Utah System of Higher Education

Importance: SARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms or other health effects occurring after acute infection, termed postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Characterizing PASC requires analysis of prospectively and uniformly collected data from diverse uninfected and infected individuals. Objective: To develop a definition of PASC using self-reported symptoms and describe PASC frequencies across cohorts, vaccination status, and number of infections. Design, Setting, and Participants: Prospective observational cohort study of adults with and without SARS-CoV-2 infection at 85 enrolling sites (hospitals, health centers, community organizations) located in 33 states plus Washington, DC, and Puerto Rico. Participants who were enrolled in the RECOVER adult cohort before April 10, 2023, completed a symptom survey 6 months or more after acute symptom onset or test date. Selection included population-based, volunteer, and convenience sampling. Exposure: SARS-CoV-2 infection. Main Outcomes and Measures: PASC and 44 participant-reported symptoms (with severity thresholds). Results: A total of 9764 participants (89% SARS-CoV-2 infected; 71% female; 16% Hispanic/Latino; 15% non-Hispanic Black; median age, 47 years [IQR, 35-60]) met selection criteria. Adjusted odds ratios were 1.5 or greater (infected vs uninfected participants) for 37 symptoms. Symptoms contributing to PASC score included postexertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements. Among 2231 participants first infected on or after December 1, 2021, and enrolled within 30 days of infection, 224 (10% [95% CI, 8.8%-11%]) were PASC positive at 6 months. Conclusions and Relevance: A definition of PASC was developed based on symptoms in a prospective cohort study. As a first step to providing a framework for other investigations, iterative refinement that further incorporates other clinical features is needed to support actionable definitions of PASC.

The origin and functions of mast cells (MCs) have been debated since their description by Paul Ehrlich in 1879. MCs have long been considered 'reactive bystanders' and 'amplifiers' in inflammatory processes, allergic reactions, and host responses to infectious diseases. However, knowledge about the origin, phenotypes and functions of MCs has increased substantially over the past 50 years. MCs are now known to be derived from multipotent hematopoietic progenitors, which, through a process of differentiation and maturation, form a unique hematopoietic lineage residing in multiple organs. In particular, MCs are distinguishable from basophils and other hematopoietic cells by their unique phenotype, origin(s), and spectrum of functions, both in innate and adaptive immune responses and in other settings. The concept of a unique MC lineage is further supported by the development of a distinct group of neoplasms, collectively referred to as mastocytosis, in which MC precursors expand as clonal cells. The clinical consequences of the expansion and/or activation of MCs are best established in mastocytosis and in allergic inflammation. However, MCs have also been implicated as important participants in a number of additional pathologic conditions and physiological processes. In this article, we review concepts regarding MC development, factors controlling MC expansion and activation, and some of the fundamental roles MCs may play in both health and disease. We also discuss new concepts for suppressing MC expansion and/or activation using molecularly-targeted drugs.

Purpose: The purpose of this article is to conduct a critical race policy analysis of Texas school finance policy. This empirical article examines three chapters of the Texas education code (TEC) and identifies the racial effects that the school funding system has on seven majority-Mexican American school districts. Methodology: Critical Race Theory (CRT) and Latina/o Critical (LatCrit) theoretical frameworks are employed in this article in which race and property are highlighted as concepts central to the analysis. The methodology allows for a critical perspective on history and the racial effects of policy to be outlined. First, a historical analysis of race and racism, schooling, and politics in Texas contextualizes the debate over school finance equity. Second, an analysis of the effects that the school finance system has on communities of color is completed. Analysis and Findings: An examination of primarily 2002—2003 school finance data, Texas Supreme Court opinions, and TEC indicates that majority-Mexican American school districts are disadvantaged by Texas school finance policy. Whether it is operational, maintenance, or facilities funding, the school finance system institutes inequity.

