AphasiaBank: Preliminary Lexical, Morphosyntactic, and Error Analyses

AphasiaBank collects and analyzes samples of the discourse of individuals with aphasia and normal participants across a range of tasks. The goal of AphasiaBank is to assemble a large repository of video-recorded discourse samples, transcribed in a format that facilitates extensive computerized language analyses. This paper outlines the AphasiaBank protocol and presents core analyses of language samples from 15 normal adults and 15 individuals with aphasia using selected analyses for lexicon, morphosyntax, errors, and repetition

Mortality associated with moderate and severe mitral regurgitation in 608 570 men and women undergoing echocardiography

Background Although the prognostic implications of severe mitral regurgitation (MR) are well recognised, they are less clear in moderate MR. We therefore explored the prognostic impact of both moderate and severe MR within the large National Echocardiography Database Australia cohort. Methods Echocardiography reports from 608 570 individuals were examined using natural language processing to identify MR severity and leaflet pathology. Atrial (aFMR) or ventricular (vFMR) functional MR was assessed in those without reported leaflet pathology. Using individual data linkage over median 1541 (IQR 820 to 2629) days, we examined the association between MR severity and all-cause (153 612/25.2% events) and cardiovascular-related mortality (47 840/7.9% events). Results There were 319 808 men and 288 762 women aged 62.1±18.5 years, of whom 456 989 (75.1%), 102 950 (16.9%), 38 504 (6.3%) and 10 127 (1.7%) individuals had no/trivial, mild, moderate and severe MR, respectively, reported on their last echo. Compared with those with no/trivial MR (26.5% had leaflet pathology, 19.2% died), leaflet pathology (51.8% and 78.9%, respectively) and actual 5-year all-cause mortality (54.6% and 67.5%, respectively) increased with MR severity. On an adjusted basis (age, sex and leaflet pathology), long-term mortality was 1.67-fold (95% CI 1.65 to 1.70) and 2.36-fold (95% CI 2.30 to 2.42) higher in moderate and severe MR cases (p<0.001) compared with no/trivial MR. The prognostic pattern for moderate and severe MR persisted for cardiovascular-related mortality and within prespecified subgroups (leaflet pathology, vFMR or aFMR, and age<65 years). Conclusions Within a large real-world clinical cohort, we confirm that conservatively managed severe MR is associated with a poor prognosis. We further reveal that moderate MR is associated with increased mortality, irrespective of underlying aetiology. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12617001387314

A Retrospective Cohort Study Examining the Utility of Perinatal Urine Toxicology Testing to Guide Breastfeeding Initiation

OBJECTIVE: National guidelines advise against breastfeeding for women who use non-prescribed substances in the third trimester. This reduces the number of women who are supported in breastfeeding initiation despite limited evidence on the prognostic value of third trimester substance use. We sought to examine the degree to which prenatal non-prescribed substance use is associated with non-prescribed use postpartum. METHODS: Retrospective cohort study of pregnant women with opioid use disorder (OUD) on methadone or buprenorphine between 2006-2015. Non-prescribed use was defined by a positive urine drug testing (UDT). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated comparing three prenatal periods with postpartum UDT results. Generalized estimating equations were used to examine the extent to which prenatal non-prescribed use was associated with postpartum use. RESULTS: Included were 545 deliveries by 503 women. Mean age was 28.3 years, 88% were white/non-Hispanic, 93% had public insurance, and 43% received adequate prenatal care. The predictive value of UDT’s 90 to 31 days prior to delivery, 30 to 0 days prior to delivery, and at delivery showed low sensitivity (44, 26, 27% respectively) and PPV (36, 36, 56% respectively), but higher NPV (80, 85, and 78% respectively), p-values all <0.05. In the final adjusted model, only non-prescribed use at delivery was significantly associated with postpartum non-prescribed use. CONCLUSION: Non-prescribed use at delivery was most strongly associated with postpartum use compared with earlier time periods currently prioritized in guidelines. In women with OUD prenatal UDT results alone are insufficient to guide breastfeeding decisions

