Robust Multimodal Cough and Speech Detection using Wearables: A Preliminary Analysis.

Cough detection is a crucial tool for long-term monitoring of respiratory illnesses. While clinical methods are accurate, they are not available in a home-based setting. In contrast, wearable devices offer a more accessible alternative, but face challenges in ensuring user speech privacy and detecting coughs accurately in real-world settings due to potential poor audio quality and background noise.

Provider use of a participatory decision-making style with youth with ADHD and their caregivers and visit satisfaction.

Objective: To examine whether youth with ADHD who received a question prompt list and video intervention and their caregivers were more likely to: (a) be asked about their treatment preferences, (b) have their input included into treatment decisions, (c) rate their providers as using more of a participatory decision-making (PDM) style, and (d) be more satisfied with their visits.

Methods: Youth with ADHD were randomized to a pre-visit question prompt list intervention or usual care. Visits were audio-recorded; youth were interviewed after visits; caregivers completed questionnaires.

Practical naloxone communication tips for pharmacists: Lessons learned from the Linguistic Model of Patient Participation in Care.

Background: Opioid overdose is an ongoing public health issue in the rural United States and can be countered by increasing access to the opioid antagonist naloxone. Community pharmacists are well-positioned to offer and dispense naloxone to patients at risk of opioid overdose, but still experience a range of communication barriers. Understanding rural patient communication preferences is essential to prepare pharmacists to discuss naloxone in a patient-centered manner.

Exploring the impact of insurance switching on the cost-effectiveness of population genetic screening for familial hypercholesterolemia to US payers.

Background: Widespread familial hypercholesterolemia screening requires a large upfront economic investment, but the health benefits and cost savings of cardiovascular disease prevention directed by screening occur over many years.

Objective: We evaluated the cost-effectiveness of population genetic screening for familial hypercholesterolemia compared to cascade testing to US payers while accounting for patient insurance switching between commercial and Medicare insurance.

Methods: We developed a hybrid decision-tree Markov model to assess genetic screening in 20-year-old adults over a lifetime horizon in which cohort members transitioned between commercial payers representing three commercial plans and Medicare.

Co-development of a community pharmacy training regarding fentanyl and xylazine test strips.

Introduction: Fentanyl and xylazine test strips (FTS, XTS) are simple point-of-care tests that determine the presence of fentanyl or xylazine in a substance before use. Access to FTS and XTS is limited. For pharmacists who are willing to sell an FTS, there is little guidance about how to implement FTS sales and counseling as no training for community pharmacists regarding FTS and XTS exists.

Impact of Genomic Classifiers on Risk Stratification and Treatment Intensity in Patients With Localized Prostate Cancer : A Systematic Review.

Background: Tissue-based genomic classifiers (GCs) have been developed to improve prostate cancer (PCa) risk assessment and treatment recommendations.

Purpose: To summarize the impact of the Decipher, Oncotype DX Genomic Prostate Score (GPS), and Prolaris GCs on risk stratification and patient-clinician decisions on treatment choice among patients with localized PCa considering first-line treatment.

Data Sources: MEDLINE, EMBASE, and Web of Science published from January 2010 to August 2024.

Insurance coverage and consistent pricing is needed for over-the-counter naloxone.

With the Food and Drug Administration's approval of the first over-the-counter naloxone nasal spray in 2023, it was expected that access to naloxone nasal spray would increase and that its cost would be reduced. However, the writers of this commentary found varying insurance coverage of naloxone during purchase attempts at local pharmacies. Failure to cover naloxone can reduce access and increase risk of overdose death.

Complete transition from laparoscopic to robotic liver surgery achieves superior outcomes in difficult hepatectomies: a seven-year retrospective study.

Background: Minimally invasive liver surgery (MILS) is superior to open surgery when considering decreased blood loss, fewer complications, shorter hospital stay, and similar or improved oncologic outcomes. However, operative limitations in laparoscopic hepatectomy have curved its applicability and momentum of complex minimally invasive liver surgery. Transitioning to robotic hepatectomy may bridge this complexity gap.

Over-the-counter naloxone availability at North Carolina community pharmacies: A secret shopper study.

Background: Over-the-counter (OTC) naloxone became available for sale at community pharmacies in September 2023. This study examines whether naloxone availability and cost are associated with pharmacy type (independent vs chain), pharmacy rurality, and their interaction.

Methods: Using a cross-sectional secret shopper study design, data were collected by phone from a stratified random sample of 600 community pharmacies in North Carolina from November 2023 to January 2024.

Availability of and attitudes toward harm reduction services: A rural pharmacy perspective.

Background: There's limited information available about the range of harm reduction (HR) services provided by rural pharmacies.

Objective: This study's objectives are to describe the types of HR services offered by rural pharmacies and examine pharmacists' attitudes and willingness to offer those services.

