The Risk of Major Bleeding With Apixaban Administration in Patients With Acute Kidney Injury.

Background: Apixaban is eliminated by the kidneys and in acute kidney injury (AKI) there is potential for an increase in apixaban exposure and bleeding events. In one instance, data have shown higher than normal bleed risk in patients with AKI, unless calibrated anti-factor Xa monitoring is used, which is not widely available.

Objective: To evaluate bleeding with apixaban administration to hospitalized patients with an AKI in an unmonitored real-world scenario.

Factors Associated With Prolonged Antibiotic Use in the Setting of Suspected Pneumonia and Negative Bronchoalveolar Lavage Cultures.

Diagnostic criterion for pneumonia includes clinical data and bronchoalveolar lavage cultures (BALCx) to identify pathogens. Although ~60% of BALCx are negative, there may be reluctance to discontinue antibiotics, leading to prolonged antibiotic use (PAU). The purpose of this study is to compare outcomes of subjects with negative BALCx with PAU versus without prolonged antibiotic use (nPAU).

Inclusion in limited distribution drug network reduces time to dalfampridine access in patients with multiple sclerosis at a health-system specialty pharmacy.

Dalfampridine improves walking speed in patients with multiple sclerosis (MS), but accessing specialty medications such as dalfampridine can be hindered by insurance restrictions, high costs, and limited distribution networks (LDNs) imposed by manufacturers. Some integrated health-systems specialty pharmacies (HSSPs) embed pharmacists in clinics and dispense medications from their internal pharmacies if included within the LDN. To assess access to dalfampridine in patients at an HSSP before and after gaining admission to the LDN.

Identification of migratory bird flyways in North America using community detection on biological networks.

Migratory behavior of waterfowl populations in North America has traditionally been broadly characterized by four north-south flyways, and these flyways have been central to the management of waterfowl populations for more than 80 yr. However, previous flyway characterizations are not easily updated with current bird movement data and fail to provide assessments of the importance of specific geographical regions to the identification of flyways. Here, we developed a network model of migratory movement for four waterfowl species, Mallard (Anas platyrhnchos), Northern Pintail (A.

Severe Bone Loss as Part of the Life History Strategy of Bowhead Whales.

The evolution of baleen constituted a major evolutionary change that made it possible for baleen whales to reach enormous body sizes while filter feeding on tiny organisms and migrating over tremendous distances. Bowhead whales (Balaena mysticetus) live in the Arctic where the annual cycle of increasing and decreasing ice cover affects their habitat, prey, and migration. During the nursing period, bowheads grow rapidly; but between weaning and approximately year 5, bowhead whales display sustained baleen and head growth while limiting growth in the rest of their bodies.

A Browser-Server-Based Tele-audiology System That Supports Multiple Hearing Test Modalities.

Introduction: Millions of global citizens suffering from hearing disorders have limited or no access to much needed hearing healthcare. Although tele-audiology presents a solution to alleviate this problem, existing remote hearing diagnosis systems support only pure-tone tests, leaving speech and other test procedures unsolved, due to the lack of software and hardware to enable communication required between audiologists and their remote patients. This article presents a comprehensive remote hearing test system that integrates the two most needed hearing test procedures: a pure-tone audiogram and a speech test.

Emergency cricothyrotomy in confined space airway emergencies: a comparison.

Introduction: In confined-space airway emergencies, prehospital personnel may need to perform cricothyrotomy when conventional airway techniques cannot be utilized or have failed. This study is a prospective, cross-over, randomized controlled trial that compares two widely-known techniques using two commercially available kits.

Methods: Twenty residents at Palmetto Health Richland Department of Emergency Medicine participated in the study.

Audiology telepractice in a clinical environment: a communication perspective.

Access to adequate hearing health care is an obstacle that many individuals face worldwide. The prospect of providing audiology services via the Internet is an attractive and viable alternative to traditional face-to-face interaction between patients and audiologists, thus affording improved access to hearing health care for traditionally underserved populations. This article details our experience of using a web-based system with wireless audiometers and videoconferencing software to administer remote audiological assessments in an active medical practice.

Design of a Web services based system for remote hearing diagnosis.

This paper presents a web services based, distributed system that allows remote pure tone hearing tests. The system network follows browser-server architecture, which minimizes hardware and software requirements on the client computers and makes hearing test services more accessible to traditionally underserved population groups. Thanks to the three tier software design, the system functionality is easily scalable to include other audiological services.

Using web services to realize remote hearing assessment.

Background: Internet-based tele-audiology is expected to relieve the dilemma between the lack of resources and high demand of audiological care services. This paper presents a web services based, distributed pure-tone hearing assessment system that improves accessibility of traditionally underserved groups to audiology care.

Methods: The system employs browser-server network architecture to connect patients to audiology specialists through a web server where all application software is hosted.

A Web services-based distributed system with browser-client architecture to promote tele-audiology assessment.

