[Thyroid surgery in a context of scarce resources at Saint Martin de Porres Dominican Hospital (Yaounde, Cameroon)]. / Chirurgie thyroïdienne dans le contexte de populations avec de faibles ressources à l'hôpital dominicain Saint Martin de Porres (Yaoundé, Cameroun).

Introduction: Surgical campaigns for thyroid surgery in low-income environments are very efficient, but there is little literature reporting results. These campaigns are complex due to multiple particularities: highly evolved cases, the need for professionals to travel or an obvious socio-cultural barrier influence towards the surgical act. We describe a surgical campaign in Cameroon to treat patients with goiter and issue some medical and sociocultural recommendations in view of our experience for its implementation with guarantees. Material and methods: An experienced group carried out an 11-day campaign at the Saint Martin de Porres Dominican Hospital, Yaounde, Cameroon. Demographic data, TSH values, surgery and complications after a 12-month follow-up were analyzed. Results: Thirty-eight patients with goiter were selected for the campaign and 32 patients (mean age, 40-years-old; 30 females) were operated. Bilateral goiter, as assessed with echography, was diagnosed in 13 patients (41%). Ten patients (31%) had a WHO grade II goiter (visible with the neck in a normal position). The surgical procedures were 18 unilateral thyroidectomy with isthmectomie, 13 total thyroidectomy, and 1 totalizing thyroidectomy, due to previous unilateral thyroidectomy (cancer recurrence). A pathological study in 13 patients (40%, extra cost 60 €) showed benign multinodular goiter/thyroid nodule (12 patients) and an extensive papillary carcinoma (one patient). Six months postoperatively, 3 patients had a slight dysphonia and one patient had persistent hypocalcemia. Follow-up was completed in all patients, either face to face (75%, 24 patients) or by phone (25%, 8 patients who failed to have a TSH test because of its cost, 23 €). Conclusions: Surgical campaigns to treat thyroid pathology can be carried out with guarantees if a series of important steps are followed: active participation of the patient's environment, thyroid ultrasound by the surgical team to decide which technique, intense awareness about monitoring and hormone replacement therapy, and the participation of local personnel for long-term follow-up.

Immune response against the SARS-CoV-2 spike protein in cancer patients after COVID-19 vaccination during the Omicron wave: a prospective study.

BACKGROUND: Cancer patients often have weakened immune systems, resulting in a lower response to vaccines, especially those receiving immunosuppressive oncological treatment (OT). We aimed to assess the impact of OT on the humoral and T-cell response to the B.1 lineage and Omicron variant following COVID-19 vaccination in patients with solid and hematological neoplasms. METHODS: We conducted a prospective study on cancer patients, stratified into OT and non-OT groups, who received a two-dose series of the COVID-19 mRNA vaccine and a booster six months later. The outcomes measured were the humoral (anti-SARS-CoV-2 S IgG titers and ACE2-S interaction inhibition capacity) and cellular (SARS-CoV-2 S-specific T-cell spots per million PBMCs) responses against the B.1 lineage and Omicron variant. These responses were evaluated four weeks after the second dose (n = 98) and eight weeks after the booster dose (n = 71). RESULTS: The humoral response after the second vaccine dose against the B.1 lineage and Omicron variant was significantly weaker in the OT group compared to the non-OT group (q-value<0.05). A booster dose of the mRNA-1273 vaccine significantly improved the humoral response in the OT group, making it comparable to the non-OT group. The mRNA-1273 vaccine, designed for the original Wuhan strain, elicited a weaker humoral response against the Omicron variant compared to the B.1 lineage, regardless of oncological treatment or vaccine dose. In contrast, T-cell responses against SARS-CoV-2, including the Omicron variant, were already present after the second vaccine dose and were not significantly affected by oncological treatments. CONCLUSIONS: Cancer patients, particularly those receiving immunosuppressive oncological treatments, should require booster doses and adapted COVID-19 vaccines for new SARS-CoV-2 variants like Omicron. Future studies should evaluate the durability of the immune response and the efficacy of individualized regimens.

Moral Distress Healthcare Providers in Spain: Observational Study.