OBJECTIVES: The PROMIS-Preference (PROPr) score is a recently developed summary score for the Patient-Reported Outcomes Measurement Information System (PROMIS). PROPr is a preference-based scoring system for seven PROMIS domains created using multiplicative multi-attribute utility theory. It serves as a generic, societal, preference-based summary scoring system of health-related quality of life. This manuscript evaluates construct validity of PROPr in two large samples from the US general population. METHODS: We utilized 2 online panel surveys, the PROPr Estimation Survey and the Profiles-Health Utilities Index (HUI) Survey. Both included the PROPr measure, patient demographic information, self-reported chronic conditions, and other preference-based summary scores: the EuroQol-5D (EQ-5D-5L) and HUI in the PROPr Estimation Survey and the HUI in the Profiles-HUI Survey. The HUI was scored as both the Mark 2 and the Mark 3. Known-groups validity was evaluated using age- and gender-stratified mean scores and health condition impact estimates. Condition impact estimates were created using ordinary least squares regression in which a summary score was regressed on age, gender, and a single health condition. The coefficient for the health condition is the estimated effect on the preference score of having a condition vs. not having it. Convergent validity was evaluated using Pearson correlations between PROPr and other summary scores. RESULTS: The sample consisted of 983 respondents from the PROPr Estimation Survey and 3,000 from the Profiles-HUI survey. Age- and gender-stratified mean PROPr scores were lower than EQ-5D and HUI scores, with fewer subjects having scores corresponding to perfect health on the PROPr. In the PROPr Estimation survey, all 11 condition impact estimates were statistically significant using PROPr, 8 were statistically significant by the EQ-5D, 7 were statistically significant by HUI Mark 2, and 9 were statistically significant by HUI Mark 3. In the Profiles-HUI survey, all 21 condition impact estimates were statistically significant using summary scores from all three scoring systems. In these samples, the correlations between PROPr and the other summary measures ranged from 0.67 to 0.70. CONCLUSIONS: These results provide evidence of construct validity for PROPr using samples from the US general population.

The growing interest internationally in leadership development and how leaders contribute to student learning makes the development of the National College for School Leadership (NCSL) an intriguing and potentially significant event. This article examines the aims and programs of the NCSL from a North American perspective. Based on a context in which the world of leadership work is changing and the socialization of school leaders is critical, the article identifies opportunities and challenges which the NCSL faces in contributing to the reform of leadership and leadership development.

This qualitative study examines the experiences of six Mexican community college transfer students attending a research-intensive institution in the Pacific Northwest. Using semi-structured interviews, the objectives of this study were to 1) understand how Mexican students made meaning of their transfer experiences and 2) how those experiences could inform conceptual and practical thinking toward building a transfer receptive culture at the receiving institution. We use intersectionality as a site of material and discursive possibility to encourage predominantly White receiving institutions to recognize how they position Mexican community college transfer students on campus. Concluding are conceptual and practical recommendations that emphasize institutional and organizational responsibility in creating equitable environments for Mexican community college transfer students.

Abstract WPSD (Weighted Pose Space Deformation) is an example based skinning method for articulated body animation. The per‐vertex computation required in WPSD can be parallelized in a SIMD (Single Instruction Multiple Data) manner and implemented on a GPU. While such vertex‐parallel computation is often done on the GPU vertex processors, further parallelism can potentially be obtained by using the fragment processors. In this paper, we develop a parallel deformation method using the GPU fragment processors. Joint weights for each vertex are automatically calculated from sample poses, thereby reducing manual effort and enhancing the quality of WPSD as well as SSD (Skeletal Subspace Deformation). We show sufficient speed‐up of SSD, PSD (Pose Space Deformation) and WPSD to make them suitable for real‐time applications . Categories and Subject Descriptors (according to ACM CCS): I.3.1 [Computer Graphics]: Hardware Architecture‐Parallel processing, I.3.5 [Computer Graphics]: Computational Geometry and Object Modeling‐Curve, surface, solid and object modeling, I.3.7 [Computer Graphics]: Three‐Dimensional Graphics and Realism‐Animation.

