US Program Research Articles

Possibilities and power during early Head Start Home visits: Comparing family- and home visitor-opened decision-making.

Decision-making by families and professionals about how to support children's development is an integral aspect of home visits. This study investigated home visit decision-making in a US program for families experiencing poverty, Early Head Start (EHS), through the following questions: What types of decisions do home visitors and families make about children's development during EHS home visits? How and to what extent do home visitors and families participate during these decisions? A convergent mixed methods research design was implemented to investigate participation through frequency counts and discourse analysis of home visit transcripts. Home visitor participants were four women, three white and one Black. Twelve families participated (12 mothers, 2 fathers). Parents identified as white (n=8), Black (n=3), and multiracial (n=3; Black and white). One parent was a bilingual Arabic and English speaker. A total of 66 decisions about children's development were identified, with 49 decisions initiated by home visitors and 17 initiated by families. Although families talked more and took on active roles when they initiated (i.e., opened) decisions, home visitors predominantly controlled decision-making. Quantitative and qualitative participation differed only in the beginning of family-opened decisions, and home visitors gradually took more control.

The state of affairs: Assessing the scope of endocrine surgery exposure in general surgery residencies across the United States

BackgroundEndocrine surgery is a core component of general surgery training. The landscape of endocrine surgery education in surgical residency and association with entrance into endocrine surgery fellowships is unknown. MethodsIn total, 353 Accreditation Council for Graduate Medical Education–accredited general surgery program websites were identified and categorized by US region, program type and size, and endocrine surgery educational experience type. Self-identified endocrine surgeons were defined as American Association of Endocrine Surgeons members or fellowship graduates (American Association of Endocrine Surgeons surgeons) or having a thyroid/parathyroid/adrenal practice. Programs that graduated an American Association of Endocrine Surgeons fellow from 2012 onwards were identified, and characteristics associated with endocrine surgery-experience type, self-identified endocrine or American Association of Endocrine Surgeons faculty, and entrance into endocrine surgery fellowship were assessed. ResultsIn total, 353 programs were studied. The median number of general surgery residents per program was 25, with 165 (46.7%) small programs (<25 residents) and 188 (53.3%) large (≥25) programs. There were 122 (34.6%) university-based programs, 82 (23.2%) community-based, 139 (39.4%) community-based/university-affiliated, and 10 (2.8%) military. A total 665 self-identified endocrine surgeons were identified at 303 (85.8%) programs; 15 (14.2%) programs had no self-identified endocrine surgeon. There were 361 American Association of Endocrine Surgeons surgeons located at 163 (46.2%) residency programs. In total, 323 (91.5%) programs had information on curriculum/rotations available, 58 (17.9%) with dedicated endocrine surgery educational experiences, 226 (70%) with rotations mixed with other subspecialties, and 39 (12.1%) with none reported. A total 113 (35%) general surgery programs produced a future endocrine surgery fellow and were most likely to be large (81%, P < .001), university-based (64%, P < .001) programs and were more likely to have a self-identified endocrine (102, 90.3%, P = .016) or an American Association of Endocrine Surgeons surgeon (82, 72.6%, P = .004). ConclusionProgram size and type were strongly associated with endocrine surgery exposure, presence of a self-identified endocrine surgeon, and same-site American Association of Endocrine Surgeons fellowship. Endocrine surgery educational experiences are inconsistent across residencies, and efforts are needed to ensure that surgical residents receive comprehensive, equitable endocrine surgery education.

Semaglutide use in people with obesity and type 2 diabetes from real-world utilization data: An analysis of the All of US Program.

To analyse data from the All of Us Research Program to evaluate the real-world application and long-term effectiveness of semaglutide in treating type 2 diabetes and obesity patients in a large population. We identified patients prescribed semaglutide and analysed differences in route of administration and the time on semaglutide. For individuals diagnosed with obesity, we measured changes in body mass index (BMI) and weight from baseline, while measured changes in HbA1c for those patients with type 2 diabetes. We also examined the occurrence of newly diagnosed common adverse events from taking semaglutide. For 3739 semaglutide patients, those on injectable semaglutide (3364 patients) averaged 301.54 days on the medication, with 20.36% having no end date, while those on oral semaglutide (435 patients) averaged 172.48 days, with 24.60% having no end date. We found average decreases of 1.54 kg/m2 in BMI, 4.65 kg in weight and 0.75% in HbA1c for semaglutide users. The decreases were larger in participants taking injectable formulation, probably because of higher starting values. Over time, improvements in these outcomes diminished, but the values remained significantly lower than baseline levels. Approximately only 1.0% of patients reported newly diagnosed common adverse events. Consistent with clinical trial findings, this real-world data analysis showed that semaglutide was well tolerated and that, for a large population, it effectively reduced BMI, body weight and HbA1c, albeit to smaller magnitudes than observed in clinical trials. These findings provide valuable insights into real-world experience and the long-term effectiveness of semaglutide.

