Examining the Re-Segregation of Public Schools in the U.S.: School Choice and Whites’ Preferences

Although the expansion of school choice options in the U.S. has been widely discussed, few studies have examined their impact on racial segregation in traditional public schools. I study this relationship by examining changes in levels of White-Black, White-Hispanic, and White-Asian segregation of school-age children in schools and their catchment areas between 2000 and 2010 in the 22 largest school districts in the U.S. Findings show that schools have higher levels of segregation than their corresponding catchment areas and that school segregation increased in a majority of these districts during this time period, independent of changes in residential segregation. In a second study of over 20,000 schools in the 2009-2010 school year, I examine the factors that predict the enrollment of Whites in their neighborhood schools. I find that, net of a school’s quality, the racial composition of the catchment area continues to have a significant effect on White enrollment.Master of Art

Designing a Bone Health and Soy Focus Group Discussion Guide Based on the Health Belief Model

Focus groups were used to assess the knowledge and skills of women in order to support curricula development. The Health Belief Model was applied to the discussion guide to enhance focus group findings and applications. Constructs related to perceived susceptibility, severity, benefits, and barriers; cues to action; and self-efficacy were probed. Focus group findings revealed that women may have a limited understanding of osteoporosis risk. Perceived barriers such as negative perceptions to soy consumption were also noted. Cues to action were identified and integrated. Basing focus group discussion guides on model constructs may enhance focus group results and their applications

Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

OBJECTIVES: In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport) in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral) and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS) system which has utility in the treatment administration. METHOD AND MATERIALS: Data were gathered prospectively on voice improvement (self-rated 6 point scale), length of response and duration of complications (breathiness, cough, dysphagia and total voice loss). Injections were performed under electromyography (EMG) guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. RESULTS: Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS) and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. CONCLUSION: Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia

Distribution of neuromuscular junctions in laryngeal and syringeal muscles in vertebrates

Vertebrates are capable of producing a variable sound spectrum. In mammals, lissamphibia, and reptiles, the larynx is the vocal organ responsible for sound production, whereas in birds it is produced by the syrinx, an avian organ located at the base of trachea. The distribution of neuromuscular junctions responsible for the fine control of laryngeal muscle (LM) and syringeal muscle (SM), although studied with some detail in human LM, remains mostly unknown in other vertebrates. In the present study, we analyzed the distribution of motor end plates (MEPs) in LM/SM of different vertebrate classes using the histochemical detection of acetylcholinesterase: the thyroarytenoid and cricoarytenoid LM of mammal (human, rat, and rabbit) and cricoarytenoid LM of nonmammalian (frog and avian) species and the tracheobronchial SM of rooster and pigeon. In humans and frogs/avians, MEPs were distributed diffusely along, respectively, the thyroarytenoid-cricoarytenoid and the cricoarytenoid LM fibers, whereas in rats and rabbits, MEPs were concentrated in a transverse band located in the middle of thyroarytenoid and cricoarytenoid muscle fibers. In roosters and pigeons, MEPs were distributed diffusely along SM fibers. The highly diffuse MEP distribution along human thyroarytenoid and cricoarytenoid fibers indicates that these muscles can markedly change their degree of contraction, which may contribute for the large range of different sounds produced by human vocal folds. The same rationale was applied to discuss the possible functional significance of the morphological distribution of MEPs along the LM/SM of the other vertebrates analyzed

Treatment of recurrent respiratory papillomatosis and adverse reactions following off-label use of cidofovir (Vistide®)

Recurrent respiratory papillomatosis (RRP) is caused by a human papilloma virus (HPV). It is a rare, sometimes debilitating disease compromising voice and airway. RRP is characterized by a variable course of disease, potentially leading to frequent annual surgical procedures, the number of which may exceed a hundred during the life time. The therapy focuses on surgical removal of the mucosal lesions in order to keep the airway open and the voice satisfactory. Till now, there is no curative therapy for the virus infection in itself. As recurrent surgery alone has proven to be insufficient in many cases, adjuvant therapy is increasingly being used. One of the mainstays of adjuvant therapy is the administration of intralesional cidofovir (Vistide Ò). Cidofovir is an antiviral agent, registered for the treatment of cytomegalovirus (CMV) retinitis in patients wit

Cepstral analysis of hypokinetic and ataxic voices : correlations with perceptual and other acoustic measures