Measuring health and health-related quality of life (HRQoL) is important for tracking the health of individuals and populations over time. Generic HRQoL measures allow for comparison across health conditions. One form of generic HRQoL measures are profile measures, which provide a description of health across several different domains (such as physical functioning, depression, and pain). Recent advances in health profile measurement include the development of measures based on item response theory. The Patient-Reported Outcomes Measurement Information System (PROMIS®) has been constructed using this theory. Another form of generic HRQoL measures are utility measures, which assess the value of health states. Multi-attribute utility theory provides a framework for valuing disparate domains of health and aggregating them into a single preference-based score. Such a score provides an overall measure of health outcomes as well as a quality of life weight for use in decision analyses and cost-effectiveness analyses. Developing a utility score for PROMIS® would allow simultaneous estimation of both health profile and utility scores using a single measure. The purpose of this paper is to provide a roadmap of the methodological steps necessary to create such a scoring system.

had made recommendations to distinguish PHOMS from true optic disc drusen (ODD) in 2018. While publications on PHOMS have increased since then, the accuracy of the definition of PHOMS and reliability of detection is unknown. In this multi-rater study, we demonstrate that the 2018 definition of PHOMS resulted in a poor multi-rater kappa of 0.356. We performed a Delphi consensus process to develop a consistent and refined definition of PHOMS with clear principles around the nature of PHOMS and how they differ from normal anatomy. Fifty explanatory teaching slides, provided as supplementary material, allowed our expert group of raters to achieve a good level of agreement (kappa 0.701, 50 OCT scans, 21 raters). We recommend adopting the refined definition for PHOMS.

This qualitative cross-case study explores three US preservice secondary science teachers' conceptions of their science teacher identities and contexts within which they draw upon those science identities for teaching. Grounded in a figured worlds framework, data analysis revealed that participants view their science teacher identity separate from their science identity, with only the latter being part of their “core” identity. Participants view their teacher identity as dominant, and draw upon their science identity's cultural tools in only two teaching contexts—teaching science content and analyzing student work to facilitate learning. Implications for teacher preparation programs are considered.

OBJECTIVE: Antidepressants do not differ significantly in their ability to treat depression. Excluding the tricyclic antidepressants (TCAs), these drugs also do not differ significantly in their incidence of adverse events. Therefore, the initial choice of antidepressant medication should be based, in part, on cost. The objective of this study was to evaluate the impact on utilization and costs of a generic steptherapy edit for antidepressant drugs excluding TCAs in a health maintenance organization (HMO) in an integrated health system (IHS). METHODS: The pharmacy department of the 440,000-member HMO in an IHS collaborated with the Behavioral Health Clinical Program to design an intervention that required generic antidepressants as first-line pharmacotherapy. Under the GenericStart! Program, a brand-name antidepressant was covered only after trial with a generic antidepressant, excluding TCAs. A step-therapy edit was added to the pharmacy claims processing system on January 1, 2005. All new starts, defined as members with no claims history of antidepressant treatment within the preceding 6 months, were required to use a generic antidepressant. The member copayment was waived for the first prescription. All generic antidepressants were in tier 1 of the drug formulary, with an average copayment of $5 to $10. All brand-name antidepressants were in either tier 2 (preferred brand), with an average copayment of $20 to $25 or 25% coinsurance, or tier 3 (nonformulary brand), with an average copayment of $40 to $45 or 50% coinsurance. Pharmacy claims data from a national pharmacy benefit manager (PBM) without interventions for antidepressants in 2004 or 2005 were used for the comparison group. RESULTS: The generic antidepressant dispensing rate increased by 20 points (32.5% to 52.5%) in the intervention group but only 7.4 points (24.9% to 32.3%) in the comparison group in 2005 compared with 2004. The principal measure of antidepressant drug cost per day of therapy in the intervention group decreased by 11.7% (from $2.40 to $2.12) in 2005 compared with 2004 versus a 2.7% decrease (from $2.60 to $2.53) in the comparison group (P <0.001). Days of antidepressant drug therapy per member per month (PMPM) dropped by 1.5% (from 1.74 to 1.71) in the intervention group versus a decrease of 5.0% (from 1.37 to 1.30) in the comparison group in 2005 compared with 2004. The combination of change in drug cost and utilization resulted in a 13.0% decrease in antidepressant drug cost, from $4.16 PMPM in 2004 to $3.62 in 2005, compared with a 7.6% decrease (from $3.57 to $3.30 PMPM) in the comparison group. The 9.0% difference in drug cost per day represents drug cost savings of approximately $0.36 PMPM or $1,880,562 in 2005 dollars for this HMO of approximately 440,000 members. CONCLUSION: A step-therapy edit requiring HMO members to use a generic antidepressant, excluding tricyclics, prior to use of a brand-name antidepressant resulted in drug cost savings of 9.0% for the entire class of antidepressants, equal to $1,880,562 ($0.36 PMPM) in 2005 dollars in the first year of the intervention. A small (-1.5%) decrease in use of antidepressants occurred in the intervention group, which was less than the 5.0% decrease in utilization of antidepressants in the comparison group.

