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Female patients using indwelling urinary catheters (IUCs) are disproportionately at risk for developing catheter-associated urinary tract infections (CAUTIs) compared to males. Female external urine wicking devices (FEUWDs) have emerged as potential alternatives to IUCs for incontinence management.
Objectives:
To assess the clinical risks and benefits of FEUWDs as alternatives to IUCs.
Methods:
Ovid MEDLINE, Embase, Scopus, Web of Science Core Collection, CINAHL Complete, and ClinicalTrials.gov were searched from inception to July 10, 2023. Included studies used FEUWDs as an intervention and reported measures of urinary tract infections and secondary outcomes related to incontinence management.
Results:
Of 2,580 returned records, 50 were systematically reviewed. Meta-analyses assessed rates of indwelling CAUTIs and IUC utilization. Following FEUWD implementation, IUC utilization rates decreased 14% (RR = 0.86, 95% CI = [0.76, 0.97]) and indwelling CAUTI rates nonsignificantly decreased up to 32% (IRR = 0.68, 95% CI = [0.39, 1.17]). Limited only to studies that described protocols for implementation, the incidence rate of indwelling CAUTIs decreased significantly up to 54% (IRR = 0.46, 95% CI = [0.32, 0.66]). Secondary outcomes were reported less routinely.
Conclusions:
Overall, FEUWDs nonsignificantly reduced indwelling CAUTI rates, though reductions were significant among studies describing FEUWD implementation protocols. We recommend developing standard definitions for consistent reporting of non-indwelling CAUTI complications such as FEUWD-associated UTIs, skin injuries, and mobility-related complications.
We examined the association between multidrug resistance and socioeconomic status (SES), analyzing microbiological and ZIP-code–level socioeconomic data. Using generalized linear models, we determined that multidrug resistance is significantly and persistently more prevalent in samples taken from patients residing in low-income ZIP codes versus high-income ZIP codes in North Carolina.
In 1980 Twentieth Century Fox Film Corporation announced that its Movietone newsfilm collection, containing documentary footage produced between 1919 and 1963, would be given to the University of South Carolina. Soon thereafter one-fifth of the collection, some twelve million feet of unduplicated footage, was shipped to the university's central campus in Columbia. Transfer of the film was suspended, however, when Twentieth Century Fox was purchased by a multinational corporation. Footage for the years between 1919 and 1935, and for the period from September 1942 through August 1944, was included in the initial gift. This material is presently housed and available for research in Columbia, South Carolina. Among these materials are hundreds of thousands of feet of documentary film with Latin American content, much of it untouched since the time it was “vaulted” by Fox fifty years ago or more. As such, this material represents a largely unmined and potentially rich source of film information on Latin America. This research note will suggest the nature and extent of this collection.
A global ageing population presents opportunities and challenges to designing urban environments that support ageing in place. The World Health Organization's Global Age-Friendly Cities movement has identified the need to develop communities that optimise health, participation and security in order to enhance quality of life as people age. Ensuring that age-friendly urban environments create the conditions for active ageing requires cities and communities to support older adults’ rights to access and move around the city (‘appropriation’) and for them to be actively involved in the transformation (‘making and remaking’) of the city. These opportunities raise important questions: What are older adults’ everyday experiences in exercising their rights to the city? What are the challenges and opportunities in supporting a rights to the city approach? How can the delivery of age-friendly cities support rights to the city for older adults? This paper aims to respond to these questions by examining the lived experiences of older adults across three cities and nine neighbourhoods in the United Kingdom. Drawing on 104 semi-structured interviews with older adults between the ages of 51 and 94, the discussion centres on the themes of: right to use urban space; respect and visibility; and the right to participate in planning and decision-making. These themes are illustrated as areas in which older adults’ rights to access and shape urban environments need to be addressed, along with recommendations for age-friendly cities that support a rights-based approach.
Distributional semantic word representations are at the basis of most modern NLP systems. Their usefulness has been proven across various tasks, particularly as inputs to deep learning models. Beyond that, much work investigated fine-tuning the generic word embeddings to leverage linguistic knowledge from large lexical resources. Some work investigated context-dependent word token embeddings motivated by word sense disambiguation, using sequential context and large lexical resources. More recently, acknowledging the need for an in-context representation of words, some work leveraged information derived from language modelling and large amounts of data to induce contextualised representations. In this paper, we investigate Syntax-Aware word Token Embeddings (SATokE) as a way to explicitly encode specific information derived from the linguistic analysis of a sentence in vectors which are input to a deep learning model. We propose an efficient unsupervised learning algorithm based on tensor factorisation for computing these token embeddings given an arbitrary graph of linguistic structure. Applying this method to syntactic dependency structures, we investigate the usefulness of such token representations as part of deep learning models of text understanding. We encode a sentence either by learning embeddings for its tokens and the relations between them from scratch or by leveraging pre-trained relation embeddings to infer token representations. Given sufficient data, the former is slightly more accurate than the latter, yet both provide more informative token embeddings than standard word representations, even when the word representations have been learned on the same type of context from larger corpora (namely pre-trained dependency-based word embeddings). We use a large set of supervised tasks and two major deep learning families of models for sentence understanding to evaluate our proposal. We empirically demonstrate the superiority of the token representations compared to popular distributional representations of words for various sentence and sentence pair classification tasks.