Theoretical modeling of electronic absorption spectra of ionized species of β-diketones.

Direct DFT evaluation of negatively charged or highly π-delocalized systems is intrinsically problematic. Single ionized (anionic) forms of β-diketones combine both these issues. In this article, we have summarized and analyzed the experimental and theoretical spectral dataset for anionic forms of different substituted perfluorinated β-diketones that were obtained by our team during the past few years. Using previously collected experimental data, spectra of anion of diketones containing phenol, 2-furoyl, 2-thiophen, 2-selenophen, 2-tellorphe, 2-pyridin, 2-naphthyl, and N-methyl-pyrrole substituted rings were considered and chosen for the simulation. The X3LYP density functional demonstrates good results in both ultraviolet and visible parts of the diketones spectra. Minnesota family show predictable ability within the reasonable errors. The linear correlation between the Hartree-Fock exchange and the errors of estimation has been observed. Density functionals with a low contribution of HF weight (0-30%) provide better prediction accuracy. Quantum chemistry calculations were performed under eighteen density functionals (Slater, Becke, OPTX, LYP, PW91C, BPE0, B3LYP, CAM-B3LYP, X3LYP, TPSS, revTPSS, TPSSh, M06-L, M06, M06-2X, M06-HF, M11-L, MN15-L), paired with the SMD solvation model implemented in GAMESS US program package. Def2-SVP basis set functions were applied to light atoms, and CRENBL effective core potential was used to Tellurium.

An Area-Level Hierarchical Bayes Bivariate Threefold Linear Model for US State and County Indicators of Adult Skills in Literacy and Numeracy

Significant enhancements have been made in small area estimation (SAE) methodology because there has been an increased demand for reliable estimates through SAE over the past decades. This article describes the advanced statistical methodology used to produce state and county model-based estimates of average scores and various proficiency levels of adults for all states and counties, using data from the first cycle of the US Program for the International Assessment of Adult Competencies and the American Community Survey. Challenges and issues are discussed especially in light of the small number of sample counties with survey data. Each major stage of the estimation process is discussed, including the approach for generating design-based survey estimates and modelled variances, identifying a set of predictor variables (available and measured consistently for all counties), the hierarchical Bayes linear threefold models, including bivariate models for proportions, and the diagnostics and evaluation.

Parental leave policies in general surgery residencies

BackgroundProspective residents use program websites to glean information regarding parental leave policies. This study investigates the online availability and content of parental leave policies for general surgery residency programs. MethodsParental leave policy information was collected from general surgery residency program and Graduate Medical Education (GME) websites. Descriptive statistics and multivariable logistic regression were used for analysis. ResultsOf the 344 general surgery residency programs, parental leave policies were found on 6% of program and 52% of GME websites. Family Medical Leave Act policies were reported the most, followed by maternity, then paternity, and then adoption/other clauses. Academic programs, program location in the Southeastern US and larger program size were all significant predictors of online policy availability. ConclusionsGeneral surgery parental leave policies vary and are not readily available online. These findings identify a significant opportunity for surgery residency programs to improve the disclosure of parental leave policy information.

US Legal and Regulatory Framework for Nuclear Waste from Present and Future Reactors and Their Fuel Cycles

The nuclear waste management and disposal program in the United States for highly radioactive waste (spent nuclear fuel and high-level waste) has thus far been unsuccessful despite an effort that spans 40 years and the expenditure of tens of billions of dollars. Yet, today, there is considerable interest in and promotion of advanced reactor technologies, such as small modular reactors that will expand spent fuel inventories that may very well remain at the site where they are generated, awaiting permanent, geologic disposal. We examine critical elements of the US legal and regulatory framework that have impeded the success of the US program. We make recommendations on steps that are required for a successful nuclear waste program, particularly considering the development of advanced nuclear reactors and their fuel cycles.

