Nymandeaton8357

With continued improvements in image quality and affordability of imaging systems as well as improved automated image interpretation tools anticipated in the near future, telemedicine for ROP is expected to play an expanding role for a uniquely vulnerable patient population.The quadrivalent meningococcal tetanus toxoid-conjugate vaccine (MenACYW-TT) was assessed as a booster in this Phase III trial (NCT02752906). Quadrivalent meningococcal conjugate vaccine (MCV4)-primed individuals aged ≥15 y (n = 810) were randomized 11 to receive a single booster dose of MenACYW-TT (n = 403) or a licensed MCV4 (Menactra®; MCV4-DT [n = 407]). Serum bactericidal antibody assay with human complement (hSBA) was used to measure functional antibodies against serogroups A, C, W, and Y at baseline and Day 30 post-vaccination. Proportions of participants achieving seroresponse (post-vaccination titer ≥116 for those with baseline titer less then 18 or ≥4-fold increase in post-vaccination titer for those with baseline titer ≥18) were determined. Safety data were collected for 180 d post-vaccination. Non-inferiority of the immune response was demonstrated for MenACYW-TT compared with MCV4-DT based on the proportion of participants achieving hSBA vaccine seroresponse for each of the meningococcal serogroups at Day 30. Moreover, ≥99% of participants in both study groups had hSBA titers ≥18 for the four meningococcal serogroups at Day 30. Reactogenicity profiles were comparable between groups. These Phase III data in adolescents and adults show that MenACYW-TT boosts the immune response in those primed with MCV4 vaccines 4-10 y previously, irrespective of whether MCV4-DT or MCV4-CRM was used for priming.Annual seasonal influenza vaccination (SIV) is recommended for people with diabetes, but vaccine coverage remains low. We estimated the probabilities of stopping or starting SIV, their correlates, and the expected time spent in the vaccinated state over 10 seasons for different patient profiles. We set up a retrospective cohort study of patients with diabetes in 2006 (n = 16,026), identified in a representative sample of beneficiaries of the French National Health Insurance Fund. We followed them up over 10 seasons (2005/06-2015/16). We used a Markov model to estimate transition probabilities and a proportional hazards model to study covariates. Between two consecutive seasons, the probabilities of starting (0.17) or stopping (0.09) SIV were lower than those of remaining vaccinated (0.91) or unvaccinated (0.83). Men, older patients, those with type 1 diabetes, treated diabetes or more comorbidities, frequent contacts with doctors, and with any hospital stay for diabetes or influenza during the last year were more likely to start and/or less likely to stop SIV. The mean expected number of seasons with SIV uptake over 10 seasons (range 2.6-7.9) was lowest for women less then 65 years with untreated diabetes and highest for men ≥65 years with type 1 diabetes. Contacts with doctors and some clinical events may play a key role in SIV adoption. Healthcare workers have a crucial role in reducing missed opportunities for SIV. The existence of empirical patient profiles with different patterns of SIV uptake should encourage their use of tailored educational approaches about SIV to address patients' vaccine hesitancy.Purpose Studies have shown that children with typical development (TD) respond to frequency and predictability when repeating nonidiomatic multiword sequences (e.g., go wash your hands). We extended these findings by explicitly examining the interaction between frequency and predictability in a repetition task for children with developmental language disorder (DLD) and children with TD. Method We created 48 four-word phrases, manipulating two factors the frequency of occurrence of the entire four-word phrase (e.g., look in the mirror vs. look in the basket) and the predictability of the fourth word in the phrase given the preceding three words (e.g., corn on the ___ vs. look in the ___). These phrases were presented in a repetition task to 17 children with DLD (M age = 58.89 months), 19 same-age children with TD (M age = 59.79 months), and 17 younger children with TD matched to the DLD group on nonword repetition and mean length of utterance (M age = 38.94 months). Children's repetitions were judged for the presence or absence of word and morphological errors. Only the first three words of the sequence were scored (e.g., look in the). Results We found a main effect of sequence frequency, with high-frequency sequences being repeated more accurately than low-frequency sequences, modulated by a significant interaction with predictability, where the effect of sequence frequency was larger for sequences with high-predictability contexts than for sequences with low-predictability contexts. We also found a significant effect of group, with children with DLD demonstrating poorer overall performance, particularly when compared to the same-age group with TD. Conclusions Frequency and predictability are strong predictors of language production in children with TD. These factors also have effects for children with DLD, raising important clinical questions about the design of facilitative contexts for the teaching of difficult linguistic forms.Background This study examined predictive relationships between two indices of language-receptive vocabulary and morphological comprehension-and inhibition in children with specific language impairment (SLI) and typically developing (TD) children. Methods Participants included 30 children with SLI and 41 TD age-matched peers (8-12 years). At two time points separated by 1 year, we