Methods: A cross-sectional online survey was sent to pharmacists who are members of a practice-based research network for rural community pharmacies.

Does Policy Uncertainty Boost Vaccine Hesitancy? Political Controversy, the FDA and COVID-19 Vaccine Hesitancy in Fall 2020.

Context: Vaccine hesitancy is associated with political and institutional distrust, but there is little research on how people's trust responds to political events. We revisit the fall of 2020 when evaluation of new COVID-19 vaccines collided with an impending national election. Drawing on a political Bayesian perspective, we assess abrupt changes in attention to political events and test hypotheses on subpopulation response: (1) partisan, (2) educational, and (3) ethnic and racial.

The impact of data resolution on dynamic causal inference in multiscale ecological networks.

While it is commonly accepted that ecosystem dynamics are nonlinear, what is often not acknowledged is that nonlinearity implies scale-dependence. With the increasing availability of high-resolution ecological time series, there is a growing need to understand how scale and resolution in the data affect the construction and interpretation of causal networks-specifically, networks mapping how changes in one variable drive changes in others as part of a shared dynamic system ("dynamic causation"). We use Convergent Cross Mapping (CCM), a method specifically designed to measure dynamic causation, to study the effects of varying temporal and taxonomic/functional resolution in data when constructing ecological causal networks.

Building Resilience in Medical Students: "Strengthening You to Strengthen Them".

Medical students, like many health professional students, are at risk for burnout and other negative well-being outcomes. Research suggests that building resilience may help to mitigate these risks. A multi-disciplinary team developed, delivered, and evaluated a training on building resilience for medical students entitled, "Resilience for Health Providers - Strengthening You to Strengthen Them.

A Unique Presentation of Diffuse Intraductal Papillary Mucinous Neoplasm of Bile Duct Successfully Treated With Orthotopic Liver Transplant and Pancreaticoduodenectomy Procedure: A Case Report.

Biliary intraepithelial neoplasm (BilIN) and intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) are recognized as the two main precursors to biliary carcinoma. Surgical resection is the mainstay of treatment, with pancreaticoduodenectomy for extrahepatic biliary duct disease involving the pancreatic or distal portion of the bile duct, and bile duct and liver resection for perihilar and intrahepatic bile duct involvement. For diffuse IPMN-B with involvement of the entirety of the biliary epithelium of both intrahepatic and extrahepatic biliary systems, there is no well-documented consensus on treatment due to its rarity.

PBDEs and dechlorane plus contamination in community e-waste recycling: Environmental and health implications in Northeastern Thailand.

Electronic waste (e-waste) poses significant environmental and health risks in Thailand due to both domestic production and international imports. A notable portion of this waste is processed in small-scale, community-based workshops, often located in poorer regions, where safety regulations are improperly enforced or entirely ignored. This study focuses on the Kalasin province in Northern Thailand, a region with numerous such workshops, where no comprehensive analysis of exposure to polybrominated diphenyl ethers (PBDEs) and dechlorane plus (DP) has been conducted.

Acute and Critical Care Nurses' Roles in Mass Shootings: An Integrative Review.

Background: From 2018 to 2022, mass shooting incidents in the United States increased by 67.7%. Health care-associated shootings also increased.

Environmental toxicants modulate disease severity in pediatric metabolic dysfunction-associated steatohepatitis.

Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in children. We hypothesized environmental toxins could drive progression to metabolic dysfunction-associated steatohepatitis (MASH), and assayed serum toxins and metabolites in children with histologically characterized MASLD/MASH.

Methods: Environmental chemicals, common in household items, perfluoroalkyl substances (PFAS), polybrominated flame retardants (polybrominated diphenyl ethers [PBDEs]), and metabolic profiles were assayed in children enrolled in the multicenter NASH Clinical Research Network Pediatric Database 2.

Fibrosis, biomarkers and liver biopsy in AAT deficiency and relation to liver Z protein polymer accumulation.

Background And Aims: The course of adults with ZZ alpha-1-antitrypsin deficiency (AATD) liver disease is unpredictable. The utility of markers, including liver biopsy, is undefined.

Methods: A prospective cohort, including protocol liver biopsies, was enrolled to address these questions.

MASLD in people with HIV exhibits higher fibrosis stage despite lower disease activity than in matched controls.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in people with HIV (PWH). The morphological spectrum of MASLD compared to matched controls and of the correlation between the NAFLD activity score (NAS) and fibrosis stage in PWH remains unknown.

Methods: Overall, 107 liver biopsies from PWH with MASLD (MASLD-PWH) were matched to 107 biopsies from individuals with MASLD and without HIV (MASLD controls) on age at biopsy, race/ethnicity, sex, type 2 diabetes, body mass index (BMI) and alanine aminotransferase (ALT) level.