Assessment of Neurology Residency Program Websites across North America during COVID-19.

With virtual interviews for residency applications, residency program websites have become increasingly important resources for applicants. We evaluated the comprehensiveness of US and Canadian neurology residency program website, comparing this to published rankings of the best neurology and neurosurgery hospitals (for US programs) and number of residency positions (for US and Canadian programs). US program websites were found to be largely more comprehensive than Canadian websites, more extensive websites were associated with better program rankings and fewer residency seats in the US, and US regional differences in comprehensiveness were present. We recommend standardized guidelines to increase website comprehensiveness across programs.

The lower limb-loss rehabilitation continuum (LLRC) – a framework for program design and implementation

Purpose: The multistep journey to prosthetic device-enabled functioning following amputation requires a structured approach for optimal care delivery, but such program structures and outcomes are inadequately characterized. The study is responsive by describing an implementation framework for lower limb loss rehabilitation and evaluating its utility. Materials and methods: The lower limb loss rehabilitation continuum framework (LLRC) was developed using literature-based continuum of care and amputation phase concepts as well as input from limb loss rehabilitation stakeholders. LLRC structure includes five sequential steps (Postsurgical Stabilization (PS), Preprosthetic Rehabilitation (PPR), Limb Healing and Maturation (LHM), Prosthetic Fitting (PF), Prosthetic Rehabilitation (PR)) between six touchpoints of patient-healthcare interaction (Surgery, Preprosthetic Rehabilitation Admission and Discharge, Functioning Evaluation and Prescription, Prosthetic Rehabilitation Admission and Discharge). The utility of this framework was evaluated through LLRC program implementation in a semiurban US setting and program functioning and process outcomes assessment from an IRB-approved, retrospective observational study about patients with unilateral lower-limb amputations completing this program. Results: Program functional (FIM gain; efficiency) scores were greater for PPR(32.6(8);3.1) compared with PR(24.3(8.5);3.8). Program completion duration was 149.7(63.4) days. LHM(75.8(58.5) days) and PF(51.4(24.3) days) were the longest steps. PR duration was significantly longer(p = 0.033) for the transfemoral level. Conclusion: The LLRC framework is useful for the design and implementation of structured limb loss rehabilitation programs. IMPLICATIONS FOR REHABILITATION The lower limb-loss rehabilitation continuum (LLRC) is a novel implementation framework with a five-step structure from limb loss to completion of prosthetic rehabilitation between six touchpoints of patient-healthcare interaction, with standardized terminology and baseline and outcome metrics. The utility of the program was demonstrated by successful program development in a suburban health setting and actionable process outcomes and superior functioning outcomes compared with literature. The LLRC can be adapted by health systems, institutions, and care providers for program development. Programs can expect high FIM gains and efficiency for Preprosthetic rehabilitation and Prosthetic rehabilitation steps. With an LLRC completion time of 5 months, long Limb healing and maturation and Prosthetic fitting steps present areas of opportunity for improvement.

The Greek Connection: The Life of Elias Demetracopoulos and the Untold Story of Watergate by James H. Barron, and: Ένα σκοτεινό δωμάτιο, 1967–1974: Ο Ιωαννίδης και η παγίδα της Κύπρου—Τα πετρέλαια στο Αιγαίο—Ο ρόλος των Αμερικανών [A dark room, 1967–1974: Ioannidis and the Cyprus trap—Aegean oil—The role of the Americans]. by Alexis Papahelas (Αλέξης Παπαχελάς)