To investigate the validity of cepstral analyses against other conventional acoustic measures of voice quality in determining the perceptual impression in different motor speech disorders—hypokinetic and ataxic dysarthria, and speech tasks—prolonged vowels and connected speech. Prolonged vowel productions and connected speech samples (reading passages and monologues) from 43 participants with Parkinson disease and 10 speakers with ataxia were analyzed perceptually by a trained listener using GRBAS. In addition, acoustic measures of cepstral peak prominence (CPP), smoothed CPP (CPPs), harmonics-to-noise ratio (HNR), shimmer %, shimmer dB, amplitude perturbation quotient (APQ), relative average perturbation (RAP), jitter, and pitch perturbation quotient (PPQ) were performed. Statistical analysis involved correlations between perceptual and acoustic measures, as well as determination of differences across speaker groups and elicitation tasks. CPP and CPPs results showed greater levels of correlation with overall dysphonia, breathiness, and asthenia ratings than the other acoustic measures, except in the case of roughness. Sustained vowel production produced a higher number of significant correlations across all parameters other than connected speech, but task choice did not affect CPP and CPPs results. There were no significant differences in any parameters across the two speaker groups. The results of this study are consistent with the results of other studies investigating the same measures in speakers with nonmotor-related voice pathologies. In addition, there was an indication that they performed better in relation to asthenia, which might be particularly relevant for the current speaker group. The results support the clinical and research use of CPP and CPPs as a quantitative measure of voice quality in populations with motor speech disorder

HER2-Specific Chimeric Antigen Receptor–Modified Virus-Specific T Cells for Progressive Glioblastoma: A Phase 1 Dose-Escalation Trial

Glioblastoma is an incurable tumor, and the therapeutic options for patients are limited. To determine whether the systemic administration of HER2-specific chimeric antigen receptor (CAR)-modified virus-specific T cells (VSTs) is safe and whether these cells have antiglioblastoma activity. In this open-label phase 1 dose-escalation study conducted at Baylor College of Medicine, Houston Methodist Hospital, and Texas Children's Hospital, patients with progressive HER2-positive glioblastoma were enrolled between July 25, 2011, and April 21, 2014. The duration of follow-up was 10 weeks to 29 months (median, 8 months). Monotherapy with autologous VSTs specific for cytomegalovirus, Epstein-Barr virus, or adenovirus and genetically modified to express HER2-CARs with a CD28.ζ-signaling endodomain (HER2-CAR VSTs). Primary end points were feasibility and safety. The key secondary end points were T-cell persistence and their antiglioblastoma activity. A total of 17 patients (8 females and 9 males; 10 patients ≥18 years [median age, 60 years; range, 30-69 years] and 7 patients <18 years [median age, 14 years; range, 10-17 years]) with progressive HER2-positive glioblastoma received 1 or more infusions of autologous HER2-CAR VSTs (1 × 106/m2 to 1 × 108/m2) without prior lymphodepletion. Infusions were well tolerated, with no dose-limiting toxic effects. HER2-CAR VSTs were detected in the peripheral blood for up to 12 months after the infusion by quantitative real-time polymerase chain reaction. Of 16 evaluable patients (9 adults and 7 children), 1 had a partial response for more than 9 months, 7 had stable disease for 8 weeks to 29 months, and 8 progressed after T-cell infusion. Three patients with stable disease are alive without any evidence of progression during 24 to 29 months of follow-up. For the entire study cohort, median overall survival was 11.1 months (95% CI, 4.1-27.2 months) from the first T-cell infusion and 24.5 months (95% CI, 17.2-34.6 months) from diagnosis. Infusion of autologous HER2-CAR VSTs is safe and can be associated with clinical benefit for patients with progressive glioblastoma. Further evaluation of HER2-CAR VSTs in a phase 2b study is warranted as a single agent or in combination with other immunomodulatory approaches for glioblastoma

A bispecific chimeric antigen receptor molecule enhances T cell activation through dual immunological synapse formation and offsets antigen escape in glioblastoma

Background Antigen escape tumor cell variants prevail in tumors recurring after treatment with chimeric antigen receptor (CAR) T cells with a single specificity. Recurrent tumors preserve alternative non-targeted tumor associated antigens. Hypothesis A bispecific CAR will mitigate antigen escape enhancing the antitumor activity of T cells. Methods and results HER2 and IL13Rα2 are currently targeted in Phase I glioblastoma (GBM) trials using CAR T cells. We created a bispecific CAR molecule with a HER2-specific scFv joined in tandem to an IL13Rα2-binding moiety in the CAR exodomain (Tandem CAR) and a CD28.ζ signaling endodomain. We used computational modeling to interrogate this design. GBM patients' Tandem CAR T cells showed distinct binding to soluble HER2 and IL13Rα2 and killed primary autologous GBM cells. Three-dimensional reconstitution and quantification of confocal images of the Tandem CAR T cell/tumor interface revealed enhanced bifunctional immunological synapses compared to conventional CARs. Further, Tandem CAR T cells exhibited significantly enhanced inexhaustible activation dynamics when compared to conventional HER2 or IL13Rα2 CAR T cells and better controlled established GBM in an orthotopic murine model by offsetting both HER2 and IL13Rα2 escape. Conclusion Tandem chimeric antigen receptors enhance T cell activation and mitigate antigen escape through bifunctional immunological synapse formation in GBM