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Incidence of non-public protective equipment (PPE) from the COVID-19 pandemic across the coastline regarding Lima, Peru.
Purpose The speech motor system uses feedforward and feedback control mechanisms that are both reliant on prediction errors. Here, we developed a state-space model to estimate the error sensitivity of the control systems. We examined (a) whether the model accounts for the error sensitivity of the control systems and (b) whether the two systems have similar error sensitivity. Method Participants (N = 50) completed an adaptation paradigm, in which their first and second formants were perturbed such that a participant's /ε/ would sound like her /ӕ/. We measured adaptive responses to the perturbations at early (0-80 ms) and late (220-300 ms) time points relative to the onset of the perturbations. As data-driven correlates of the error sensitivity of the feedforward and feedback systems, we used the average early responses and difference responses (i.e., late minus early responses), respectively. We fitted the state-space model to participants' adaptive responses and used the model's parameters as model-based estimates of error sensitivity. Results We found that the late responses were larger than the early responses. Additionally, the model-based estimates of error sensitivity strongly correlated with the data-driven estimates. However, the data-driven and model-based estimates of error sensitivity of the feedforward system did not correlate with those of the feedback system. Conclusions Overall, our results suggested that the dynamics of adaptive responses as well as error sensitivity of the control systems can be accurately predicted by the model. 10-Deacetylbaccatin-III Furthermore, our results suggested that the feedforward and feedback control systems function independently. Supplemental Material https//doi.org/10.23641/asha.14669808.Background Standards for auditory rehabilitation are currently lacking for adults who receive cochlear implants. Speech recognition outcomes are highly variable, and many adults with cochlear implants present with suboptimal performance. Functional real-life communication abilities are not routinely measured clinically and are not strongly linked to performance on traditional measures of speech recognition. In fact, even individuals with relatively good speech recognition outcomes often present with persistent communication difficulties. In contrast to pediatric cochlear implant users, speech-language pathologists are not routinely involved in the rehabilitation of adults who receive cochlear implants. Purpose The purpose of this article is to describe the value of including a speech-language pathologist in a comprehensive approach to auditory rehabilitation for adults with cochlear implants. Method The theoretical and clinical foundations of incorporating a speech-language pathologist into an adult auditory rehabilitation program are discussed. A description of the skills and potential roles of the speech-language pathologist for providing adult cochlear implant rehabilitation services is presented, along with potential barriers to implementation. Conclusion Person-centered management of postlingually deafened adults with cochlear implants can be augmented by a more complete approach utilizing the skill set of a speech-language pathologist. Supplemental Material https//doi.org/10.23641/asha.14669652.Introduction There is need for greater understanding of tests used in assessing all aspects of auditory processing disorder (APD). This is important so that specific deficits can be identified and later remediated with the smallest possible test battery. The American Speech-Language-Hearing Association (ASHA) recommends five areas/domains for behavioral assessment (a) temporal, (b) binaural (dichotic) separation/integration, (c) monaural low redundancy, (d) binaural interaction/localization/lateralization, and (e) auditory discrimination. Multiple-factor studies support the first three domains, which are most often used for APD assessment and which can be measured in a test battery normed within the United States (Multiple Auditory Processing Assessment-2 [MAPA-2]). This study was designed to determine if factored results from children would clarify whether a behavioral test (Listening in Spatialized Noise-Sentences Test [LiSN-S]) would factor within one of the first three domains or be separate, possibly witbattery.
Treatment and monitoring options for patients with metastatic breast cancer (MBC) are increasing, but little is known about variability in care. We sought to improve understanding of MBC care and its correlates by analyzing real-world claims data using a search engine with a novel query language to enable temporal electronic phenotyping.

Using the Advanced Cohort Engine, we identified 6,180 women who met criteria for having estrogen receptor-positive, human epidermal growth factor receptor 2-negative MBC from IBM MarketScan US insurance claims (2007-2014). We characterized treatment, monitoring, and hospice usage, along with clinical and nonclinical factors affecting care.

We observed wide variability in treatment modality and monitoring across patients and geography. Most women received first-recorded therapy with endocrine (67%) versus chemotherapy, underwent more computed tomography (CT) (76%) than positron emission tomography-CT, and were monitored using tumor markers (58%). Nearly half (46%) met crfactors and by nonclinical factors such as geographic region, suggesting that treatment decisions are influenced by local practice patterns and/or resources. A search engine designed to express complex electronic phenotypes from longitudinal patient records enables the identification of variability in patient care, helping to define disparities and areas for improvement.
Multiple large clinical trials have investigated adjuvant tyrosine kinase inhibitors (TKIs) to reduce the risk of cancer recurrence and progression to metastasis in high-risk renal cell carcinoma. We sought to maintain living and interactive evidence on this topic, until a high level of certainty is reached for key clinical outcomes such that further updates become unnecessary and unlikely to change clinical practice.

We created a living interactive evidence synthesis platform to maintain a continuously updated meta-analysis on TKI monotherapy in adjuvant renal cell carcinoma. We implemented an automated search strategy with weekly updates to identify randomized phase 2 and 3 clinical trials. Study selection, appraisal, and data extraction were done in duplicate. Cumulative meta-analysis was performed using Analyzer Module in Living Interactive Evidence platform. For each outcome (overall survival [OS], disease-free survival [DFS], and all-cause and treatment-related adverse events), we assessed certainty of evidence using GRADE approach and conducted trial sequential analysis.
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