Reviewed by: The Greek Connection: The Life of Elias Demetracopoulos and the Untold Story of Watergate by James H. Barron, and: Ένα σκοτεινό δωμάτιο, 1967–1974: Ο Ιωαννίδης και η παγίδα της Κύπρου—Τα πετρέλαια στο Αιγαίο—Ο ρόλος των Αμερικανών [A dark room, 1967–1974: Ioannidis and the Cyprus trap—Aegean oil—The role of the Americans]. by Alexis Papahelas (Αλέξης Παπαχελάς) Konstantina E. Botsiou (bio) James H. Barron, The Greek Connection: The Life of Elias Demetracopoulos and the Untold Story of Watergate. New York: Melville House. 2020. Pp. xiii + 482. 21 illustrations. Hardcover $31.67. Alexis Papahelas (Αλέξης Παπαχελάς), Ένα σκοτεινό δωμάτιο, 1967–1974: Ο Ιωαννίδης και η παγίδα της Κύπρου—Τα πετρέλαια στο Αιγαίο—Ο ρόλος των Αμερικανών[A dark room, 1967–1974: Ioannidis and the Cyprus trap—Aegean oil—The role of the Americans]. Athens: Metechmio, 2021. Pp. 630. Cloth €18.90. Due to a scarcity of archival sources and the aversion of historians, the foreign and defense policies of the seven-year Greek military dictatorship (1967–1974) have not been systematically researched. Although more widely explored than most of the dictatorship’s foreign connections, Greek-American relations during this period are no exception to the rule. Ideologically driven interpretations or “what ifs” hardly substitute for structured analyses of alliances, animosities, and political decisions. As a matter of fact, they strengthen the superficial perception of the junta as a tragic parenthesis in the history of postwar Greece. This tendency is changing, however, and two recent publications are especially noteworthy. James H. Barron and Alexis Papahelas both present detailed accounts of the dictators’ worldviews and actions. They also offer thorough overviews of the Greek political ecosystem in the 1950s and 1960s, where the future dictators thrived. Various continuities and discontinuities with the earlier period place the dictatorship in a historical context driven by anticommunism—and its local version, εθνικοφροσύνη (ethnikofrosyni)—which the colonels took up as their mission when Greek politicians loosened their grip in the era of international détente. Committed to the zeitgeist of bipolarity, the colonels baptized personal competitors as enemies of the state. Barron’s story of Elias Demetracopoulos’s multiple persecutions by Greek and American officials before and during the dictatorship captivates the reader. Demetracopoulos suffered the various types of character assassination that an [End Page 137] assertive journalist posing inconvenient questions would undergo. A prominent example of his research concerned the stationing of nuclear missiles on Greek soil as a result of the “Sputnik effect.” Demetracopoulos maintained many doubts about the Greek government’s denial of any participation in the US program of intercontinental ballistic missiles (ICBMs), which had involved Italy and Turkey before the Cuban Missile Crisis of October 1962. He believed that Greek participation in the ICBM program would be vital for alleviating the West’s feeling of technological inferiority after the Soviet Union launched Sputnik 1, the world’s first artificial satellite, which suggested that the American soil became vulnerable to a potential Soviet attack (105–110). The refusal to accept the Greek government’s denials severely damaged Demetracopoulos’s relations with the Greek premier Konstantinos Karamanlis (1955–1963). Similar difficulties awaited Demetracopoulos in the US. His close ties with top American public figures were frequently undermined by unforgiving cold warriors who saw in Demetracopoulos a threat to the dominant narrative of law and order. These contradictions underscore the difference that personality can make in any given historical situation. Barron paints a comprehensive portrait of Demetracopoulos, a devoted journalist who earned exceptional resistance credentials as a teenager during the Axis occupation. He later spent his adult life in the twilight zone between censure and shelter by Greek and American agencies and individuals who ranged from committed friends and acquaintances to various top politicians such as Konstantinos Karamanlis, George Papandreou, and Ted Kennedy. In the 1950s, Demetracopoulos had built a reputation as a trustworthy liaison between the Greek media and the American community in Greece. Shortly after the establishment of the military dictatorship he sought refuge in the US via Denmark, acting out of a justified fear that assassination attempts would no longer be limited to his character. Barron’s book stresses for American audiences the Greek dimension of the Watergate scandal. Fate reserved for Demetracopoulos a crucial part in the history of both the junta and the Nixon administration, since it was he who came to reveal the Nixon administration’s “Greek connection.” According to his reports at the...

