Following the Money: The Responses of Political Actors to Betting Market Conditions and Other Measures of Campaign Competitiveness

This paper sets out to quantify whether actors who contribute independent expenditures in support of U.S. House candidates do so in a strategic way. Specifically, whether more money is spent on candidates that are perceived to be in more competitive elections. It also discusses different sources of information from which spenders can discover whether a candidate is competitive. Data from political betting markets are utilized in a novel setting to support the conclusions. I expected that political expenditures will be significantly related to measures of competitiveness, and that betting markets would be a significant source of that information. I used a generalized additive model to isolate the relationship between the implied competitiveness of a candidate based on betting market data and the amount of independent expenditure supporting them that they received, controlling for various individual candidate effects and other sources of information regarding competitiveness. I found the expected relationship, but that betting markets were not a significant source of information when making spending decisions.No embargoAcademic Major: EconomicsAcademic Major: Political Scienc

Impact of Racial Disparities in Preoperative Cardiovascular Evaluation and Surgical Outcomes in Patients Undergoing Metabolic and Bariatric Surgery: A Retrospective Cohort Analysis

Background: We investigated preoperative referral patterns, rates of cardiovascular testing, surgical wait times, and postoperative outcomes in White versus Black, Hispanic, or other racial or ethnic groups of patients undergoing metabolic and bariatric surgery. Methods and Results: This was a single center retrospective cohort analysis of 797 consecutive patients undergoing metabolic and bariatric surgery from January 2014 to December 2018; 86% (n=682) were Black, Hispanic, or other racial or ethnic groups. White versus Black, Hispanic, or other racial or ethnic groups had similar baseline comorbidities and were referred for preoperative cardiovascular evaluation in similar proportion (65% versus 68%, P=0.529). Black, Hispanic, or other racial or ethnic groups of patients were less likely to undergo preoperative cardiovascular testing (unadjusted odds ratio [OR], 0.56; 95% CI, 0.33–0.95; P=0.031; adjusted for Revised Cardiac Risk Index OR, 0.59; 95% CI, 0.35–0.996; P=0.049). White patients had a shorter wait time for surgery (unadjusted hazard ratio [HR], 0.7; 95% CI, 0.58–0.87; P=0.001; adjusted HR, 0.7; 95% CI, 0.56–0.95; P=0.018). Reduction in body mass index at 6 months was greater in White patients (12.9 kg/m2 versus 12.0 kg/m2, P=0.0289), but equivalent at 1 year (14.9 kg/m2 versus 14.3 kg/m2, P=0.330). Conclusions: White versus Black, Hispanic, or other racial or ethnic groups of patients were referred for preoperative cardiovascular evaluation in similar proportion. White patients underwent more preoperative cardiac testing yet had a shorter wait time for surgery. Early weight loss was greater in White patients, but equivalent between groups at 12 months.Lewis Katz School of MedicineMedicin

Early surgical intervention is indicated for recurrent spontaneous pneumothorax in children and adolescents

Background: Primary spontaneous pneumothorax (PSP) occurs most often in adolescent patients. There is consensus that surgical intervention plays an important role in preventing recurrence, however, the optimum timing of surgery is debated. We hypothesize that clinical and radiographic factors are associated with eventual need for surgery.  Experimental Design: We searched the medical record for PSP patients between ages 9 and 21 treated from 1/1/08 to 12/31/17 and collected data on chest tube management, radiographic measurements, operative management, and recurrence. We performed univariate analysis on relationships between admission events and eventual surgery or other management strategies.  Results: We identified 68 PSP admissions from 31 patients. Considering only first-time admissions, there was no association between eventual surgery and clinical factors and radiographic findings.  The single factor associated with eventual surgery was history of pneumothorax in any lung (p=0.015). For patients with prior pneumothorax who underwent surgery, operation the day after admission would have reduced hospital stay by an average of 1.5 days (min=0, max=9) and an average of 2.2 days (min=0, max=10) if performed on the day of admission, with a mean 1.85 fewer chest x-rays (min=0, max=7). Considering only first admissions, ipsilateral recurrence rate was 16.7% after surgery, 46.7% after chest tube alone, and 100% after observation alone.  Conclusion: This analysis suggests that though eventual surgery is difficult to predict, ipsilateral recurrence rate is reduced following surgery. Furthermore, earlier operation in recurrent patients could reduce resource utilization. Thus, expedited surgical treatment may merit consideration in patients with a history of pneumothorax.&nbsp

