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e., at different levels of muscle contraction and for different numbers of discharges per position. The results demonstrate that the algorithm eliminates artifacts more effectively than any previously available method and does so without distorting the waveform of the signal. Graphical abstract The raw scanning-EMG signal, which can be composed by several discharges of the MU, is processed by the MMLSS algorithm so as to eliminate the artifact interference. Firstly, artifacts are detected for each discharge from the raw signal, obtaining a multi-discharge validity mask that indicates the samples that have been corrupted by artifacts. Secondly, a least-squares smoothing procedure simultaneously operating in the spatial dimension and among the discharges is applied to the raw signal. This second step is performed using only the not contaminated samples according to the validity mask. The resulting MMLSS-processed scanning-EMG signal is clean of artifact interference.Care-delays can further exacerbate racial and ethnic health disparities in novel coronavirus disease 2019 (COVID-19) related complications. The purpose of our study was to describe and evaluate a Patient Engagement Messaging campaign (PEM campaign) promoting health care seeking behaviors among community and rural clinic patients in North Carolina. Text and voice messages were delivered over 3-weeks. Messages encouraged patients to call a regional operation call center (ROC) line for information related to health care appointments and testing. A cross-sectional evaluation was conducted on the total population (n = 48,063) and a sample without recent health care contact (n = 29,214). Among the sample, logistic regression was used to model determinants of calls to the ROC-line and associations between calling the ROC-line and health care seeking behaviors (scheduling any health care appointment or receiving a COVID-19 test). learn more 69.9% of text messages and 89% of voice messages were delivered. Overall, 95.4% of the total population received at least 1 message. Successful delivery was lower among Black patients and higher among patients with moderate health-risk comorbidities. Among the sample, 7.4% called the ROC-line, with higher odds of calling among minority patients (vs. White) and among Medicaid and uninsured (vs. private insurance). Calling the ROC-line was associated with higher odds of scheduling any health care appointment (OR 4.14; 95% CI 2.93-5.80) and receiving a COVID-19 test (OR 2.39; 95% CI 1.64-3.39). Messaging campaigns may help disconnected patients access health care resources and reduce disparities, but are likely still limited by existing barriers.Hearing loss is a growing public health concern and has been associated with poor cardiovascular health, diabetes, increased social isolation and poor cognitive functioning. Addressing this issue, especially in rural communities, will require increased awareness of hearing loss and its link to emotional and physical well-being. The purpose of this study was to understand the challenges that those with hearing loss living in rural and urban communities experience and to examine the feasibility of using primary care physicians to assist with improving access to hearing healthcare in rural communities. One hundred thirty-four participants were recruited from rural and urban counties in West Central and South Alabama. All participants completed a hearing evaluation and a Healthcare and Hearing Healthcare Accessibility Questionnaire. Over half of the adults in the study with hearing loss did not have access to hearing healthcare because of distance to a hearing healthcare professional. Other reasons for participants not having access to hearing healthcare included financial constraints, lack of awareness of having a hearing loss, lack of time to see a hearing healthcare provider, and not knowing how to access a provider. Results, however, revealed that most adults in the study had access to a primary care professional. The primary care provider, therefore, could be a valuable resource for the dissemination of information related to hearing healthcare. Collaborative work with primary care providers will help to develop and expand hearing healthcare awareness, research and services provided through the Here Hear Alabama project, a rural outreach initiative in West Central and South Alabama.Premature ejaculation (PE) is the most prevalent male sexual dysfunction, and the most recently defined. PE is often mistakenly considered a purely psychosexological symptom by patients the lacking awareness in regards to the pathophysiology and treatments often lead to resignation from the patients' side, making PE the most underdiagnosed sexual complaint. However, an ever-growing body of evidence supporting several organic factors has been developed in the last decades and several definitions have been suggested to encompass all defining features of PE. In the present document by the Italian Society of Andrology and Sexual Medicine (SIAMS), we propose 33 recommendations concerning the definition, pathophysiology, treatment and management of PE aimed to improve patient care. These evidence-based clinical guidelines provide the necessary up-to-date guidance in the context of PE secondary to organic and psychosexological conditions, such as prostate inflammation, endocrine disorders, and other sexual dysfunctions, and suggest how to associate pharmacotherapies and cognitive-behavioral therapy in a couple-centered approach. New therapeutic options, as well as combination and off-label treatments, are also described.

To determine the burden of illness in patients with not adequately controlled chronic hypoparathyroidism receiving conventional therapy in Belgium and the Netherlands.

Data were generated from a cross-sectional, two-part online survey where endocrinologists from both countries and nephrologists from Belgium were invited by phone to participate. Part 1 included collecting data on general management of patients with hypoparathyroidism. In Part 2, physicians were requested to provide data on one or two current cases of patients with chronic hypoparathyroidism not adequately controlled on conventional therapy. Data collected included aetiology of hypoparathyroidism, clinical manifestations, comorbidities, results of laboratory and other investigations used for diagnosis and screening for complications, therapy received, and physician's perception of impaired quality of life (QoL).

Thirty-six endocrinologists and 29 nephrologists from Belgium and 28 endocrinologists from the Netherlands participated in the survey.