Reducing Caregiver Burden in Spinal Cord Injuries and Disorders (SCI/D)

The following capstone project focused on the exploration of clinical and community-based resources that help reduce caregiver burden in the adult spinal cord injuries and disease (SCI/D) population. In order to best serve the chosen population, this capstone project aimed to help adults with SCI/D and their caregivers have access to resources that assist with handling adjustment, learning independent living skills, and navigating their relationship with one another, while ultimately taking into consideration their specific mental health needs

The N2K Consortium. III. Short-Period Planets Orbiting HD 149143 and HD 109749

We report the detection of two short-period planets discovered at Keck Observatory. HD 149143 is a metal-rich G0 IV star with a planet of M sin i = 1.33M_J and an orbital radius of 0.053 AU. The best-fit Keplerian model has an orbital period, P = 4.072 days, semivelocity amplitude, K = 149.6 m s^(-1), and eccentricity, e = 0.016 ± 0.01. The host star is chromospherically inactive and metal-rich, with [Fe/H] = 0.26. Based on the T_(eff) and stellar luminosity, we derive a stellar radius of 1.49 R_☉. Photometric observations of HD 149143 were carried out using the automated photometric telescopes at Fairborn Observatory. HD 149143 is photometrically constant over the radial velocity period to 0.0003 ± 0.0002 mag, supporting the existence of the planetary companion. No transits were detected down to a photometric limit of approximately 0.02%, eliminating transiting planets with a variety of compositions and constraining the orbital inclination to less than 83°. A short-period planet was also detected around HD 109749, a G3 IV star. HD 109749 is chromospherically inactive, with [Fe/H] = 0.25 and a stellar radius of 1.24. The radial velocities for HD 109749 are modeled by a Keplerian with P = 5.24 days and K = 28.7 m s^(-1). The inferred planet mass is M sin i = 0.28M_J and the semimajor axis of this orbit is 0.0635 AU. Photometry of HD 109749 was obtained with the SMARTS consortium telescope, the PROMPT telescope, and by transitsearch.org observers in Adelaide and Pretoria. These observations did not detect a decrement in the brightness of the host star at the predicted ephemeris time, and they constrain the orbital inclination to less than 85° for gas giant planets with radii down to 0.7R_J

ASASSN-14ko is a Periodic Nuclear Transient in ESO 253-G003

We present the discovery that ASASSN-14ko is a periodically flaring AGN at the center of the galaxy ESO 253-G003. At the time of its discovery by the All-Sky Automated Survey for Supernovae (ASAS-SN), it was classified as a supernova close to the nucleus. The subsequent six years of V- and g-band ASAS-SN observations reveal that ASASSN-14ko has nuclear flares occurring at regular intervals. The seventeen observed outbursts show evidence of a decreasing period over time, with a mean period of $P_0 = 114.2 \pm 0.4$ days and a period derivative of $\dot{P} = -0.0017\pm0.0003$. The most recent outburst in May 2020, which took place as predicted, exhibited spectroscopic changes during the rise and a had a UV bright, blackbody spectral energy distribution similar to tidal disruption events (TDEs). The X-ray flux decreased by a factor of 4 at the beginning of the outburst and then returned to its quiescent flux after ~8 days. TESS observed an outburst during Sectors 4-6, revealing a rise time of $5.60 \pm 0.05$ days in the optical and a decline that is best fit with an exponential model. We discuss several possible scenarios to explain ASASSN-14ko's periodic outbursts, but currently favor a repeated partial TDE. The next outbursts should peak in the optical on UT 2020-09-7.4$\pm$1.1 and UT 2020-12-26.5$\pm$1.4.Comment: 26 pages, 15 figures, 7 tables. Will be submitted to ApJ. The latest flare is currently ongoing, as we predicte

Common Genetic Variants Contribute to Risk of Transposition of the Great Arteries.

RATIONALE: Dextro-transposition of the great arteries (D-TGA) is a severe congenital heart defect which affects approximately 1 in 4,000 live births. While there are several reports of D-TGA patients with rare variants in individual genes, the majority of D-TGA cases remain genetically elusive. Familial recurrence patterns and the observation that most cases with D-TGA are sporadic suggest a polygenic inheritance for the disorder, yet this remains unexplored. OBJECTIVE: We sought to study the role of common single nucleotide polymorphisms (SNPs) in risk for D-TGA. METHODS AND RESULTS: We conducted a genome-wide association study in an international set of 1,237 patients with D-TGA and identified a genome-wide significant susceptibility locus on chromosome 3p14.3, which was subsequently replicated in an independent case-control set (rs56219800, meta-analysis P=8.6x10 CONCLUSIONS: This work provides support for a polygenic architecture in D-TGA and identifies a susceptibility locus on chromosome 3p14.3 nea

