Notes

Megastudy brings mental faculties cellular inventory.
The two authors intend to underline the continuities and discontinuities that organize the Milan Approach, after the splitting from Selvini Palazzoli and Prata; they intend to tell the teachings of Luigi Boscolo and Gianfranco Cecchin from the beginning of training in 1978 till nowadays. After having spoken of some important stages in the work till the death of the two masters, the article underlines two major new aspects. 1. We speak about the corporeal turn embodied experience as preconceptual know-how from which concepts are structured. We speak about the connections between bodies and social issues that enact forms of knowledge and understanding. 2. In this period of war, violence, and tyranny, we speak about epistemology and ontology as complementary stances the need to let others disclose themselves, by allowing them to speak their own terms of engagement. The therapeutic effort is one of deactivating the dangers of one's own presuppositions and prejudices that limit one's capacity to describe and make hypothesis. There are social ontologies, communities with strong moral intensity, historical and social realities that need therapists to take position, since they need to take side and be aware of the categories they utilize. Historical and social ontology deals with the continuous change of symptoms in connection to the continuous change of the social panorama in the context we live in. We live by the bodies we are.
Although the European Medicines Agency and the US Food and Drug Administration have, respectively, approved rivaroxaban for the prevention of recurrent major adverse cardiovascular events in patients with myocardial infarction and stable coronary artery disease, its efficacy and safety is unclear. This meta-analysis aimed to evaluate the benefit and risk of adding rivaroxaban in coronary artery disease (CAD) patients, focusing on treatment effects stratified by different baseline clinical presentations.

There are differences in treatment effects of adding rivaroxaban among CAD patients with different baseline clinical presentations.

Medline, EMBASE, and Cochrane Databases were systematically searched from inception to 21 July 2020 for randomized controlled trials (RCTs) comparing rivaroxaban in CAD patients. The primary efficacy endpoint and safety endpoint were assessed by using Mantel-Haenszel pooled risk ratios (RRs) and 95% confidence intervals (CIs).

Five RCTs that included 43 650 patients were identified. Patients receiving rivaroxaban had a significantly lower risk of the primary efficacy endpoint (RR, 0.86; 95% CI, 0.76-0.97, p = .01) accompanied by increased risk of the primary safety endpoint (RR, 1.83; 95% CI, 1.10-3.05, p = .02). Subgroup analyses showed that in males the risk-benefit appears to be more favorable while in patients ≥65 years, in females, in patients with diabetes, those with mild to moderate impaired renal function, and region of Asia/other seems unfavorable.

Rivaroxaban may provide an additional choice for secondary prevention in CAD patients. However, careful estimation of the risk of ischemic and bleeding events using patient characteristics are critical to achieving net benefit.
Rivaroxaban may provide an additional choice for secondary prevention in CAD patients. However, careful estimation of the risk of ischemic and bleeding events using patient characteristics are critical to achieving net benefit.
The need for gender-affirming voice care has been increasing in the transgender population in the last decade. Currently, objective treatment outcome measurements are lacking to assess the success of these interventions. This study uses neural network models to predict binary gender from short audio samples of "male" and "female" voices. This preliminary work is a proof-of-concept for further work to develop an AI-assisted treatment outcome measure for gender-affirming voice care.

Retrospective cohort study.

Two hundred seventy-eight voices from male and female speakers from the Perceptual Voice Qualities Database were used to train a deep neural network to classify voices as male or female. Each audio sample was mapped to the frequency domain using Mel spectrograms. To optimize model performance, we performed 10-fold cross validation of the entire dataset. The dataset was split into 80% training, 10% validation, and 10% test.

Overall accuracy of 92% was obtained, both when considering the accuracy per spectrum and per patient metric. Selleckchem Kynurenic acid The accuracy of the model was higher for recognizing female voices (F1 score of 0.94) compared to male voices (F1 score of 0.87).

This proof of concept study shows promising performance for further development of an AI-assisted tool to provide objective treatment outcome measurements for gender affirming voice care.

3 Laryngoscope, 131E1611-E1615, 2021.
3 Laryngoscope, 131E1611-E1615, 2021.
To determine if constraint-induced movement therapy (CIMT) is more effective than standard care in improving upper-limb activity outcomes in children with neonatal brachial plexus palsy (NBPP).

Twenty-one children with NBPP (mean age 25mo, SD=10.3, range=17-48mo; 11 males, 10 females) were enrolled in a crossover trial and randomly allocated to first receive CIMT or standard care, each for 8 weeks. The intervention arm consisted of 3 weeks of casting the unaffected limb followed by 5 weeks of transference activities. The Assisting Hand Assessment (AHA) was used to measure bimanual activity performance at baseline, 8 weeks, and 16 weeks, scored by blinded raters. The Pediatric Motor Activity Log-Revised (PMAL-R) was used as a caregiver-reported secondary outcome measure.

After concealed random allocation (n=21), there were no significant differences on demographics or baseline measures. CIMT was superior compared to control in terms of bimanual activity performance with a mean difference in AHA change score of 4.8 (SD=10.5, p=0.04, Cohen's δ=0.46). There were no significant differences between treatment conditions on the PMAL-R.

CIMT is favored over standard care for bimanual activity performance. Future research should investigate a longer follow-up period, additional comparator interventions, and analyse differences by participant characteristics.

Gains in bimanual activity performance were greater after constraint-induced movement therapy (CIMT) compared to no CIMT. Frequency and quality of movement were not significantly different between treatment groups.
Gains in bimanual activity performance were greater after constraint-induced movement therapy (CIMT) compared to no CIMT. Frequency and quality of movement were not significantly different between treatment groups.
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