Objective: To evaluate the moral distress (MD)in health professionals of pediatric and adult units to show how the complexity of care in the pediatric field causes the professionals who carry out their activity in these units to present a higher level of moral distress and a worse climate ethical. Design: Observational study with health professionals who currently work in Spanish Hospitals. Methods: A 58-item questionnaire was electronically distributed which included sociodemographic and employment characteristics, the Spanish version of the Measure of Moral Unrest for Healthcare Professionals (MMD-HP-SPA) and the Hospital Ethical Climate Survey (HECS). Results: A total of 169 health professionals completed the questionnaire. The moral distress was significantly higher among nurses than among physicians and nursing assistant care technicians. Focusing on the type of unit, moral distress it was only significantly higher for those physicians treating adult patients compared to those treating pediatric patients. Regarding the total score of the HECS survey, the medical group shows higher scores compared to the nursing group. Conclusion: Statistically significant differences have been found only in the medical group that treats adult patients, presenting a higher level of moral unrests than the pediatrician group. The MMD-HP-SPA questionnaire is a valid and useful instrument to detect MD in our hospital units in order to be able to implement strategies/interventions that improve the ethical climate and other factors that can mitigate and prevent this MD.

Assessment and indicators of kinematic behavior and perceived fatigability.

OBJECTIVE: The objective of this study was to investigate the relationship between upper limb kinetics and perceived fatigability in elderly individuals during an upper limb position sustained isometric task. METHODS: A total of 31 elderly participants, 16 men (72.94±4.49 years) and 15 women (72.27±6.05 years), performed a upper limb position sustained isometric task. Upper-limb acceleration was measured using an inertial measurement unit. Perceived fatigability was measured using the Borg CR10 scale. RESULTS: Higher mean acceleration in the x-axis throughout the activity was associated with higher final perceived fatigability scores. Moderate correlations were observed between perceived fatigability variation and mean acceleration cutoffs in all axes during the second half of the activity. In women, significant correlations were found between all perceived fatigability cutoffs and mean acceleration in the y- and x-axes. However, in men, the relationships between perceived fatigability variation and mean acceleration were more extensive and stronger. CONCLUSION: The acceleration pattern of the upper limb is linked to perceived fatigability scores and variation, with differences between sexes. Monitoring upper limb acceleration using a single inertial measurement unit can be a useful and straightforward method for identifying individuals who may be at risk of experiencing high perceived fatigability or task failure.

[Abortion in Melilla: barriers to ocean and frontier]. / Aborto en Melilla: barreras de océano y frontera.

OBJECTIVE: To provide insights into the challenges faced by women seeking abortion services in Melilla, Spain. It seeks to describe the journey these women undertake and to identify and analyze the barriers they encounter in accessing abortion care. METHOD: A qualitative research approach was employed, involving a series of eight semi-structured interviews during 2022. Three interviews were conducted with national experts in the field of abortion, while five interviews were conducted with healthcare professionals from the Melilla Health Area who are directly involved in providing abortion services and supporting women throughout the process. The study was guided by a theoretical framework that focuses on barriers to abortion access and sexual and reproductive rights. The collected data was analyzed using content analysis and categorized based on key dimensions of the study. RESULTS: The study identified several significant barriers to abortion care access in Melilla. These include conscientious objection among healthcare providers, the geographical remoteness of Melilla, the legal challenges faced by Moroccan women due to their irregular status, and the requirement of parental consent for minors aged 16 and 17. Consequently, women seeking abortion services are forced to travel to mainland Spain, continue with undesired pregnancies, or resort to unsafe clandestine abortions in Morocco, thereby endangering their lives in the worst cases. CONCLUSIONS: The barriers to abortion access identified in this study represent a violation of women's reproductive rights in Melilla. Urgent action is required to review the current process, ensuring that access is improved and the right to safe abortion is guaranteed for all women residing in Melilla.

Relationship between emotional awareness, symptoms, and protective factors in children exposed to intimate partner violence.