Speech-Language Pathologists in Disaster Management: Team Roles

Purpose: Disaster management is a topic that is multi-faceted and intricately maintained by the professionals who volunteer their expertise and time to assist those who have been affected by an unforeseen disaster. Creating a well-rounded and effective team is of immense importance during disaster situations; speech-language pathologists (SLPs) can provide vital skills in the realm of communication, feeding, and other areas. However, the role of SLPs within the disaster management team is not well documented in the literature. The purpose of the study was to identify awareness, involvement, and training of SLPs in disaster management cycles through exploration of their self-reported knowledge, skills, and roles in order to better understand their likelihood of response and potential collaborative roles within the team. Method: To explore how SLPs view themselves as part of the disaster management cycle, a cross-sectional survey study was designed. The study specifically targeted licensed, SLPs within the state of Florida. Results: There were 216 viable survey responses to analyze. Upon rendering of the data, a descriptive and correlational analysis was conducted to further examine how speech-language professionals perceive their fit in the arena of disaster management. SLPs who responded to this survey were primarily white, 40–49-year-old females who had experienced some form of disaster. Most respondents reported receiving no training for disaster management; however, they indicated that SLPs and other healthcare professionals have unique skills that could contribute to disaster cycles. Although there was reportedly limited training and guidance available and minimal professional experience with disaster, SLPs who reported having professional experience with disaster cycles, indicated an increased likelihood of participating in future disaster response. Conclusions: Similar to interdisciplinary teams found in clinical practice, healthcare professionals need training and education about their roles to form teams to holistically address the needs of clients in all disaster management stages. Analyses show SLPs feel they could provide important contributions to the interdisciplinary disaster management team; however, they have not had adequate professional experience or training

Speech-Language Pathologists and Disaster Management: Team Roles

Purpose: Disaster management is a topic that is multi-faceted and intricately maintained by professionals who volunteer their expertise and time to assist those who have been affected by an unforeseen disaster. Creating a well-rounded and effective team is of immense importance during disaster situations. Speech-language pathologists can provide vital skills in the realm of communication, feeding, and other areas. However, the role of speech language pathologists within the disaster management team is not well documented in the literature. The purpose of the study was to identify awareness, involvement, and training of speech language pathologists in disaster management stages through exploration of their self-reported knowledge, skills, and roles to better understand their likelihood of response and potential collaborative roles within a disaster management team. Method: To gather data on self-reported awareness, knowledge, skills, participation, training, and perceptions of speech language pathologists as part of the disaster management stage, a cross-sectional survey study was designed. The study specifically targeted licensed speech language pathologists within the state of Florida. Results: There were 216 viable survey responses to analyze. Descriptive and correlational analyses were conducted to examine how speech-language professionals perceive their fit in the arena of disaster management. Speech language pathologists who responded to this survey were primarily white, 40–49-year-old females who had experienced some form of disaster. Most respondents reported receiving no training in disaster management; however, they indicated that speech language pathologists and other healthcare professionals have unique skills that could contribute to disaster management stages. Although there was reportedly limited training and guidance available and minimal professional experience with disaster, speech language pathologists who reported having professional experience with disaster stages, indicated an increased likelihood of participating in future disaster management. Conclusions: Similar to interdisciplinary teams found in clinical practice, healthcare professionals need training and education about their roles to form teams to address the needs of individuals in all disaster management stages. Analyses indicated that speech language pathologists perceive themselves, and other healthcare professionals, could provide meaningful contributions to the disaster management team; however, they have not had adequate professional experience or training