Evaluating US defense posture in light of great power competition

This article seeks a debate on the future of the US defense posture in the Great Power Competition. It contains a robust list of defense initiatives to consider in improving the US defense posture. Since the United States is no longer in combat operations in CENTCOM, now is the time to focus on changing the US defense posture and program to meet the challenges of the emerging security environment. The article details where the United States stands and major changes that should be made, emphasizing both conventional and strategic nuclear forces.The US Navy’s fleet and end strength has been constrained for far too long and must be expanded to meet the geopolitical requirements of the Great Power Competition. The US Navy’s size deeply declined as a byproduct of the Cold War’s end and Department of Defense post-Cold War force design planning. The lesson learned here is simple and straightforward: navies can be reduced quickly but cannot be rebuilt quickly. The industrial, construction, and labor issues associated with shipbuilding require multi-year construction schedules, effective labor force management and dedicated, long-range management and executive planning.

Presence of Diversity or Inclusion Information on US Ophthalmology Residency Program Websites

Groups historically underrepresented in medicine also remain underrepresented within ophthalmology. Prospective applicants, in particular women and racial and ethnic minority groups, consider program factors related to gender diversity, ethnic diversity, and program culture more than nonminority groups. A prospective applicant's decision to apply to a particular residency program may be influenced by the information presented on the program's website. To evaluate for presence of diversity or inclusion information on US ophthalmology program websites. This quality improvement study, conducted from May 1 to June 2, 2021, included a cross-sectional review of ophthalmology program websites. Ophthalmology program websites were reviewed for the presence of 6 predetermined diversity or inclusion information criteria. The presence of 6 predetermined diversity or inclusion information criteria. Association between program size and ranking with presence of diversity or inclusion information criteria was assessed. Of the 121 US program websites reviewed, 29 (24%) met at least 1 of the 6 predetermined criteria. Programs with more than 12 residents (odds ratio [OR], 3.58; 95% CI, 1.39-9.55; P = .004) and programs ranked within the top 20 best hospitals for ophthalmology (OR, 3.28; 95% CI, 1.05-10.1; P = .02) were more likely to have at least 1 of the diversity or inclusion information criteria on their website. Results of this quality improvement study suggest that the majority of US ophthalmology residency programs do not have information regarding diversity or inclusion on their websites. Although this investigation cannot determine how an ophthalmology residency program's website reflects the diversity and inclusion within the program, these findings suggest that there is a gap in the information that prospective applicants can collect when evaluating ophthalmology residency program websites.

The Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P): A research program striving to improve blood donor safety and optimize transfusion outcomes across the lifespan.

The Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P) is a new iteration of prior National Heart, Lung, and Blood Institute (NHLBI) REDS programs that focus on improving transfusion recipient outcomes across the lifespan as well as the safety and availability of the blood supply. The US program includes blood centers and hospitals (22 including 6 free-standing Children's hospitals) in four geographic regions. The Brazilian program has 5 participating hemocenters. A Center for Transfusion Laboratory Studies (CTLS) and a Data Coordinating Center (DCC) support synergistic studies and activities over the 7-year REDS-IV-P program. The US is building a centralized, vein-to-vein (V2V) database, linking information collected from blood donors, their donations, the resulting manufactured components, and data extracts from hospital electronic medical records of transfused and non-transfused patients. Simultaneously, the Brazilian program is building a donor, donation, and component database. The databases will serve as the backbone for retrospective and prospective observational studies in transfusion epidemiology, transfusion recipient outcomes, blood component quality, and emerging blood safety issues. Special focus will be on preterm infants, patients with sickle cell disease, thalassemia or cancer, and the effect of donor biologic variability and component manufacturing on recipient outcomes. A rapid response capability to emerging safety threats has resulted in timely studies related to Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). The REDS-IV-P program endeavors to improve donor-recipient-linked research with a focus on children and special populations while also maintaining the flexibility to address emerging blood safety issues.

Tracking the rise of United States foreign military training: IMTAD-USA, a new dataset and research agenda.

Training other countries’ armed forces is a go-to foreign policy tool for the United States and other states. A growing literature explores the effects of military training, but researchers lack detailed data on training activities. To assess the origins and consequences of military training, as well as changing patterns over time, this project provides a new, global dataset of US foreign military training. This article describes the scope of the data along with the variables collected, coding procedures, and spatial and temporal patterns. We demonstrate the added value of the data in their much greater coverage of training activities, showing differences from both existing datasets and aggregate foreign military aid data. Reanalyzing prior research findings linking US foreign military training to the risk of coups d’état in recipient states, we find that this effect is limited to a single US program representing a small fraction of overall US training activities. The data show comprehensively how the United States attempts to influence partner military forces in a wide variety of ways and suggest new avenues of research.

