Olsensherrill5736

Overall, gorillas spent significantly more time immobile (85.2% of observations) than mobile (14.8%), revealing energy expenditure levels comparable to western lowland gorillas living in zoos. There was no difference in behavioral diversity when gorillas were mobile versus immobile but adult females exhibited substantially less behavioral diversity while immobile than other age-sex classes. There was more diversity in behaviors following the transition from immobile to mobile than vice versa, particularly for adult females. Future studies should concurrently measure mobility state and behavior to improve the precision of activity budget data and serve as a more useful tool for evaluating optimal activity levels for wildlife in human care.An important rationale for legally-farmed and synthetic wildlife products are that they reduce illegal wild-sourced trade by supplying markets with sustainable alternatives. For this to work, more established illegal-product consumers must switch to legal alternatives than new legal-product consumers drawn to illegal wild products. Despite widespread debate on the magnitude and direction of switching, studies among actual consumers are lacking. We used an anonymous online survey of 1421 Traditional Chinese Medicine consumers in China to investigate switching between legal farmed, synthetic, and illegal wild bear bile. We examined past consumption behaviour, and applied a discrete choice experiment framed within worsening hypothetical disease scenarios, using latent class models to investigate groups with shared preferences. Bear bile consumers (86% respondents) were wealthier, more likely to have family who consumed bile, and less knowledgeable about bile treatments than non-consumers. Consumer preferences wettempting to predict consumer behaviour in complex wildlife markets. This article is protected by copyright. All rights reserved.In America's prisons, long-term incarceration carries fears that one could die in prison alone and abandoned. Death by incarceration looms as inescapable for myriad inmates who are terminally ill or "graying" in prison. These realities inform this study of a prison-based hospice program staffed by male inmate volunteers in a mixed medium/maximum security facility. Of special concern are the experiences of the men who sit by the bedside of others who are dying. I begin with the assumption that prisons loom as states of exception, epitomized by the realities of substandard prison medicine, the devaluation of care as anathema to prison survival, and the persistent neglect of the ill and aging. The ethos and practices associated with inmate-driven end-of-life care demarcate an inverted space of non-judgmental praxis that simultaneously envelopes the dying man while also instigating self-reflection, change, and self-care among inmate hospice volunteers.Although no precise moment or unique event marks its birth, neuroimmunoendocrinology arguably shares a great deal of history with other medical and biologic disciplines. It originated from empirical observations and suppositions that failed to prevail upon the existing axioms. Despite the widespread resistance to embracing novel ideas, the seeming defeats inspired visionary researchers. Those pioneers managed to systematize the emerging knowledge and were able to contribute to science with real foundations. In consequence, new concepts and ideas arose in physiology, anatomy, endocrinology and early immunology. Together, they gave rise to a budding approach on the integration between the nervous, immune and endocrine systems. Then, neuroimmunoendocrinology emerged as a discipline integrating an intricate system with multidirectional functions and interactions that allow for responding to internal and external threats. Such response is mediated by cytokines, hormones and neurotransmitters, involved in different physiologic mechanisms of the organism homeostasis. Neuroimmunoendocrinology is no longer an area of scientific skepticism; on the contrary, it has cemented its position as a biomedical discipline worldwide for the past 70 years. Now, it offers a better understanding of pathologic processes.Adaptive enrichment designs in clinical trials have been developed to enhance drug developments. They permit, at interim analyses during the trial, to select the sub-populations that benefits the most from the treatment. Because of this selection, the naive maximum likelihood estimation of the treatment effect, commonly used in classical randomized controlled trials, is biased. In the literature, several methods have been proposed to obtain a better estimation of the treatments' effects in such contexts. To date, most of the works have focused on normally distributed endpoints, and some estimators have been proposed for time-to-event endpoints but they have not all been compared side-by-side. In this work, we conduct an extensive simulation study, inspired by a real case-study in heart failure, to compare the maximum-likelihood estimator (MLE) with an unbiased estimator, shrinkage estimators, and bias-adjusted estimators for the estimation of the treatment effect with time-to-event data. DMAMCL The performances of the estimators are evaluated in terms of bias, variance, and mean squared error. Based on the results, along with the MLE, we recommend to provide the unbiased estimator and the single-iteration bias-adjusted estimator the former completely eradicates the selection bias, but is highly variable with respect to a naive estimator; the latter is less biased than the MLE estimator and only slightly more variable.The problem of dynamic prediction with time-dependent covariates, given by biomarkers, repeatedly measured over time, has received much attention over the last decades. Two contrasting approaches have become in widespread use. The first is joint modeling, which attempts to jointly model the longitudinal markers and the event time. The second is landmarking, a more pragmatic approach that avoids modeling the marker process. Landmarking has been shown to be less efficient than correctly specified joint models in simulation studies, when data are generated from the joint model. When the mean model is misspecified, however, simulation has shown that joint models may be inferior to landmarking. The objective of this article is to develop methods that improve the predictive accuracy of landmarking, while retaining its relative simplicity and robustness. We start by fitting a working longitudinal model for the biomarker, including a temporal correlation structure. Based on that model, we derive a predictable time-dependent process representing the expected value of the biomarker after the landmark time, and we fit a time-dependent Cox model based on the predictable time-dependent covariate. Dynamic predictions based on this approach for new patients can be obtained by first deriving the expected values of the biomarker, given the measured values before the landmark time point, and then calculating the predicted probabilities based on the time-dependent Cox model. We illustrate the approach in predicting overall survival in liver cirrhosis patients based on prothrombin index.