// Veerakumar Balasubramaniyan 1,4,9,* , Brian Vaillant 1,4,* , Shuzhen Wang 1,4 , Joy Gumin 3,4 , M. Elena Butalid 2 , Ke Sai 1,4 , Farah Mukheef 2 , Se Hoon Kim 2,4 , H.W.G.M. Boddeke 5 , Frederick Lang 3,4 , Kenneth Aldape 6 , Erik P. Sulman 4,7 , Krishna P. Bhat 2,4 and Howard Colman 1,4,8 1 Department of Neuro-Oncology, University of Texas, MD&nbsp;Anderson Cancer Center, Houston, Texas, USA 2 Department of Translational Molecular Pathology, University of Texas, MD&nbsp;Anderson Cancer Center, Houston, Texas, USA 3 Department of Neurosurgery, University of Texas, MD&nbsp;Anderson Cancer Center, Houston, Texas, USA 4 Brain Tumor Center, University of Texas, MD&nbsp;Anderson Cancer Center, Houston, Texas, USA 5 Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands 6 Department of Pathology, Toronto General Hospital/Princess Margaret Cancer Centre, Toronto, Ontario 7 Department of Radiation Oncology, University of Texas, MD&nbsp;Anderson Cancer Center, Houston, Texas, USA 8 Department of Neurosurgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA 9 Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands * These authors have contributed equally to this work Correspondence to: Krishna P. Bhat, email: // Howard Colman, email: // Keywords : glioblastoma, glioma stem-like cells, serum differentiation, mesenchymal, tumorigenicity Received : June 10, 2014 Accepted : August 08, 2015 Published : August 19, 2015 Abstract Differentiation has been proposed as a therapeutic strategy for glioblastoma (GBM) in part due to observations of stem-like cells in GBM that have been shown to undergo terminal differentiation in response to growth factor withdrawal and BMP activation. However, the effects of long term exposure to serum culture conditions on glioma sphere cultures/glioma stem-like cells (GSCs) have not been examined. Here we show that GSCs retained both neurosphere formation and tumor initiation abilities after short or long term serum exposure. Under these conditions, GSCs expressed both neural lineage and stem cell markers, highlighting the aberrant pseudo-differentiation state. GSCs maintained under adherent serum cultured conditions continued to proliferate and initiate tumor formation with efficiencies similar to GSCs maintained under proliferating (neurosphere) conditions. Proneural (PN) GSCs under serum exposure showed an induction of mesenchymal (MES) gene expression signatures. Our data indicate that exposure to serum containing media result in aberrant differentiation (e.g. toward MES lineage) and activation of alternative oncogenic pathways in GSCs.

In recent decades, efforts to diversify Science, Technology, Engineering, and Mathematics (STEM) fields have relied on a variety of recruitment and retention programs designed to improve access and outcomes of traditionally underrepresented populations. Examining how such programs emerge within institutions of higher education in the United States – including original motivations, sources of funding, and institutional agents involved in the development and stages of implementation of the program – reveals a lack of strategic and systematic approach to diversifying these fields. Drawing on interviews with administrators representing nearly 40 STEM intervention programs at 10 universities in the United States, this study examines program origins through the lens of institutional isomorphism. The analyses provide evidence of mimetic and coercive isomorphism, and little evidence of strategic decision-making and resource allocation.