For the Love of Islam: US Foreign Policy, Islamophilia, and the Islam Centennial 14

This article explores the historical and lingering effects of US government involvement in defining Islam as public and foreign policy. It focuses on the Islam Centennial 14, a US program to celebrate the fourteenth centennial of Islam – and manage the US’s global image – which was active in the late 1970s and early 1980s. The Islam Centennial 14 organized a nationally touring museum exhibit, distributed information on Islam to partners and public schools, produced a newsletter, documentaries, and speaker series on Islam. It also culminated in one of the first academic centers in the US devoted to the study of Islam. The Islam Centennial 14’s activities provided a counter-narrative to rising Islamophobia and anti-Arab sentiment, while the discourses that swirled around them – including their own press reports, outside conspiracy theories, and academic analyses – foreshadowed more contemporary xenophobic politics. This article presents the Islam Centennial 14 specifically as a case study through which to consider the workings and ramifications of American Islamophilia. It examines how such celebrations of Islam as part and parcel of international and national governance reinscribe both racialized representations of Islam and, however inadvertently, anti-Muslim sentiments. It argues that Islamophilia is an undertheorized corollary to more explicit anti-Muslim positions, and one whose deployment and effects more than merit sustained attention.

Success in pediatric surgery: An updated survey of Program Directors 2020

BackgroundOne of the most competitive surgical sub-specialty fellowships remains Pediatric Surgery (PS), which requires candidates to develop a strong and research-oriented curriculum vitae. Although some objective factors of matriculation are known, factors for the interview selection and ranking per the program directors (PDs) have not been reviewed in over a decade. MethodsA web-based survey of US and Canadian PS program directors (PDs) (n = 58) was used to evaluate a comprehensive list of factors in the selection criteria for PS fellowships. A mix of dichotomous, ranking, five-point Likert scale, and open-ended questions evaluated applicant characteristics, ABSITE scores, research productivity, interview day, and rank order criteria. ResultsFifty-five programs responded to the survey for a 95% participation rate. PDs desired an average of two years in dedicated research and weighted first authorship and total number of publications heavily. Only 38% of programs used an ABSITE score cutoff for offering interviews; however, the majority agreed that an overall upward trend was important. Quality letters of recommendation, especially from known colleagues, carried weight when deciding to offer interviews. Interview performance, being a team player, observed interpersonal interactions, perceived operative skills and patient care, and leadership were some of the notable factors when finalizing rank lists. ConclusionsA multitude of factors define a successful matriculant, including quality of letters of recommendation, quality and quantity of publications, supportive phone calls, observed interactions, interview performance, perceptions of being team player with leadership skills as well as perceptions of good operative skills and patient care. Level of evidenceType II. Type of studyPrognostic (retrospective).

Genomics of Obsessive-Compulsive Disorder-Toward Personalized Medicine in the Era of Big Data.

Pathogenesis of obsessive-compulsive disorder (OCD) mainly involves dysregulation of serotonergic neurotransmission, but a number of other factors are involved. Genetic underprints of OCD fall under the category of “common disease common variant hypothesis,” that suggests that if a disease that is heritable is common in the population (a prevalence >1–5%), then the genetic contributors—specific variations in the genetic code—will also be common in the population. Therefore, the genetic contribution in OCD is believed to come from multiple genes simultaneously and it is considered a polygenic disorder. Genomics offers a number of advanced tools to determine causal relationship between the exposure and the outcome of interest. Particularly, methods such as polygenic risk score (PRS) or Mendelian Randomization (MR) enable investigation of new pathways involved in OCD pathogenesis. This premise is also facilitated by the existence of publicly available databases that include vast study samples. Examples include population-based studies such as UK Biobank, China Kadoorie Biobank, Qatar Biobank, All of US Program sponsored by National Institute of Health or Generations launched by Yale University, as well as disease-specific databases, that include patients with OCD and co-existing pathologies, with the following examples: Psychiatric Genomics Consortium (PGC), ENIGMA OCD, The International OCD Foundation Genetics Collaborative (IOCDF-GC) or OCD Collaborative Genetic Association Study. The aim of this review is to present a comprehensive overview of the available Big Data resources for the study of OCD pathogenesis in the context of genomics and demonstrate that OCD should be considered a disorder which requires the approaches offered by personalized medicine.