OBJECTIVE: This study was designed to analyze the associations between emotional awareness (EA) and internalizing and externalizing symptoms, and mood states in children ages 8-12 who were previously exposed to intimate partner violence (EIPV). The study also aimed to explore the association between EA and external and internal protective factors of resilience. METHOD: A descriptive design study was used; participants were 61 children (M = 10 years, 52.5% girls) who were EIPV patients from three Child and Adolescent Mental Health Centers in the Barcelona metropolitan area, Spain. The hypotheses of this study were that (a) an increased capacity for EA would be associated with less severity of internalizing and externalizing symptoms in children EIPV and (b) an increased capacity for EA would correlate with greater resilience. RESULTS: Lower EA was found to be associated with more symptoms, specifically trait anxiety, depression, somatic complaints, total externalizing and internalizing symptoms, and increased feelings of anger and sadness. Greater EA was linked to improved social skills, higher self-esteem, empathy, humor, and both external and internal resilience, as well as with reduced aggressiveness/antisocial behavior and loneliness/social anxiety. The variables that best explained the EA factors were trait anxiety, dysphoria, problem attention, sadness, humor, self-esteem, internal and external protective factors, appropriate social skills, and friendship. CONCLUSION: This study highlights the relevance of EA for children EIPV. Lower EA was associated with higher symptom severity, while higher EA was linked to better self-esteem, social skills, and resilience. The findings suggest the significance of addressing EA in therapeutic interventions for this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Assessment and indicators of kinematic behavior and perceived fatigability

SUMMARY OBJECTIVE: The objective of this study was to investigate the relationship between upper limb kinetics and perceived fatigability in elderly individuals during an upper limb position sustained isometric task. METHODS: A total of 31 elderly participants, 16 men (72.94±4.49 years) and 15 women (72.27±6.05 years), performed a upper limb position sustained isometric task. Upper-limb acceleration was measured using an inertial measurement unit. Perceived fatigability was measured using the Borg CR10 scale. RESULTS: Higher mean acceleration in the x-axis throughout the activity was associated with higher final perceived fatigability scores. Moderate correlations were observed between perceived fatigability variation and mean acceleration cutoffs in all axes during the second half of the activity. In women, significant correlations were found between all perceived fatigability cutoffs and mean acceleration in the y- and x-axes. However, in men, the relationships between perceived fatigability variation and mean acceleration were more extensive and stronger. CONCLUSION: The acceleration pattern of the upper limb is linked to perceived fatigability scores and variation, with differences between sexes. Monitoring upper limb acceleration using a single inertial measurement unit can be a useful and straightforward method for identifying individuals who may be at risk of experiencing high perceived fatigability or task failure.

Orthopaedic Simulation of a Morton's Extension to Test the Effect on Plantar Pressures of Each Metatarsal Head in Patients without Deformity: A Pre-Post-Test Study.

BACKGROUND: the area beneath the metatarsal heads is a common location of foot pain, which is often associated with high plantar pressures. The aim of this study was to determine the effect of the application of a Morton's extension on the pressure in the metatarsal bones of the foot using a pressure platform. METHODS: twenty-five subjects without musculoskeletal pathology were selected for this study, and an experiment was conducted with them as the subjects, before and after application of a Morton's extension. The foot regions were divided into the forefoot (transversely subdivided into six areas corresponding to the first, second, third, fourth, and fifth metatarsal heads, and the hallux), midfoot, and rearfoot, and then the maximum and average pressures exerted at each region were measured before and after placing a Morton's extension. MAIN FINDINGS: we found a pressure reduction, with a p-value less than (p < 0.05), in the head of the second and third metatarsals in statics and dynamics. CONCLUSIONS: we can conclude that the Morton's extension produces a variation in plantar pressures on the lesser metatarsals. The application of a Morton's extension may be beneficial for the management of forefoot pathology. This study will help clinicians consider various tools to treat forefoot disorders. NCT05879094 (ClinicalTrial.gov (accessed on 18 May 2023)).

Effects of Myofascial Induction Therapy on Ankle Range of Motion and Pressure Pain Threshold in Trigger Points of the Gastrocnemius-A Clinical Trial.

BACKGROUND: The myofascial induction technique (MIT) has been shown to increase shoulder range of motion (ROM) in breast cancer survivors and decrease pain pressure threshold over the radial nerve in patients with epicondylalgia. To the authors' best knowledge, no study on trigger points and MIT has been published to date. The effect on ROM of latent trigger points is also unknown. METHODS: A total of 20 twins with one latent trigger point of the gastrocnemius muscle were evaluated pre- and post-MIT in the calf. We measured static footprint variables in a pre-post study. RESULTS: We found differences in PPT (p = 0.001) and no differences in ROM with knee flexed (p = 0.420) or stretched (p = 0.069). CONCLUSIONS: After Calf MIT, latent myofascial trigger points improve PPT but no change in ankle dorsiflexion with knee bent or knee flexed were found in non-restriction healthy subjects.

