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The Relationship Between Upper Esophageal Sphincter Opening Duration as a Function of Laryngeal Elevation
No full textSwallowing is a complex, low-level autonomic function requiring the coordination of numerous muscles and nerves. Disordered swallowing, dysphagia, can result in an interruption of this coordination, manifesting as dysfunction within one or more phases of swallowing: oral, pharyngeal, esophageal. The aims of this study included: 1) compare upper esophageal sphincter opening duration (UESOd) and laryngeal elevation between patients with suspected dysphagia (n=50) and age-matched healthy persons (n=50); and 2) establish the relationship or correlation of UESOd to laryngeal elevation across the two investigated data sets. Videofluoroscopic images were retrospectively analyzed to measure UESOd, the interval between the first frame of upper esophageal sphincter (UES) opening and the first frame of UES closure, and laryngeal elevation, the total displacement of the larynx to the hyoid bone, in individuals swallowing approximately 3 mL thin liquid boluses. A comparison of group medians and analyses of group differences were performed to address the presenting aims. Results revealed a significant difference in UESOd between patient participants (Mdn=1200.00 milliseconds) and healthy participants (Mdn=633.33 milliseconds); p < .001. This difference carried a large effect size (d=2.15). Similarly, there was a significant difference in laryngeal elevation distance between patient participants (Mdn=0.26 pixels) and healthy participants (Mdn=0.31 pixels); p=.014. This difference carried a medium effect size (d=-0.49). For healthy participants, there was only a weakly positive and significant correlation found between measures of UESOd and laryngeal elevation; r=.29, p=.040. There was no significant correlation found between UESOd and laryngeal elevation in patient participants; r=-.03, p=.825. Clinically, these results provide objective data on UESOd and laryngeal elevation that can aid in clinical decision making
Sex-Specific Differences in Adipokine Responses following Acute Resistance Exercise
No full textBone and muscle are known to have secretory properties that can influence the body through a variety of mechanisms. More recently, adipose tissue has been identified to play a role in bone and muscle metabolism, particularly in response to exercise. Thus, exploring the relationships among biomarkers of muscle, bone, and adipose tissue following exercise can provide insights into potential crosstalk among tissues. PURPOSE: To investigate sex-differences in the effect of acute resistance exercise on concentrations of adipokines, myokines, and osteokines, and associations among biomarkers of tissue crosstalk. METHODS: 37 participants, 22 males and 15 females, participated in an acute resistance exercise test (ARET) comprised of a 6 x 10-rep 75% 1-RM squat. Blood samples were collected via venipuncture at rest (PRE) and immediately following completion of the ARET (PWO), and serum samples were analyzed for concentrations of irisin, sclerostin, leptin, total adiponectin, and HMW adiponectin using enzyme-linked immunosorbent assays. Body composition data, including lean mass, fat mass, and bone mineral content, were collected using total body dual-energy x-ray absorptiometry (DXA) scans. 2x2 (sex*time) repeated measures ANOVAs were conducted to assess sex-differences in absolute changes in biomarker concentrations prior to and following exercise. ANCOVAs with body composition compartments as covariates were performed, along with Spearman correlations to test associations among muscle-bone-adipose crosstalk biomarkers. RESULTS: Analyses of biomarker concentrations before and following exercise revealed increases in irisin, sclerostin, total adiponectin, and HMW adiponectin, and decreases in leptin. More notably, these changes differed between sexes for irisin, HMW adiponectin, and leptin, highlighting the possibility of sex-specific responses to resistance exercise. Most changes are no longer significant after adjusting for various body composition metrics, though HMW adiponectin remained significant. In relation to muscle-bone-adipose crosstalk, only correlations among absolute changes in adipokines were significant, though when assuming normality, irisin and sclerostin changes were also correlated with adipokine changes. CONCLUSION: The results of this investigation provide new evidence on sex-specific changes in bone-related biomarkers to acute resistance exercise. Further exploration into the body composition metrics and metabolic and reproductive hormones that influence adipokines can continue to elucidate how adipokines influence muscle-bone-adipose crosstalk in acute exercise settings
Evaluating One-Sided Communication for Graph Analytics with MPI-RMA and OpenSHMEM
No full textThe message passing interface (MPI) remains the primary parallel-pro\-gram\-ming library for developing and running code on massively parallel distributed systems. While traditionally used for two-sided and collective communication, the latest MPI standards support remote memory access (RMA) between processes to enable one-sided communication. This paradigm is associated with fine-grained communication and irregular memory accesses, commonly found in graph analytics. This research develops and evaluates distributed implementations of betweenness centrality, a staple graph analysis algorithm, using traditional MPI, MPI-RMA, and OpenSHMEM. The performance of all three versions is found to be nearly identical due to the algorithm's trivially parallel nature, making it a poor fit for evaluating the impact of each communication library on distributed computing performance. The study then focuses on Graph500, a popular benchmark built upon breadth-first search (BFS) on an undirected graph, known for its sparse data accesses and fine-grained communication. The scalability of multiple BFS implementations using MPI-RMA is analyzed and compared against existing OpenSHMEM-based implementations optimized to maximize the benefits of one-sided communication. Additionally, we evaluate these implementations against the state-of-the-art MPI reference code using different numbers of processing elements and various problem sizes. Our experimental evaluation shows consistently