Most children with COVID-19have mild symptoms, but data on the Omicron variant are rare. This paper describes unexpected cases with convulsions during 1week in January 2022.

Four children with COVID-19 were admitted with convulsions to the paediatric department in Örebro, Sweden, when Omicron accounted for more than 98% of the country's COVID-19 cases. Three children tested positive for the virus, and one had clinical COVID-19. I was able to contact the parents of three boys, who gave consent for these case studies.

Two boys aged 3 and 21months tested positive for the virus and a 14-year-old boy tested negative, but had a cold and family members who had tested positive. The teenager had a history of urinary tract infections, but the younger boys had no earlier comorbidities. None had a history of epilepsy or febrile convulsions. The younger children had a fever and the teenager had upper respiratory symptoms. The 3-month-old child had repeated convulsions for several hours, the 21-month-old had continuous convulsions for 15-20min, and the teenager had a convulsion for 30-60s, followed by uncharacteristic aggression.

Convulsions may be a sign of the Omicron variant in children with COVID-19.

Convulsions may be a sign of the Omicron variant in children with COVID-19.Outcome values in randomized controlled trials (RCTs) may be missing not at random (MNAR), if patients with extreme outcome values are more likely to drop out (eg, due to perceived ineffectiveness of treatment, or adverse effects). In such scenarios, estimates from complete case analysis (CCA) and multiple imputation (MI) will be biased. We investigate the use of the trimmed means (TM) estimator for the case of univariable missingness in one continuous outcome. The TM estimator operates by setting missing values to the most extreme value, and then "trimming" away equal fractions of both groups, estimating the treatment effect using the remaining data. The TM estimator relies on two assumptions, which we term the "strong MNAR" and "location shift" assumptions. We derive formulae for the TM estimator bias resulting from the violation of these assumptions for normally distributed outcomes. We propose an adjusted TM estimator, which relaxes the location shift assumption and detail how our bias formulae can be used to establish the direction of bias of CCA and TM estimates, to inform sensitivity analyses. The TM approach is illustrated in a sensitivity analysis of the CoBalT RCT of cognitive behavioral therapy (CBT) in 469 individuals with 46 months follow-up. Results were consistent with a beneficial CBT treatment effect, with MI estimates closer to the null and TM estimates further from the null than the CCA estimate. We propose using the TM estimator as a sensitivity analysis for data where extreme outcome value dropout is plausible.

To examine the association between oral frailty and oral Candida carriage as a general indicator of deteriorating oral function in older adults.

Older adults exhibit an elevated risk of oral candidiasis caused by Candida. Although many studies have identified factors associated with oral Candida carriage, none have evaluated its relationship with oral function.

This study included 210 community-dwelling older adults aged ≥60years who participated in wellness checks. Fungal flora expression in saliva samples was evaluated to identify oral C.albicans and C.glabrata. Participants were categorised by detection of neither strain (group 1), either one of the strains (group 2), or both strains (group 3). The relationship between oral Candida carriage and oral frailty was evaluated by multinomial logistic regression analysis.

The participants included 58 men and 152 women with a mean age of 74.2±6.1years. A total of 88 (41.9%), 94 (44.8%) and 28 (13.3%) participants were assigned to groups 1, 2 and 3 respectively. In the multinomial logistic regression analysis, significant associations were observed between group 1 and group 2 for "Have you choked on your tea or soup recently?" and the number of applicable oral frailty items. Between group 1 and group 3, significant associations were observed for the number of remaining teeth, masticatory performance and the number of applicable oral frailty items.

We obtained basic data useful for intervention studies aimed at verifying whether oral function management prevents deterioration of the oral bacterial flora.

We obtained basic data useful for intervention studies aimed at verifying whether oral function management prevents deterioration of the oral bacterial flora.