molecular subtypes have been identified for other epithelial malignancies such as pancreatic, colorectal, prostate, bladder, and sub-classification of triple-negative breast cancers [6-10].
Extracellular Vesicles (EVs) have the potential to function as a minimally invasive liquid biopsy marker for delivering molecular information to assist treatment decisions (i.e., precision medicine) since they carry RNA cargo that is thought to be connected with the cell-of-origin. We describe the high-volume production-capable affinity isolation of EV subpopulations using monoclonal antibodies mounted to the surface of a microfluidic chip made of plastic. The efficacy of the EV-Microfluidic Affinity Purification (EV-MAP) chip was established in a proof-of-concept application to give molecular subtyping data for breast cancer patients by isolating EVs derived from two-orthogonal cell types
Essays in Applied Microeconomics
No full textThis dissertation has three chapters. In the first two chapters, I have studied the left-behind children issue in China. According to the latest statistics (2018 Ministry of Civil Affairs), there are 69.7 million children who are separated from their migrant worker parents and are receiving education in their respective hometowns which accounts for more than one-fifth of the Chinese children population today. Hence, there is significant amount of literature on this. However, in the process of studying the causal effect of left-behind children’s status on the outcome variables, endogeneity has always been a challenge. My contribution in the literature is the deployment of two stage least square method to reduce endogeneity. I have used the family Hukou type of left-behind children as an instrumental variable in order to analyze the outcome variable, which is a novel attempt with more technical robustness. In the third chapter, we focus on the widely known "Hot Hand" phenomenon in the NBA. The “Hot Hand” phenomenon is the perception that whenever a player starts to make consecutive shots, he/she is more likely to continue making those shots for being on a “hot streak”. In our research, we focused on the impact of an NBA player's first shot in a game on the behavior of subsequent players, coaches, and opposing players. Since the first shot in a game represents a player’s first impression which is of paramount importance, we believe that previous researchers have not given its necessary attention. Our research also sheds light on the importance of the phenomenon of first impressions in everyday life
How many people in the world do research and development?
No full textThe traditional approach to comparing research and development (R&D) capacity across countries has been to compare Gross Domestic R&D expenditures (GERD). In this paper, we argue for an expansion of R&D capacity that includes people engaged in research and research and development activities (research human capital density, RHCD). To achieve this goal, we first discuss how to estimate counts of researchers and create a measure of researcher human capital density within a country. Next, we examine whether RHCD is a useful variable in models of innovation capacity. Finally, we consider whether RHCD has explanatory power for models of research outputs including patents and publications. We find that RHCD has more explanatory power than GERD in the production of patents and publications. We argue that surveys of individuals that include questions on R&D activities are useful for assessing innovation capacity, and, if adopted more broadly, can provide a strategic framework for countries and regions to develop human capital to support innovative activities
Discounting of Hyper-Palatable Food and Money: Associations with Food Addiction Symptoms
No full textA grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Introduction: Delay discounting (DD), the tendency to prefer small, immediate rewards over larger, delayed rewards, is associated with health-risk behaviors. The study examined associations between DD for money and hyper-palatable foods (HPF) with food addiction (FA) symptoms among a general population sample. Methods: Participants (N = 296) completed an adjusting DD task that consisted of a single-commodity condition with HPF as the reward (HPF now vs. HPF later) and cross-commodity conditions comparing money and HPF (money now vs. HPF later; HPF now vs. money later). The Yale Food Addiction Scale 2.0 was used to assess FA symptoms. Zero-inflated negative binomial regression models tested whether discounting of HPF and money was associated with FA symptoms. Results: Findings indicated there were no significant associations between DD and FA symptoms in the single-commodity HPF condition (logit: OR = 1.02, p-value = 0.650; count: IRR = 1.04, p-value = 0.515). There were no significant associations among cross-commodity conditions comparing money now vs. HPF later (logit: OR = 0.96, p-value = 0.330; count: IRR = 1.02, p-value = 0.729) or conditions comparing HPF now vs. money later (logit: OR = 1.02, p-value = 0.682; count: IRR = 0.92, p-value = 0.128) and FA symptoms. Conclusions: Discounting HPF may not be a key behavioral feature among individuals who endorse FA symptoms.
Keywords: delay discounting; choice impulsivity; food choice; addictive behavior
Hybrid Inquiry-Based Laboratory Curriculum Highlights Scientific Method Using Bacterial Conjugation as a Model
No full textUndergraduate microbiology students are exposed to the theory of the scientific method throughout their undergraduate coursework, but laboratory course curricula often focus on technical skills rather than fully integrating scientific thinking as a component of competencies addressed. Here, we have designed a six-session inquiry-based laboratory (IBL) curriculum for an upper-level microbiology laboratory course that fully involves students in the scientific process using bacterial conjugation as the model system, including both online discussions and in-person laboratory sessions. The student learning objectives focus on the scientific method, experimental design, data analysis, bacterial conjugation mechanisms, and scientific communication. We hypothesized students would meet these learning objectives after completing this IBL and tracked student learning and surveyed students to provide an assessment of the structure of the IBL using pre- and post-IBL quizzes and the Laboratory Course Assessment Survey. Overall, our results show this IBL results in positive student learning gains