improved performance with MPI-RMA over the best OpenSHMEM implementation on Graph500's BFS kernel with scales up to 32 nodes on the Pittsburgh Supercomputing Center Bridges-2 Regular Memory partition and University of Pittsburgh Center for Research Computing (Pitt CRC) MPI Cluster. However, we were unable to outperform the MPI reference implementation in most scenarios with one-sided communication. While we demonstrate MPI-RMA to achieve ∼1.8× better performance over the MPI reference implementation on 32 nodes when only using 4 cores per node, the reference version was more performant in the majority of configurations tested. While one-sided communication has shown promising performance on some large-scale computing tasks, the difficulty of designing and developing applications to efficiently leverage one-sided communication remains a challenge. Additionally, we show that system architecture and library choices can significantly impact the expected performance of one-sided communication
Perceptions of the value of higher education among undergraduate students
No full textA rising tide of reports, commentaries, surveys, and studies seems to herald a crisis in higher education – a crisis frequently framed as a question of value. There are many variations of the question: What benefits does postsecondary education yield? What is the purpose of attending a postsecondary institution? Do such institutions deliver on this purpose? Does the value of a degree lie in its purported utility value on the job market? Does it hold intrinsic value or offer a path to self-development? Is college “worth it”? The skyrocketing cost of higher education in recent years is perhaps the most influential factor driving such questioning and is both a reflection of a neoliberal framing of education and a source of the many conflicts prompting questions of its value. The present study examines to what extent questions of value enter into the way students think about their own educational experiences. It draws on nine in-depth interviews with undergraduate students at the University of Pittsburgh to investigate how students themselves think about the complex concept of value. It probes the tensions and conflicts that exist within multifarious perceptions, seeking to understand how students themselves define value and how they subsequently reflect on that value based on their lived experiences. The present study’s methodology reflects this aim through the deliberate selection of a sample of students representing a wide range of backgrounds, including year in school, major, amount of debt, and generation status. The study finds that students primarily view the purpose of college as getting a desirable job and building a network, yet place considerable value on other, less instrumental benefits. This results in a tension between conflicting conceptions, appearing to be largely due to cost, which complicates how students consider value. This thesis strives to illuminate the ways students view their college educations, highlighting what they consider beneficial and important as well as challenging and problematic, in the hopes of adding clarification to the often confusing and contradictory nature of such abstract notions as value
Prenatal Genetic Counselors’ Perceptions of their Disability Training and Preparedness for Addressing Disability in Practice: A Thematic Analysis
No full textPrenatal genetic counselors often engage families in discussions about what it would mean for their child to be born with a genetic condition and, potentially, live with a disability. They are responsible for providing adequate, value-neutral information about the impact of genetic disease and facilitating informed decision-making based on their patients’ beliefs and values. Without sufficient disability training aimed at improving the knowledge, confidence, and competence necessary to support people with disabilities, genetic counseling students may feel unprepared or even uncomfortable having such discussions when they enter the profession. Prior studies have found that genetic counselors are more comfortable discussing the medical aspects of genetic disease, as opposed to social aspects and lived experiences, in part due to their graduate training. To our knowledge, there are no published qualitative studies exploring the extent and impact of disability training in genetic counseling programs. Through nine semi-structured interviews, this qualitative study explored prenatal genetic counselors’ comfort level with, and preparedness for, addressing disability in practice, as well as examined the perceived adequacy and impact of their disability training. Using semantic inductive thematic analysis, we identified six themes: 1) experiences outside of genetic counseling training contribute to disability competency, 2) theoretical and experiential learning about disability outside of a medical context are critical for disability training, 3) limitations of disability training in genetic counseling programs, 4) disability training differences and inconsistencies between and within genetic counseling programs, 5) challenges in discussing disability with patients, and 6) variability in genetic counseling approaches to and strategies for discussing disability with patients. The results captured by this study may be used to inform and improve disability curricula within genetic counseling programs. Disability training that incorporates the diverse perspectives of individuals with disabilities is necessary for genetic counseling curricula and the promotion of public health
Discoverability and interpretability of spurious associations in data-driven decisions
No full textBig data and machine learning tools have jointly empowered humans in making data-driven decisions. Many of them capture empirical associations that might be spurious due to confounding factors and subgroup heterogeneity. The famous Simpson's paradox is such a phenomenon where aggregated and subgroup-level associations contradict with each other, causing confusion and decision difficulties. Existing algorithms and systems fail to offer sufficient support for humans, especially the broad range of non-experts of causal inference and machine learning, to locate, understand, identify subgroups free of spuriousness, and make reliable decisions from spurious associations in practice.