assessed receptive vocabulary and morphological comprehension via standardized language measures and inhibition via a Flanker task. We used Bayesian model averaging and Bayesian regression analytical techniques. Results Findings indicated predictive relationships between language indices and inhibition reaction time (RT), but not between language indices and inhibition accuracy. For the SLI group, Year 1 inhibition RT predicted Year 2 morphological comprehension. For the TD group, Year 1 morphological comprehension predicted Year 2 inhibition RT. Conclusions This study provides preliminary evidence of a predictive relationship between language and inhibition, but this relationship differed between children with SLI and those with typical development. Findings suggest that inhibition RT played a larger predictive role in later morphological comprehension in children with SLI relative to the other relationships examined. Targeting inhibition skills as a part of language intervention may improve subsequent morphological comprehension. Supplemental Material https//doi.org/10.23641/asha.12014823.In France, the incidence of invasive meningococcal disease (IMD) is around 1/100,000, with the following trends over the 2011-2018 period a leading role of group B in subjects less then 15 years, a decrease of group C among less then 1 year since 2017, an increase of group W in all age groups including subjects less then 1 year since 2014 and a positive correlation between group Y and age group.In Europe, vaccination progressed with conjugate ACWY vaccines and proteins-based B vaccines. Their benefit-risk-cost balance is however not so obvious for area at low incidence ( less then 2/100,000), explaining tremendous variations between countries, from no recommendation to recommend all available vaccines. In France, the calendar still includes only C with a good adhesion in infants but a fiasco of the catch-up campaign in adolescents and young adults.In Europe, it is time to consider not only national epidemiology but also trends in the neighborhood. The increase of group W cases encourages switching C to ACWY vaccine both in infants and adolescents. It is also time to protect infants with B vaccine. Large pedagogy on the disease is required to increase the adhesion to the vaccination and to recognize and treat earlier the residual cases.Background Recent outbreaks of vaccine-preventable diseases have affected members of religious communities. While major religions support vaccines, the views of individual clergy who practice and propagate major faith traditions are unclear. Our objective was to explore clergy attitudes toward vaccines and vaccine advocacy.Methods In 2018-2019, we conducted qualitative interviews with clergy in Colorado and North Carolina. We inductively analyzed transcripts using a grounded theory approach, developing codes iteratively, resolving disagreements by consensus, and identifying themes.Results We interviewed 16 clergy (1 Buddhist, 3 Catholic, 2 Jewish, 1 Hindu, 1 Islamic, 7 Protestant, and 1 Unity). Analyses yielded seven themes attitudes toward vaccines, congregational needs, public health climate, perceived responsibility, comfort and competing interests, reported advocacy efforts, and clergy health advocacy goals. Most clergy had positive vaccination attitudes and were open to vaccine advocacy, although discomfort with medical concepts and competing interests in their congregations influenced whether many had chosen to advocate for vaccines. Over half reported promoting vaccination in various contexts.Conclusions In our sample, U.S. ALK assay clergy held complex attitudes toward vaccines, informed by experience and social norms as much as religious beliefs or Scriptures. Clergy may be open to vaccine advocacy, but a perceived lack of relevance in their faith communities or a lack of medical expertise may limit their advocacy efforts in diverse contexts. Amidst growing vaccine hesitancy, pediatricians could partner with clergy in their communities, answer questions about vaccines, raise awareness of recent outbreaks, and empower clergy in joint educational events.Background The introduction of artificial intelligence (AI) in medicine has raised significant ethical, economic, and scientific controversies. Introduction Because an explicit goal of AI is to perform processes previously reserved for human clinicians and other health care personnel, there is justified concern about the impact on patient safety, efficacy, equity, and liability. Discussion Systems for computer-assisted and fully automated detection, triage, and diagnosis of diabetic retinopathy (DR) from retinal images show great variation in design, level of autonomy, and intended use. Moreover, the degree to which these systems have been evaluated and validated is heterogeneous. We use the term DR AI system as a general term for any system that interprets retinal images with at least some degree of autonomy from a human grader. We put forth these standardized descriptors to form a means to categorize systems for computer-assisted and fully automated detection, triage, and diagnosis of DR. The components of the categorization system include level of device autonomy, intended use, level of evidence for diagnostic accuracy, and system design. Conclusion There is currently minimal empirical basis to assert that certain combinations of autonomy, accuracy, or intended use are better or more appropriate than any other. Therefore, at the current stage of development of this document, we have been descriptive rather than prescriptive, and we treat the different categorizations as independent and organized along multiple axes.