Approach to Using Trend Arrows in the FreeStyle Libre Flash Glucose Monitoring Systems in Adults

The use of personal continuous glucose monitoring (CGM) has expanded dramatically among individuals with diabetes. CGM systems provide retrospective data, as well as the current glucose value and trend arrow data, which indicate the direction and velocity of changing glucose. In 2017, Aleppo and colleagues developed a simplified approach for adults with diabetes to safely adjust rapid-acting insulin doses using trend arrow information in the Dexcom G5 CGM system. Since then, the FreeStyle Libre and FreeStyle Libre 14-day CGM systems have become available in the United States; however, guidance on using trend arrow data that take the unique features of these systems into consideration is lacking. Specifically, the FreeStyle Libre systems do not have automatic alarms, which impact how the system and trend arrow data are used. The Endocrine Society convened an expert panel to address this gap and develop an approach to adjusting rapid-acting insulin doses for adults using trend arrows in the FreeStyle Libre systems. We based our approach on previous work and expanded upon engagement and scanning recommendations, and we incorporated pre-exercise planning specific to these systems. Our approach provides insulin dose adjustments as discrete insulin units based on an individual\u27s insulin sensitivity and directionality of the trend arrow. We focus on the needs of patients treated with multiple daily injections because these individuals currently make up a greater proportion of individuals on intensive insulin therapy. Our recommendations are intended to provide a safe, practical approach to using trend arrows in the FreeStyle Libre systems

A Practical Approach to Using Trend Arrows on the Dexcom G5 CGM System for the Management of Adults With Diabetes

After reviewing previously published methods, we developed a practical approach to adjusting insulin doses based on insulin sensitivity for adult patients with diabetes using rtCGM trend arrow data

A Retrospective Cohort Study Examining the Utility of Perinatal Urine Toxicology Testing to Guide Breastfeeding Initiation

Objective: National guidelines advise against breastfeeding for women who use nonprescribed substances in the third trimester. This reduces the number of women who are supported in breastfeeding initiation despite limited evidence on the prognostic value of third trimester substance use. We sought to examine the degree to which prenatal nonprescribed substance use is associated with non-prescribed use postpartum. Methods: Retrospective cohort study of pregnant women with opioid use disorder on methadone or buprenorphine between 2006 and 2015. Nonprescribed use was defined by a positive urine drug testing (UDT). Sensitivity, specificity, positive predictive value, and negative predictive value were calculated comparing 3 prenatal periods with postpartum UDT results. Generalized estimating equations were used to examine the extent to which prenatal nonprescribed use was associated with postpartum use. Results: Included were 545 deliveries by 503 women. Mean age was 28.3 years, 88% were White/non-Hispanic, 93% had public insurance, and 43% received adequate prenatal care. The predictive value of UDT's 90 to 31 days before delivery, 30 to 0 days before delivery, and at delivery showed low sensitivity (44, 26, 27%, respectively) and positive predictive value (36, 36, 56%, respectively), but higher negative predictive value (80, 85, and 78%, respectively), P-values all <0.05. In the final adjusted model, only nonprescribed use at delivery was significantly associated with postpartum nonprescribed use. Conclusions: Nonprescribed use at delivery was most strongly associated with postpartum use compared with earlier time periods currently prioritized in guidelines. In women with opioid use disorder prenatal UDT results alone are insufficient to guide breastfeeding decisions

Renegade Bodies : Canadian Dance in the 1970's

"Comprising 15 essays by Canadian writers and scholars, Renegade Bodies is a book that embraces lively discussion about artistic and cultural shifts along with the social and political transformations of the 1970s. How were dance and its practitioners affected by the vigorous and varying beliefs, the principles and key societal trends of the times?" -- Publisher's website