The purpose of this research was to extend applications of the Internet and other telecommunication means to the assessment of hearing. The newly developed distributed system consists primarily of an application server and its database, and Web services under browser-server architecture to support remote hearing assessment. A pilot study was conducted: three independent audiologists assessed hearing of 25 subjects using testing approaches with different data communication configurations.

Population structure and covariate analysis based on pairwise microsatellite allele matching frequencies.

We describe a general model for pairwise microsatellite allele matching probabilities. The model can be used for analysis of population substructure, and is particularly focused on relating genetic correlation to measurable covariates. The approach is intended for cases when the existence of subpopulations is uncertain and a priori assignment of samples to hypothesized subpopulations is difficult.

Detecting genetic structure in migrating bowhead whales off the coast of Barrow, Alaska.

We develop a general framework for analysing and testing genetic structure within a migratory assemblage that is based on measures of genetic differences between individuals. We demonstrate this method using microsatellite DNA data from the Bering-Chukchi-Beaufort stock of bowhead whales (Balaena mysticetus), sampled via Inuit hunting during the spring and autumn migration off Barrow, Alaska. This study includes a number of covariates such as whale ages and the time separation between captures.

Auditory temporal resolution in normal-hearing preschool children revealed by word recognition in continuous and interrupted noise.

The purpose of this study was to examine temporal resolution in normal-hearing preschool children. Word recognition was evaluated in quiet and in spectrally identical continuous and interrupted noise at signal-to-noise ratios (S/Ns) of 10, 0, and -10 dB. Sixteen children 4 to 5 years of age and eight adults participated.

Auditory pattern recognition and brief tone discrimination of children with reading disorders.

Unlabelled: Auditory pattern recognition skills in children with reading disorders were investigated using perceptual tests involving discrimination of frequency and duration tonal patterns. A behavioral test battery involving recognition of the pattern of presentation of tone triads was used in which individual components differed in either frequency or duration. A test involving measurement of difference limens for long and short duration tones was also administered.

An investigation of telephone use among cochlear implant recipients.

The purpose of this study was to examine telephone use among cochlear implant recipients. A questionnaire was constructed and mailed to 803 adults who received a Clarion cochlear implant system manufactured by Advanced Bionics Corporation. Questionnaire recipients were implanted at least 12 months prior to receiving the questionnaire (i.

Influence of duration and location of pauses on comprehension of a temporarily ambiguous utterance in adults.

Despite the important influence of prosody on comprehension, it remains unclear how the individual parameters of prosody contribute to the process. Therefore, this study examined the magnitude of one prosodic cue, duration of the pause, that precipitates comprehension when the pause is located either early or late in an ambiguous phrase. Adults between the ages of 20 and 40 years (men: M = 27.

Internet-based tele-audiometry system for the assessment of hearing: a pilot study.

The application of tele-audiology is in its infancy. Several systems have been developed to screen hearing, yet the application of real-time diagnostic audiology to a remote location is new. This paper describes a tele-audiometric system developed for the application of realtime diagnostic audiometry via the Internet.

Internet application to tele-audiology--"nothin' but net".

The Telehealth program at East Carolina University has developed a system for real-time assessment of auditory thresholds using computer driven control of a remote audiometer via the Internet. The present study used 45 adult participants in a double-blind study of 2 different systems: a conventional audiometer and an audiometer operated remotely via the Internet. The audiometric thresholds assessed by these 2 systems varied by no more than 1.

Auditory temporal processing performance of young adults with reading disorders.

The present study investigated the temporal processing abilities of college students with diagnosed reading disorders. A behavioral test battery was used that involved discrimination of the pattern of presentation of tone triads in which individual components differed in either frequency or duration. An additional test involving measurement of frequency difference limens for long- and short-duration tones was also administered.

Auditory processing skills and hearing aid satisfaction in a sample of older adults.

The present study investigated the relationship between central auditory processing skills and satisfaction with hearing aids in a hearing-impaired geriatric sample of 58 adult wearers of hearing aids who were between the ages of 65 and 91 years. Analysis suggests the importance of adding central auditory tasks such as compressed speech or dichotic listening tasks to the evaluation of candidacy for hearing aids. This could lead to the better understanding of satisfaction with amplification by the geriatric population.

Bootstrapping for pharmacokinetic models: visualization of predictive and parameter uncertainty.

Purpose: We explore use of "bootstrapping" methods to obtain a measure of reliability of predictions made in part from fits of individual drug level data with a pharmacokinetic (PK) model, and to help clarify parameter identifiability for such models.

Methods: Simulation studies use four sets (A-D) of drug concentration data obtained following a single oral dose. Each set is fit with a two compartment PK model, and the "bootstrap" is employed to examine the potential predictive variation in estimates of parameter sets.

Perception of time-altered monosyllables in a specific group of phonologically disordered children.

Temporal auditory processing of open (e.g. pie) versus closed (e.