Notes

Breastfeeding points of views about reducing exercise-free behaviour in sub-acute healthcare facility options: A mixed strategies study.
Cochlear implant (CI) users have more difficulty understanding speech in temporally modulated noise than in steady-state (SS) noise. This is thought to be caused by the limited low-frequency information that CIs provide, as well as by the envelope coding in CIs that discards the temporal fine structure (TFS). Contralateral amplification with a hearing aid, referred to as bimodal hearing, can potentially provide CI users with TFS cues to complement the envelope cues provided by the CI signal. In this study, we investigated whether the use of a CI alone provides access to only envelope cues and whether acoustic amplification can provide additional access to TFS cues. To this end, we evaluated speech recognition in bimodal listeners, using SS noise and two amplitude-modulated noise types, namely babble noise and amplitude-modulated steady-state (AMSS) noise. We hypothesized that speech recognition in noise depends on the envelope of the noise, but not on its TFS when listening with a CI. Secondly, we hypothesized that the amount of benefit gained by the addition of a contralateral hearing aid depends on both the envelope and TFS of the noise. DMX5084 The two amplitude-modulated noise types decreased speech recognition more effectively than SS noise. Against expectations, however, we found that babble noise decreased speech recognition more effectively than AMSS noise in the CI-only condition. Therefore, we rejected our hypothesis that TFS is not available to CI users. In line with expectations, we found that the bimodal benefit was highest in babble noise. However, there was no significant difference between the bimodal benefit obtained in SS and AMSS noise. Our results suggest that a CI alone can provide TFS cues and that bimodal benefits in noise depend on TFS, but not on the envelope of the noise.Derma roller, a device rolled onto the skin to form micropores, is extensively used for cosmetic purposes. The pores thus created are utilized to either result in the induction of collagen production, leading to glowing and wrinkle-free skin or for permeating the applied formulations to the site of action within the skin. Recent studies have shown the benefits of using derma rollers for transdermal delivery of drugs. In the nascent stage, this approach paves a way to successfully breach the stratum corneum and aid in the movement of medications directed towards the dermis and the hair follicles. The review essentially summarizes the evidence of the use of derma rollers in cosmetic setup, their designing, and the preclinical and clinical reports of efficacy, safety, and concerns when translated for pharmaceutical purposes and transdermal drug delivery.When individuals with autism and intellectual and developmental disabilities exhibit severe problem behavior, assessment and treatment are often warranted. Parents of such individuals are at high risk for developing parenting stress. In this study, 194 parents completed the Parenting Stress Index-Short Form at their child's time of admission to and discharge from inpatient or outpatient treatment for severe problem behavior. Parent stress was examined in relation to rate and function of child problem behavior as determined via functional analysis. Repeated measures analyses of variance were conducted, and differential effects were observed when child participants exhibited an attention, automatic, or mands function for problem behavior. These findings highlight the importance of considering function of problem behavior in relation to parenting stress.Deep learning is the fastest growing field in artificial intelligence and has led to many transformative innovations in various domains. However, lack of interpretability sometimes hinders its application in hypothesis-driven domains such as biology and healthcare. In this paper, we propose a novel deep learning model with individual feature ranking. Several simulated datasets with the scenarios that contributing features are correlated and buried among non-contributing features were used to characterize the novel analysis approach. A publicly available clinical dataset was also applied. The performance of the individual level dropout feature ranking model was compared with commonly used artificial neural network model, random forest model, and population level dropout feature ranking model. The individual level dropout feature ranking model provides a reasonable prediction of the outcomes. Unlike the random forest model and population level dropout feature ranking model, which can only identify global-wise contributing features (i.e., at population level), the individual level dropout feature ranking model allows further identification of impactful features on response at individual level. Therefore, it provides a basis for clustering patients into subgroups. This may provide a new tool for enriching patients in clinical drug development and developing personalized or individualized medicine.We investigated the impact of Medicaid expansions made possible by the 2010 Affordable Care Act on HIV Pre-Exposure Prophylaxis (PrEP) utilization in the US over the period 2012-2018. We used data on PrEP utilization from Symphony Health in a difference-in-differences regression analysis with bootstrapped standard errors. We found that Medicaid Expansion resulted on average in 7.78 additional estimated PrEP users per 100,000 population on a yearly basis (z = 2.72; p = 0.007). When restricting the sample to males, Medicaid Expansion resulted in 14.67 additional PrEP users per 100,000 population each year (z = 2.5; p = 0.012). People in the age group 25-34 were those who benefitted the most from Medicaid Expansion with 16.95 additional PrEP users per 100,000 population per year attributable to Medicaid Expansion (z = 3.2; p  less then  0.001). States that are considering expanding Medicaid may recognize the benefits in PrEP utilization we document here.
Patients dying with cancer can experience various physical and psychological symptoms. We aimed to determine the type and severity of symptoms within the last 6months of life in a large real-world cohort of patients with cancer.

We examined prospectively collected patient-reported outcomes of patients with lung, colorectal, breast, prostate or pancreatic cancer using the revised Edmonton Symptom Assessment System (ESASr) questionnaire from a large province in Canada from 2016 to 2017. The ESASr was categorized into physical and psychological symptom subscores and total symptom score, and each was classified as none to mild (0-3) or moderate to severe (4-10) based on intensity. Multivariable logistic regression analyses were performed to evaluate the relationship between clinical characteristics and symptom scores.

We identified 1159 patients eligible for analysis, of whom 52.2% were men and median age was 68years. There were 613, 192, 149, 111 and 94 patients with lung, colorectal, breast, prostate and pancreatic cancer, respectively.
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