VocabStudy: A remote collection of naturalistic topic-structured parental speech and toddlers' vocabularies using a mobile phone application.

The current work presents VocabStudy, a collection of natural language samples and children's vocabularies collected remotely by parents via a mobile phone application. The corpus contains 567,003 word tokens and represents 144 hours of speech over a period of six months from the language environment of 63 British toddlers aged 13 to 28 months. The corpus incorporates labeled speech samples of five typical routines: mealtime, bedtime, playtime, bathtime, and nappytime (i.e., diaper). To explore consistency and variability across these five linguistic contexts, topic modeling was employed. The topic most successfully detected as having a unique structure was mealtime, which was identified as such nearly 100% of the time; bathtime, nappytime, and bedtime were found to cluster together most of the time, suggesting that they have a similar language structure; playtime was correctly identified as such about 14% of the time. To validate the accuracy of parents marking the words that their child produced, the child's utterances found in the audio recordings were examined. About 18% of the vocabulary reported by parents appeared in the transcripts, and the reported vocabulary sizes were highly correlated with the number of unique words uttered by the children (ρ = .72, p < 001). The results suggest that most parents marked the words soon after their children start producing them (p < .001, d = 0.9). I discuss the advantages and disadvantages of using a mobile phone application as a method to collect children's data remotely, what worked to keep participants entering data, and what could have been done to avoid some issues encountered.

The Effectiveness of Hard Insoles for Plantar Pressure in Cycling: A Crossover Study.

BACKGROUND: Hard insoles have been proposed to decrease plantar pressure and prevent foot pain and paresthesia due to repetitive loading. The aim of this research was to analyze the effect of three different hard insoles in cycling on healthy subjects. METHODS: A crossover randomized trial was carried out. The mean age of the subjects was 35 ± 3.19 years, and all of them were men. While the subjects were cycling on a stationary bicycle, their plantar pressure was recorded with nine in-shoe sensors placed in nine specific foot areas to test a standard ethylene-vinyl-acetate 52° Shore A hardness insole, a polypropylene 58° Shore D insole, and a polypropylene 580 Shore D insole with selective aluminum 60 HB Brinell hardness in the metatarsal head and hallux. RESULTS: The maximum plantar pressure decreased significantly with the polypropylene insole containing selective aluminum in the metatarsal head and hallux areas. The maximum plantar data of the polypropylene aluminum insole in the M2 area (5.56 kgF/cm2), fifth metatarsal styloid process (6.48 kgF/cm2), M3-M4 area (4.97 kgF/cm2), and hallux (8.91 kgF/cm2) were of particular interest compared to the other insoles. CONCLUSIONS: The use of insoles made of polypropylene with aluminum in the metatarsal head and hallux areas decreases the maximum plantar pressure in cycling compared to standard EVA and polypropylene insoles.

Interdisciplinary management of mpox-related local complications: report on a series of cases.

Monkeypox (mpox) is a viral zoonosis, and human-to-human transmission can result from close contact with the respiratory secretions and mucocutaneous lesions of an infected person. The prodromal phase is followed by an eruptive phase, with skin and/or mucosal lesions that progress through several stages at different sites. In this study, we describe the importance of interdisciplinary care management and follow-up of patients with complicated mpox. A cross-sectional study was conducted from May 2022 until August 2022 at a secondary hospital in Madrid (Spain). Out of 100 patients with mpox seen at this institution, we selected and analyzed 11 with local complications. All the patients were male at birth, and the mean age was 32 (30-42) years. The clinical manifestations included skin rash or mucosal lesions, fever, myalgia and lymphadenopathies. The most frequent local complications were pharyngitis associated with dysphagia, penile edema, infection of the mucocutaneous lesions, and ulceration of the genital lesions. A multidisciplinary team was created for the care of patients with complications secondary to mpox. The team comprised dermatologists and specialists in infectious diseases, preventive medicine, and emergency medicine. This approach improved the ability to diagnose and treat early with supportive, topical, and systemic treatment. In our center most of the cases were self-limiting, and none were life-threatening. An interdisciplinary response to a public health alert enhances the management of complex patients and should be implemented in successive outbreaks of mpox.

Epidemiological and Clinical Characteristics of Patients Admitted to a Secondary Hospital with Suspected MPOX Virus Infection: Is HIV Playing a Role?