How Position of Reading Questions Affects the Reading Comprehension of High and Low Ability Readers

This study investigates the optimum placement of reading questions in textbooks. Is it better to have reading questions embedded in chapters or placed at the end of chapters? One independent variable is reading question placement (embedded vs. end). Another independent variable is reading comprehension ability (higher vs. lower). Participants read a chapter from a statistics book, listened to stories as a distractor task, and then answered three types of questions about the statistics chapter. The dependent variable is the percent correct for each question type. Target questions tested the same content as a previous reading question. Related questions tested similar content. Non-target questions tested unrelated content. We will analyze our data with three 2 x 2 factorial ANOVAs. We expect embedded questions will help lower-ability readers on target and related questions. Further, embedded questions will hurt the performance of higher-ability readers on non-target questions. Higher and lower comprehenders differ in their ability to suppress irrelevant information. Embedded questions facilitate suppression processes by highlighting specific content in the reading. However, for high comprehenders who already suppress irrelevant information effectively, embedded questions may lead to “over suppression,” causing non-target information to be processed less well

Survivors of Congenital Diaphragmatic Hernia Repair Face Barriers to Long-Term Follow-Up Care

BACKGROUND: Congenital diaphragmatic hernia (CDH) carries high morbidity and mortality, and survivors commonly have neurodevelopmental, gastrointestinal, and pulmonary sequela requiring multidisciplinary care well beyond repair. We predict that following hospitalization for repair, CDH survivors face many barriers to receiving future medical care. METHODS: A retrospective review was conducted of all living CDH patients between ages 0 to 12 years who underwent repair at Riley Hospital for Children (RHC) from 2010 through 2019. Follow-up status with specialty providers was reviewed, and all eligible families were contacted to complete a survey regarding various aspects of their child's care, including functional status, quality of life, and barriers to care. Bivariate analysis was applied to patient data (P < 0.05 was significant) and survey responses were analyzed qualitatively. RESULTS: After exclusions, 70 survivors were contacted. Thirty-three (47%) were deemed lost to follow up to specialist providers, and were similar to those who maintained follow-up with respect to defect severity type (A-D, P = 0.57), ECMO use (P = 0.35), number of affected organ systems (P = 0.36), and number of providers following after discharge (P = 0.33). Seventeen (24%) families completed the survey, of whom eight (47%) were deemed lost to follow up to specialist providers. Families reported distance and time constraints, access to CDH-specific information and care, access to CDH-specific resources, and access to healthcare as significant barriers to care. All respondents were interested in a multidisciplinary CDH clinic. CONCLUSIONS: CDH survivors require multidisciplinary care beyond initial repair, but attrition to follow-up after discharge is high. A multidisciplinary CDH clinic may address caregivers' perceived barriers

Viral Double-Strand RNA-Binding Proteins Can Enhance Innate Immune Signaling by Toll-Like Receptor 3

Toll-like Receptor 3 (TLR3) detects double-stranded (ds) RNAs to activate innate immune responses. While poly(I:C) is an excellent agonist for TLR3 in several cell lines and in human peripheral blood mononuclear cells, viral dsRNAs tend to be poor agonists, leading to the hypothesis that additional factor(s) are likely required to allow TLR3 to respond to viral dsRNAs. TLR3 signaling was examined in a lung epithelial cell line by quantifying cytokine production and in human embryonic kidney cells by quantifying luciferase reporter levels. Recombinant 1b hepatitis C virus polymerase was found to enhance TLR3 signaling in the lung epithelial BEAS-2B cells when added to the media along with either poly(I:C) or viral dsRNAs. The polymerase from the genotype 2a JFH-1 HCV was a poor enhancer of TLR3 signaling until it was mutated to favor a conformation that could bind better to a partially duplexed RNA. The 1b polymerase also co-localizes with TLR3 in endosomes. RNA-binding capsid proteins (CPs) from two positive-strand RNA viruses and the hepadenavirus hepatitis B virus (HBV) were also potent enhancers of TLR3 signaling by poly(I:C) or viral dsRNAs. A truncated version of the HBV CP that lacked an arginine-rich RNA-binding domain was unable to enhance TLR3 signaling. These results demonstrate that several viral RNA-binding proteins can enhance the dsRNA-dependent innate immune response initiated by TLR3