Motivated by identified research gaps and audience needs, this dissertation's objective is twofold: firstly, to empower users in identifying the presence of spurious associations and paradoxical trends within their data, and secondly, to facilitate the interpretation of these phenomena, enabling more informed decision-making when dealing with observational data. To accomplish these aims, it introduces a multifaceted novel solution comprising three key components: a data-driven algorithm named Deparadox Tree, a practical human-centric workflow called Deparadox Workflow, and a visual analytic system titled VISPUR. In particular, the Deparadox Tree automatically uncovers subgroup patterns behind paradoxical associations, employing innovative split criteria that balance confounders and homogenize inconsistent effects throughout a recursive partitioning process. The Deparadox Workflow is developed from in-depth semi-structured interviews and engagements with three diverse target user groups, integrating their challenges and requirements in handling spurious or paradoxical phenomena in data analysis. Aligned closely with the workflow, VISPUR is designed to perform four main tasks, including identifying confounding factors, exploring diverse subgroup patterns susceptible to misinterpretations of causality, interpreting paradoxical phenomena, and aiding in informed decision-making. The combined integration of quantitative and visual signals, coupled with interactive features, culminates in a more comprehensive and nuanced understanding of the underlying data.
My research bridges the divide between causality theory and practical applications, with a profound emphasis on both discoverability and interpretability. Grounded in causal theory, it translates complex causal factors behind spurious associations into clear visual signals and interactive features, fostering a clearer understanding of data patterns and preventing misinterpretations. The development, execution, and evaluation of my solutions are intricately shaped through extensive collaboration with target users. This user-centric methodology ensures that the toolkit caters to the challenges and needs of a diverse array of audiences including data scientists and policymakers. Moreover, my research contributes to the broader realm of data-driven decision-making and knowledge discovery. Through both quantitative and qualitative evaluations (i.e., expert interview and controlled user experiments), it demonstrates a great potential of raising awareness of pitfalls arising from spurious associations, enhancing comprehension of critical causal mechanisms underpinning a Simpson's paradox, as well as fostering reliable, accountable, and informed decisions
The expression of narcissistic traits in daily life: an ecological momentary assessment study
No full textIt is widely agreed that narcissistic individuals experience significant interpersonal dysfunction, but there are gaps in the literature on how different interpersonal contexts affect the expression of narcissistic traits and how these differences give rise to social impairment. This study aims to understand the expression of narcissistic traits in relation to interpersonal contexts in daily life. The data used for this study were drawn from two independent samples of undergraduate students (S1) and community members (S2). Both samples completed a series of baseline assessments and subsequent ambulatory assessment protocols. Results from within-person correlations indicated mixed evidence that specific social partners have an influence on momentary narcissism. Results from multilevel regression analyses showed that there were no significant relations between variety in arguments or emotional support and daily levels of narcissism. Results from baseline correlations indicated a negative correlation between variety in emotional support and baseline grandiosity, and a positive correlation between variety in arguments and baseline vulnerability between both samples. Future research focused on narcissism in daily life should aim to include more daily contextual features relevant to the interaction. Further, these studies should aim to examine how the interplay between processes simultaneously impacts the expression of narcissistic states to gain a better understanding of the mechanisms underlying narcissistic dysfunction
Genomic Insights into Early Childhood Caries: A Comprehensive Analysis using GWAS, TWAS, and Rare Variant Approaches
No full textEarly childhood caries (ECC) is a rapidly progressive form of early-onset tooth decay. Despite the established heritability of caries, comprehensive genetic association studies have not yet been performed for ECC. This dissertation leverages data from five cohorts of children in two countries (COHRA1, COHRA2, IFS, IHS, ALSPAC) to investigate the genetic basis for ECC. Recognizing the limitations of the case definition of ECC, this study incorporates a range of early caries phenotypes (ECPs) which capture additional dimensions, such as ECC severity and time-dependence. These include ECC case status, severe ECC (SECC), quantitative scores representing counts of the number of decayed and restored primary teeth (dft) and tooth surfaces (dfs), CIPD score (an age-informed caries staging system), and primary maxillary incisor caries (MIC).