Effects of Address Coverage Enhancement on Estimates from Address-Based Sampling Studies.

For over a decade, address-based sampling (ABS) frames have often been used to draw samples for multistage area sample surveys in lieu of traditionally listed (or enumerated) address frames. However, it is well known that the use of ABS frames for face-to-face surveys suffer from undercoverage due to, for example, households that receive mail via a PO Box rather than being delivered to the household's street address. Undercoverage of ABS frames has typically been more prominent in rural areas but can also occur in urban areas where recent construction of households has taken place. Procedures have been developed to supplement ABS frames to address this undercoverage. In this article, we investigate a procedure called Address Coverage Enhancement (ACE) that supplements the ABS frame with addresses not found on the frame, and the resulting effects the addresses added to the sample through ACE have on estimates. Weighted estimates from two studies, the Population Assessment of Tobacco and Health Study and the 2017 US Program for the International Assessment of Adult Competencies, are calculated with and without supplemental addresses. Estimates are then calculated to assess if poststratifying analysis weights to control for urbanicity at the person level brings estimates closer to estimates from the supplemented frame. Our findings show that the noncoverage bias was likely minimal across both studies for a range of estimates. The main reason is because the Computerized Delivery Sequence file coverage rate is high, and when the coverage rate is high, only very large differences between the covered and not covered will result in meaningful bias.

Enhancing foreign language teacher candidates’ oral proficiency: An international comparison

Despite the importance of advanced language proficiency when teaching a foreign language, little research has investigated the oral proficiency of aspiring foreign language teachers across multiple countries and what their teacher training programs do to enhance it. In response, the researchers collected and analyzed both quantitative and qualitative data from foreign language teacher candidates in Germany, China, and the United States. Results suggested that oral proficiency varies significantly both within individual teacher training programs and across nations. The teacher candidates from Germany demonstrated significantly greater oral proficiency in the target language than their Chinese counterparts, who in turn, demonstrated significantly greater oral proficiency than the US teacher candidates. Helping to explain these findings, the data suggested that foreign language teacher training programs have differing areas of focus. While the programs in Germany and China focused more attention on language development, the US program emphasized pedagogical skills. Implications for practice are discussed.

Predicting Right Ventricular Failure Following Left Ventricular Assist Device Support: A Derivation-Validation Multicenter Risk Score

<h3>Purpose</h3> Despite several models predicting right ventricular failure (RVF) after durable left ventricular assist device (LVAD) support, poor performance when externally validated has limited their widespread use. We sought to derive a predictive model for RVF after LVAD implantation, and ascertain its performance in an independent cohort. <h3>Methods</h3> End-stage heart failure (HF) patients requiring continuous-flow LVAD were prospectively enrolled at one US program (n=477, derivation cohort), with two other US medical centers forming the validation cohort (n=321). The primary outcome was RVF incidence, defined as the need for right ventricular assist device or inotropes for >14 days. Multivariable logistic regression in the derivation set yielded a RVF predictive model, which was subsequently applied to the validation cohort, and a risk score was ultimately developed. <h3>Results</h3> Derivation cohort included patients less likely to be African-Americans (7% vs 37%; p<0.001), Hispanics (7% vs 30%; p<0.001), have a remote history of hypertension (49% vs 60%; p=0.002) or be bridged with short-term MCS (8% vs 16%; p=0.001), compared to the validation set. RVF incidence was 16% in the derivation and 36% in the validation cohort (p<0.001). Multivariable analysis identified 7 variables <b>(Figure)</b> as predictive of RVF, with the model achieving a C statistic of 0.734 (95% CI=0.674-0.794) in the derivation and 0.709 (95% CI=0.651-0.767) in the heterogeneous validation cohort. Patients were stratified into 3 RVF risk groups (all comparisons; p<0.001) <b>(Figure)</b>. <h3>Conclusion</h3> We propose a novel scoring system to predict post-LVAD RVF, achieving high discriminative performance in distinct, heterogeneous LVAD cohorts.