Differences in results and related factors between hospital-at-home modalities in Catalonia: a cross-sectional study

This is the final version. Available on open access from MDPI via the DOI in this record. Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient's home for a condition that would otherwise require hospitalization. The aims were to describe the characteristics of different types of hospital-at-home (HaH), assess their results, and examine which factors could be related to these results. A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered-admission avoidance (n = 7,214; 75.1%) and early assisted discharge (n = 2,387; 24.9%). The main outcome indicators were readmission, mortality, and length of stay (days). Multivariable models were fitted to assess the association between explanatory factors and outcomes. Hospital admission avoidance is a scheme in which, instead of being admitted to acute care hospitals, patients are directly treated in their own homes. Early assisted discharge is a scheme in which hospital in-care patients continue their treatment at home. In the hospital avoidance modality, there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early assisted discharge modality, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. The results of HaH in Catalonia are similar to those observed in other contexts. The factors related to these results identified might help to improve the effectiveness and efficiency of the different HaH modalities

Auditory but Not Audiovisual Cues Lead to Higher Neural Sensitivity to the Statistical Regularities of an Unfamiliar Musical Style

It is still a matter of debate whether visual aids improve learning of music. In a multisession study, we investigated the neural signatures of novel music sequence learning with or without aids (auditory-only: AO, audiovisual: AV). During three training sessions on 3 separate days, participants (nonmusicians) reproduced (note by note on a keyboard) melodic sequences generated by an artificial musical grammar. The AV group (n = 20) had each note color-coded on screen, whereas the AO group (n = 20) had no color indication. We evaluated learning of the statistical regularities of the novel music grammar before and after training by presenting melodies ending on correct or incorrect notes and by asking participants to judge the correctness and surprisal of the final note, while EEG was recorded. We found that participants successfully learned the new grammar. Although the AV group, as compared to the AO group, reproduced longer sequences during training, there was no significant difference in learning between groups. At the neural level, after training, the AO group showed a larger N100 response to lowprobability compared to high-probability notes, suggesting an increased neural sensitivity to statistical properties of the grammar; this effect was not observed in the AV group. Our findings indicate that visual aids might improve sequence reproduction while not necessarily promoting better learning, indicating a potential dissociation between sequence reproduction and learning. We suggest that the difficulty induced by auditory-only input during music training might enhance cognitive engagement, thereby improving neural sensitivity to the underlying statistical properties of the learned material

In need of mediation: The relation between syntax and information structure

This paper defends the view that syntax does not directly interact with information structure. Rather, information structure affects prosody, and only the latter has an interface with syntax. We illustrate this point by discussing scrambling, focus preposing, and topicalization. The position entertained here implies that syntax is not very informative when one wants to narrow down the interpretation of terms such as “focus”, “topic”, etc

The German Music@Home: Validation of a questionnaire measuring at home musical exposure and interaction of young children.

The present study introduces the German version of the original version of the Music@Home questionnaire developed in the UK, which systematically evaluates musical engagement in the home environment of young children. Two versions are available, an Infant version for children aged three to 23 months and a Preschool version for children aged two to five and a half years. For the present study, the original Music@Home questionnaire was translated from English into German and 656 caregivers completed the questionnaire online. A confirmatory factor analysis showed moderate to high fit indices for both versions, confirming the factor structure of the original questionnaire. Also, the reliability coefficients for the subscales (Parental beliefs, Child engagement with music, Parent initiation of singing, Parent initiation of music-making for the Infant version and Parental beliefs, Child engagement with music, Parent initiation of music behavior and Breadth of musical exposure for the Preschool version) ranged from moderate to high fits. Furthermore, the test-retest analysis (N = 392) revealed high correlations for the general factor and all subscales confirming their internal reliability. Additionally, we included language questionnaires for children of two and three years of age. Results showed that higher scores on the Music@Home questionnaire were moderately associated with better language skills in two-year-olds (N = 118). In sum, the study presents the validated German Music@Home questionnaire, which shows good psychometric properties. The two versions of the questionnaire are available for use in order to assess home musical engagement of young children, which could be of interest in many areas of developmental research

CMY-31 and CMY-36 Cephalosporinases Encoded by ColE1-Like Plasmids▿

Two CMY-2 derivatives, CMY-31 (Gln215→Arg) from Salmonella enterica serotype Newport and CMY-36 (Ala77→Cys and Gln193→Glu) from Klebsiella pneumoniae, were characterized. Both cephalosporinases functionally resembled CMY-2. blaCMY alleles occurred as parts of a putative transposon comprising ISEcp1B and a Citrobacter freundii-derived sequence carried by ColE1-like plasmids similar to CMY-5-encoding pTKH11 from Klebsiella oxytoca

Patterns of cervical lymph node metastasis in supraglottic laryngeal cancer and therapeutic implications of surgical staging of the neck

Purpose!#!Accurate therapeutic management of the neck is a challenge in patients with supraglottic laryngeal cancer. Nodal metastasis is common at all disease stages, and treatment planning relies on clinical staging of the neck, for both surgical and non-surgical treatment. Here, we compared clinical and surgical staging results in supraglottic carcinoma patients treated with primary surgery to assess the accuracy of pre-therapeutic clinical staging and guide future treatment decisions.!##!Methods!#!Retrospective analysis of clinical, pathological, and oncologic outcome data of 70 patients treated with primary surgery and bilateral neck dissection for supraglottic laryngeal cancer. Patients where clinical and pathological neck staging results differed, were identified and analyzed in detail.!##!Results!#!On pathologic assessment, patients with early stage (pT1/2) primaries showed cervical lymph node metastases in 55% (n = 17/31) of cases, compared to 67% (n = 26/39) of patients with pT3/4 tumors. In 24% (n = 17/70) of all patients, cN status differed from pN status, resulting in an upstaging in 16% of cases (n = 11/70) and a downstaging in 9% (n = 6/70) of cases. 14% of patients with cN0 status had occult metastases (n = 5/30). As assessed by a retrospective tumor board, in case of a non-surgical treatment approach, the inaccurate clinical staging of the neck would have led to an over- or undertreatment of the neck in 20% (n = 14/70) of all patients.!##!Conclusion!#!Our data re-emphasize the high cervical metastasis rates of supraglottic laryngeal cancer across all stages. Inaccurate clinical staging of the neck is common and should be taken into consideration when planning treatment