The study took three approaches to investigate the role of common and rare variants in caries risk:
(1) Through genome-wide association studies (GWASs) of ECPs, we identified for the first time thirteen genome-wide significant loci, predominantly located in regions linked with tooth and salivary gland development, the innate immune system, periodontal disease, and craniofacial and bone development (e.g., near TMTC2, ALPL, DEFB1, STX6, KIAA1614, IFITM5, and MIR6874).
(2) The first transcriptome-wide association studies (TWASs) of ECPs nominated fourteen significantly associated gene transcripts. These transcripts are linked to taste and olfactory receptors, as well as bone and tooth biology, anxiety/neurological health and the innate immune system of the oral cavity (e.g., CDH17, TAS2R43, SMIM10L1, TAS2R14, GPR158, TTC19, NCOR1 and ADORA2A).
(3) Rare and low-frequency variant analyses for the first time confirmed a role for rare and low-frequency coding variants in ECPs. The gene-based analyses identified 34 genes, many of which are differentially expressed in the brain. Key genes include ATF7IP2, CCDC65, PCDH9, POU2F1, and PDK2.
The study validates the utility of the employed caries phenotypes for genetic investigations of ECC and underscores the potential of novel phenotypes like CIPD and more narrow ones like SECC and MIC, which isolate disease severity and specific teeth. This study has public health significance. It provides insights into ECC pathogenesis and lays foundations for screening, prevention and treatment strategies for this prevalent disease
Virtually Defenseless in a Digital Era: The Necessary Revisions HIPAA Must Adopt in the Twenty-First Century
No full textIn the wake of rapid technological advancements, the convergence of location data and artificial intelligence poses significant challenges to an individual’s right to health privacy in the United States. This paper explores the implications of this intersection, particularly regarding the use of inferred protected health information (PHI) outside the purview of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Despite the earnest attempt to safeguard PHI, the statute is useless when put against modern digital advancements. Through a thorough examination of current regulatory gaps and recent events, the paper underscores the critical need to move forward with necessary revisions to current HIPAA provisions. Failing to address these concerns will undermine an individual’s fundamental right to privacy and ultimately lead to distrust in the healthcare institution. The urgency to address these evolving threats will persist until concrete action is taken to hold non-regulated entities accountable and establish measures to guarantee the protection of future generations' PHI from malicious actors
Understanding the Relationship between Sleep Duration and Blood Pressure Based on Differing Neighborhood Condition Perceptions in Black Postpartum Individuals
No full textBackground: Hypertension is a leading cause of maternal morbidity and mortality among Black postpartum women. Sleep is associated with hypertension risk in the general adult population, but the relationship between sleep and hypertension postpartum is less understood. Additionally, the impact of the social determinants of health, like neighborhood conditions, on this link is not well understood and studied. This study aimed 1) to investigate the correlation between sleep duration and blood pressure at 2 and 6 months postpartum in Black-identifying individuals and 2) to determine if these correlations differed by neighborhood conditions. Methods: This was a secondary data analysis of the Pittsburgh Girls Study-Health Over the Peripartum Period (PGS-HOP), a prospective cohort of Black postpartum individuals (n=180). Systolic and Diastolic blood pressure (SBP, DBP) was measured by trained study team members. Mean arterial pressure (MAP) was generated using the SBP and DBP values. The Your Neighborhood Questionnaire was used to measure neighborhood conditions. We used a median split to define low and high perceived neighborhood conditions. We used Spearman correlations to characterize the relationships between sleep and blood pressure overall and stratified by neighborhood conditions. Results: Results showed no associations between sleep duration and blood pressure or MAP at 2 and 6 months (2 months: SBP rho= 0.0032, DBP rho= 0.075, MAP rho= 0.047, all n.s.; 6 months: SBP rho=0.023, DBP rho= 0.12, MAP rho=0.093, all n.s.) . Within the neighborhood stratification, we also report null associations for 2 and 6 months for both the better and worse perceived neighborhood conditions groups (2 months: SBP rho=0.0032, DBP rho=0.075, and MAP rho=0.047, all n.s.; 6 months: SBP rho=0.023, DBP rho= 0.12, and MAP rho=0.093, all n.s.). Discussion: In this analysis, we did not observe any associations between sleep duration and blood pressure at 2 and 6 months postpartum. Future research with adequate sample sizes should examine associations between other sleep domains (e.g., sleep regularity, sleep quality) and blood pressure, an area of great public health significance