To determine the attributable cost and length of stay of hospital-acquired Clostridioides difficile infection (HA-CDI) from the healthcare payer perspective using linked clinical, administrative, and microcosting data.
Design:
A retrospective, population-based, propensity-score–matched cohort study.
Setting:
Acute-care facilities in Alberta, Canada.
Patients:
Admitted adult (≥18 years) patients with incident HA-CDI and without CDI between April 1, 2012, and March 31, 2016.
Methods:
Incident cases of HA-CDI were identified using a clinical surveillance definition. Cases were matched to noncases of CDI (those without a positive C. difficile test or without clinical CDI) on propensity score and exposure time. The outcomes were attributable costs and length of stay of the hospitalization where the CDI was identified. Costs were expressed in 2018 Canadian dollars.
Results:
Of the 2,916 HA-CDI cases at facilities with microcosting data available, 98.4% were matched to 13,024 noncases of CDI. The total adjusted cost among HA-CDI cases was 27% greater than noncases of CDI (ratio, 1.27; 95% confidence interval [CI], 1.21–1.33). The mean attributable cost was $18,386 (CAD 2018; USD $14,190; 95% CI, $14,312–$22,460; USD $11,046-$17,334). The adjusted length of stay among HA-CDI cases was 13% greater than for noncases of CDI (ratio, 1.13; 95% CI, 1.07–1.19), which corresponds to an extra 5.6 days (95% CI, 3.10–8.06) in length of hospital stay per HA-CDI case.
Conclusions:
In this population-based, propensity score matched analysis using microcosting data, HA-CDI was associated with substantial attributable cost.
Studies of the end-Permian mass extinction have suggested a variety of patterns from a single catastrophic event to multiple phases. But most of these analyses have been based on fossil distributions from single localities. Although single sections may simplify the interpretation of species diversity, they are susceptible to bias from stratigraphic incompleteness and facies control of preservation. Here we use a data set of 1450 species from 18 fossiliferous sections in different paleoenvironmental settings across South China and the northern peri-Gondwanan region, and integrate it with high-precision geochronologic data to evaluate the rapidity of the largest Phanerozoic mass extinction. To reduce the Signor-Lipps effect, we applied constrained optimization (CONOP) to search for an optimal sequence of first and last occurrence datums for all species and generate a composite biodiversity pattern based on multiple sections. This analysis indicates that an abrupt extinction of 62% of species took place within 200 Kyr. The onset of the sudden extinction is around 252.3 Ma, just below Bed 25 at the Meishan section. Taxon turnover and diversification rates suggest a deterioration of the living conditions nearly 1.2 Myr before the sudden extinction. The magnitude of the extinction was such that there was no immediate biotic recovery. Prior suggestions of highly variable, multi-phased extinction patterns reflect the impact of the Signor-Lipps effect and facies-dependent occurrences, and are not supported following appropriate statistical treatment of this larger data set.
The Children and Young People's Improving Access to Psychological Therapies (CYP IAPT) programme emphasizes the meaningful contribution session-by-session routine outcome monitoring (ROM) can make to clinical practice and its importance in highlighting services’ effectiveness. Two studies on issues related to the implementation of ROM in children's services were conducted. Study 1 was qualitative; 12 Child and Adolescent Mental Health Services (CAMHS) professionals participated in focus groups. Themes identified included the idea that ROM could provide objectivity, could be collaborative and empowering. Concerns included how measures may adversely influence therapeutic sessions and how the information may be used by the service. These themes were used to develop a questionnaire about professionals’ experience of and views on session-by-session ROM. In Study 2, 59 professionals from four CAMHS teams completed the questionnaire. It was found that only 6.8% reported ‘almost always’ utilizing session-by-session ROM. Detailed analysis of questionnaire responses suggested two subscales reflecting the perceived negative and positive impact of session-by-session ROM. It was found that clinicians who currently use session-by-session ROM hold stronger positive and negative beliefs than clinicians who do not. This study suggests that session-by-session ROM is not currently routine practice within CAMHS and highlights the importance of considering how this practice can be best implemented within this setting with reference to clinician attitudes.
The American music critic and lecturer William James Henderson (1855–1937) wrote for The New York Times and The New York Sun, provided the libretto for Walter Damrosch's opera Cyrano (1913) and authored fiction, poetry, sea stories and a textbook on navigation. He also taught at the New York College of Music and the Institute of Musical Art. Taking up the cause of Wagner with considerable understanding, he published this substantial work in 1902, barely twenty years after the composer's death. It is an illuminating account of Wagner's life and artistic aims, complemented by an insightful analysis of each of his music dramas from Rienzi to Parsifal. Its purpose, states Henderson, 'is to supply Wagner lovers with a single work which shall meet all their needs'. With Ernest Newman's Study of Wagner (1899), also reissued in this series, it reflects the composer's contemporary popularity.