The current study examined the complex associations among marital status, home environments, and family strain (i.e. income, maternal depressive symptoms, social support, and parenting stress), as they predict preschool children's pre-academic and social skills at 36 and 54 months. Findings from the NICHD Study of Early Child Care and Youth Development (N = 897) showed that the home learning environment, which was significantly lower among single-parent families, worked as a mediator to explain the relationship between single-parent families and children's pre-academic skills at 36 and 54 months. Additionally, parenting stress, which was significantly higher among single-parent families, worked as a mediator to explain the relationship between single status and the home learning environment. Finally, moderation analyses showed that family income is important for improving the home social environment, and the home social environment is strongly associated with children's social skills in single-parent families, but not in cohabiting families. Copyright © 2016 John Wiley & Sons, Ltd.

Through a case study including focus groups with 32 cisgender women and document analysis of campus newspaper and websites, we highlight ways college women navigate multiple and conflicting messages about campus safety and sexual violence on campus. Although students are aware of statistics indicating most sexual violence happens between two people who know each other, they still engage in safety strategies related to stranger danger. We highlight implications related to messaging about campus safety and sexual violence on campuses.

BACKGROUND: A prognostic test was developed to guide adjuvant chemotherapy (ACT) decisions in early-stage non-small cell lung cancer (NSCLC) adenocarcinomas. The objective of this study was to compare the cost-utility of the prognostic test to the current standard of care (SoC) in patients with early-stage NSCLC. MATERIALS AND METHODS: Lifetime costs (2014 U.S. dollars) and effectiveness (quality-adjusted life-years [QALYs]) of ACT treatment decisions were examined using a Markov microsimulation model from a U.S. third-party payer perspective. Cancer stage distribution and probability of receiving ACT with the SoC were based on data from an academic cancer center. The probability of receiving ACT with the prognostic test was estimated from a physician survey. Risk classification was based on the 5-year predicted NSCLC-related mortality. Treatment benefit with ACT was based on the prognostic score. Discounting at a 3% annual rate was applied to costs and QALYs. Deterministic one-way and probabilistic sensitivity analyses examined parameter uncertainty. RESULTS: Lifetime costs and effectiveness were $137,403 and 5.45 QALYs with the prognostic test and $127,359 and 5.17 QALYs with the SoC. The resulting incremental cost-effectiveness ratio for the prognostic test versus the SoC was $35,867/QALY gained. One-way sensitivity analyses indicated the model was most sensitive to the utility of patients without recurrence after ACT and the ACT treatment benefit. Probabilistic sensitivity analysis indicated the prognostic test was cost-effective in 65.5% of simulations at a willingness to pay of $50,000/QALY. CONCLUSION: The study suggests using a prognostic test to guide ACT decisions in early-stage NSCLC is potentially cost-effective compared with using the SoC based on globally accepted willingness-to-pay thresholds. IMPLICATIONS FOR PRACTICE: Providing prognostic information to decision makers may help some patients with high-risk early stage non-small cell lung cancer receive appropriate adjuvant chemotherapy while avoiding the associated toxicities and costs in patients with low-risk disease. This study used an economic model to assess the effectiveness and costs associated with using a prognostic test to guide adjuvant chemotherapy decisions compared with the current standard of care in patients with non-small cell lung cancer. When compared with current standard care, the prognostic test was potentially cost effective at commonly accepted thresholds in the U.S. This study can be used to help inform decision makers who are considering using prognostic tests.