The N2K consortium. III. short-period planets orbiting HD 149143 and HD 109749

We report the detection of two short-period planets discovered at Keck Observatory. HD 149143 is a metal-rich G0 IV star with a planet of M sin i = 1.33MJ and an orbital radius of 0.053 AU. The best-fit Keplerian model has an orbital period, P = 4.072 days, semivelocity amplitude, K = 149.6 m s-1, and eccentricity, e = 0.016 ± 0.01. The host star is chromospherically inactive and metal-rich, with [Fe/H] = 0.26. Based on the Teff and stellar luminosity, we derive a stellar radius of 1.49 R☉. Photometric observations of HD 149143 were carried out using the automated photometric telescopes at Fairborn Observatory. HD 149143 is photometrically constant over the radial velocity period to 0.0003 ± 0.0002 mag, supporting the existence of the planetary companion. No transits were detected down to a photometric limit of approximately 0.02%, eliminating transiting planets with a variety of compositions and constraining the orbital inclination to less than 83°. A short-period planet was also detected around HD 109749, a G3 IV star. HD 109749 is chromospherically inactive, with [Fe/H] = 0.25 and a stellar radius of 1.24. The radial velocities for HD 109749 are modeled by a Keplerian with P = 5.24 days and K = 28.7 m s-1. The inferred planet mass is M sin i = 0.28MJ and the semimajor axis of this orbit is 0.0635 AU. Photometry of HD 109749 was obtained with the SMARTS consortium telescope, the PROMPT telescope, and by transitsearch.org observers in Adelaide and Pretoria. These observations did not detect a decrement in the brightness of the host star at the predicted ephemeris time, and they constrain the orbital inclination to less than 85° for gas giant planets with radii down to 0.7RJ.Debra A. Fischer, Gregory Laughlin, Geoffrey W. Marcy, R. Paul Butler, Steven S. Vogt, John A. Johnson, Gregory W. Henry, Chris McCarthy, Mark Ammons, Sarah Robinson, Jay Strader, Jeff A. Valenti, P. R. McCullough, David Charbonneau, Joshua Haislip, Heather A. Knutson, Daniel E. Reichart, Padric McGee, Berto Monard, Jason T. Wright, Shigeru Ida, Bun'ei Sato, and Dante Minnit

COVID-19 in Adults With Congenital Heart Disease.

BACKGROUND Adults with congenital heart disease (CHD) have been considered potentially high risk for novel coronavirus disease-19 (COVID-19) mortality or other complications. OBJECTIVES This study sought to define the impact of COVID-19 in adults with CHD and to identify risk factors associated with adverse outcomes. METHODS Adults (age 18 years or older) with CHD and with confirmed or clinically suspected COVID-19 were included from CHD centers worldwide. Data collection included anatomic diagnosis and subsequent interventions, comorbidities, medications, echocardiographic findings, presenting symptoms, course of illness, and outcomes. Predictors of death or severe infection were determined. RESULTS From 58 adult CHD centers, the study included 1,044 infected patients (age: 35.1 ± 13.0 years; range 18 to 86 years; 51% women), 87% of whom had laboratory-confirmed coronavirus infection. The cohort included 118 (11%) patients with single ventricle and/or Fontan physiology, 87 (8%) patients with cyanosis, and 73 (7%) patients with pulmonary hypertension. There were 24 COVID-related deaths (case/fatality: 2.3%; 95% confidence interval: 1.4% to 3.2%). Factors associated with death included male sex, diabetes, cyanosis, pulmonary hypertension, renal insufficiency, and previous hospital admission for heart failure. Worse physiological stage was associated with mortality (p = 0.001), whereas anatomic complexity or defect group were not. CONCLUSIONS COVID-19 mortality in adults with CHD is commensurate with the general population. The most vulnerable patients are those with worse physiological stage, such as cyanosis and pulmonary hypertension, whereas anatomic complexity does not appear to predict infection severity

Common Genetic Variants Contribute to Risk of Transposition of the Great Arteries

RATIONALE: Dextro-transposition of the great arteries (D-TGA) is a severe congenital heart defect which affects approximately 1 in 4,000 live births. While there are several reports of D-TGA patients with rare variants in individual genes, the majority of D-TGA cases remain genetically elusive. Familial recurrence patterns and the observation that most cases with D-TGA are sporadic suggest a polygenic inheritance for the disorder, yet this remains unexplored. OBJECTIVE: We sought to study the role of common single nucleotide polymorphisms (SNPs) in risk for D-TGA. METHODS AND RESULTS: We conducted a genome-wide association study in an international set of 1,237 patients with D-TGA and identified a genome-wide significant susceptibility locus on chromosome 3p14.3, which was subsequently replicated in an independent case-control set (rs56219800, meta-analysis P=8.6x10-10, OR=0.69 per C allele). SNP-based heritability analysis showed that 25% of variance in susceptibility to D-TGA may be explained by common variants. A genome-wide polygenic risk score derived from the discovery set was significantly associated to D-TGA in the replication set (P=4x10-5). The genome-wide significant locus (3p14.3) co-localizes with a putative regulatory element that interacts with the promoter of WNT5A, which encodes the Wnt Family Member 5A protein known for its role in cardiac development in mice. We show that this element drives reporter gene activity in the developing heart of mice and zebrafish and is bound by the developmental transcription factor TBX20. We further demonstrate that TBX20 attenuates Wnt5a expression levels in the developing mouse heart. CONCLUSIONS: This work provides support for a polygenic architecture in D-TGA and identifies a susceptibility locus on chromosome 3p14.3 near WNT5A. Genomic and functional data support a causal role of WNT5A at the locus