OBJECTIVE: To examine the effect of the diagnosis of asymptomatic disease on health-related quality of life (HRQoL). DESIGN: Secondary analysis of a national data set. METHOD: We analysed adult participants in the 2011-2012 National Health and Nutrition Examination Survey (NHANES) of the civilian non-institutionalized US general population. Across three asymptomatic diseases (glucose intolerance, hyperlipidaemia, and hypertension), we examined four groups (without disease; with disease but no diagnosis; with disease and diagnosis but no treatment; and with disease, diagnosis, and treatment). For each asymptomatic disease, we examined group differences in self-rated health (ordinal logistic regression) and Healthy Days outcomes (number of the last 30 days that physical health was not good, mental health was not good, or inactive; regression). Models were adjusted for age, sex, smoking status, insurance status, income, education, race, body mass index, and comorbid conditions. RESULTS: Analyses included 6012 respondents (glucose intolerance), 2772 respondents (hyperlipidaemia), and 5524 respondents (hypertension). In adjusted models, those who did not know about their disease had the same self-rated health scores as those without the disease, those with the disease without treatment, and those with disease and treatment. In adjusted analyses of the Healthy Days questions, those with unknown disease reported the same number of unhealthy days as those without disease with the exception of glucose intolerance. Conversely, in four of the nine possible comparisons, those with known disease without treatment reported more unhealthy days than those with who did not know about their disease. CONCLUSIONS: In adjusted analyses, individuals knowing about their asymptomatic disease are more likely to experience decrements in healthy days compared to those without knowledge of their asymptomatic disease. Statement of contribution What is already known on this subject? There has been sparse evidence that diagnosis of asymptomatic diseases is related to reduced health-related quality of life in population studies. Previous studies have included patients receiving treatment, which impedes the ability to isolate the effects of diagnosis from the effects of treatment. What does this study add? This report examines three asymptomatic health conditions: glucose intolerance, hyperlipidaemia, and hypertension. Those who did not know about their health condition generally had the same health-related quality of life scores as those without health conditions. Conversely, those diagnosed with disease but not receiving treatment reported worse health-related quality of life.

This study examined the role of relationship quality on physical and psychological health among older adults. It included 2,298 adults aged 50 and older who participated in the Midlife in the US national longitudinal study of health and well-being. We assessed the effect of spousal support and strain on psychological and physical health, controlling for age, education, income, depression levels and prior health. Results indicated that spousal support and strain affected psychological health but not physical health. Despite prior research showing an association between marital quality and physical health, this study did not support the conceptualization that relationship quality measured by spousal support or strain has a direct effect on long-term health in this sample of older adults. This study does not preclude the presence of a mediated or moderated association between relationship quality and physical health. Higher levels of spousal support are associated with positive psychological health among adults over age 50 while spousal strain is associated with negative psychological health. This study supports the premise that relationship quality has an ongoing impact on the psychological health of mature adults, bolstering arguments to include psychological health screening and couples relationship education among health services provided to older adults.

Abstract Our study critiques nonprofits in the United States, using settler colonial and critical whiteness theories. Nonprofits rely on the donations of wealthy white donors to support marginalized communities. Yet, nonprofits, through donor support, fund projects that benefit marginalized communities without critiquing how the money was earned, who it belongs to, and why such inequities exist. If nonprofits seek to truly invest in marginalized communities, they need to be critical of their own model. This article depicts a composite counter‐story about a woman reflecting on her experience working for a nonprofit, and her decision to quit her job when she realizes that the organization she worked for did not truly put “power back in the community” like they claimed. Using a fictionalized counter‐story, this article presents the very real ways in which nonprofits can use Indigenous values to go beyond performative generosity. The five values that emerge from our counter‐story are: relationality, respect, responsibility, reciprocity, and reflection. These values can help us work towards a future where philanthropy is no longer needed.

There are now many recombinant human growth hormone (rhGH) products and delivery devices available for rhGH therapy. Not all products are approved to treat both children and adults, and they vary with respect to indications approved by the US Food and Drug Administration. Dosing of rhGH is based on weight, and a higher dose (per kg) is recommended in children than adults. This approximates the normal difference in growth hormone (GH) secretion between these 2 patient populations. Patient adherence to treatment is influenced by a number of factors, and patient inclusion in treatment decisions, such as the choice of delivery device, appears to be important. Unmet expectations are a key issue for many patients and families who decide to discontinue treatment. Counseling patients and families about predicted adult height with rhGH therapy should be based on realistic expectations. Managed care organizations face several challenges in providing rhGH therapy, including deciding who is most likely to benefit from treatment and when to discontinue treatment if the benefits appear to level off.