MPOX (monkeypox) is a zoonotic viral disease, endemic in some Central and West African countries. However, in May 2022, cases began to be reported in non-endemic countries, demonstrating community transmission. Since the beginning of the outbreak, different epidemiological and clinical behaviors have been observed. We conducted an observational study at a secondary hospital in Madrid to characterize suspected and confirmed cases of MPOX epidemiologically and clinically. Besides the general descriptive analysis, we compared data between HIV-positive and HIV-negative subjects; 133 patients were evaluated with suspected MPOX, of which 100 were confirmed. Regarding positive cases, 71.0% were HIV positive, and 99.0% were men with a mean age of 33. In the previous year, 97.6% reported having sex with men, 53.6% used apps for sexual encounters, 22.9% practiced chemsex, and 16.7% went to saunas. Inguinal adenopathies were significantly higher in MPOX cases (54.0% vs. 12.1%, p < 0.001), as the involvement of genital and perianal area (57.0% vs. 27.3% and 17.0% vs. 1.0%, p = 0.006 and p = 0.082 respectively). Pustules were the most common skin lesion (45.0%). In HIV-positive cases, only 6.9% had a detectable viral load, and the mean CD4 count was 607.0/mm3. No significant differences were observed in the disease course, except for a greater tendency towards the appearance of perianal lesions. In conclusion, the MPOX 2022 outbreak in our area has been related to sexual intercourse among MSM, with no severe clinical cases nor apparent differences in HIV and non-HIV patients.

Upper-Limb Kinematic Behavior and Performance Fatigability of Elderly Participants Performing an Isometric Task: A Quasi-Experimental Study.

Upper-limb position-sustained tasks (ULPSIT) are involved in several activities of daily living and are associated with high metabolic and ventilatory demand and fatigue. In older people, this can be critical to the performance of daily living activities, even in the absence of a disability. OBJECTIVES: To understand the ULPSIT effects on upper-limb (UL) kinetics and performance fatigability in the elderly. METHODS: Thirty-one (31) elderly participants (72.61 ± 5.23 years) performed an ULPSIT. The UL average acceleration (AA) and performance fatigability were measured using an inertial measurement unit (IMU) and time-to-task failure (TTF). RESULTS: The findings showed significant changes in AA in the X- and Z-axes (p < 0.05). AA differences in women started earlier in the baseline cutoff in the X-axis, and in men, started earlier between cutoffs in the Z-axis. TTF was positively related to AA in men until 60% TTF. CONCLUSIONS: ULPSIT produced changes in AA behavior, indicative of movement of the UL in the sagittal plane. AA behavior is sex related and suggests higher performance fatigability in women. Performance fatigability was positively related to AA only in men, where movement adjustments occurred in an early phase, though with increased activity time.

Earnings management in socially responsible firms around seasoned equity offerings: Evidence from France, Germany, Italy and Spain.

Earnings manipulation (EM) has been a matter of interest to researchers for decades. How this is measured or the motivations of managers to engage in such actions have been studied in detail. Some studies find that managers have incentives to manipulate the earnings that accompany financing activities such as seasoned equity offerings (SEO). Under the corporate social responsibility (CSR) approach, profit manipulation actions have been shown to be mitigated in socially responsible companies. To the best of our knowledge, there are no studies that analyse whether CSR mitigate EM actions in a SEO context. Our work contributes to filling this gap. We investigate whether socially responsible companies exhibit EM in periods prior to SEO. This study uses a panel data model of listed non-financial firms from countries with the same currency and similar accounting rules (France, Germany, Italy and Spain) between 2012 and 2020. Our results show that in all the countries analysed, except Spain, there is a manipulation of operating cash flows in the year prior to capital increases, and only in French companies is there a decrease in the management of this variable in companies with higher development of corporate social responsibility.

Dry needling of the flexor digitorum brevis muscle reduces postural control in standing: A pre-post stabilometric study.

There are studies that show the better balance after dry needling in lumbar pain. However, the postural control effects after foot dry needling are unknown. Our objective was to check if dry needling reduces postural control. Eighteen subjects with flexor digitorum brevis (FDB) muscle Myofascial trigger point were evaluated pre- and post-deep dry needling. We measured stabilometric variables in a pre-post study. We have found significant differences in three stabilometric variables: surface with eyes closed (29.36-53.21 mm2 ) (p = 0.000), medium speed of the laterolateral displacement with eyes closed (1.42-1.64 mm/s) (p = 0.004), and medium speed of the anteroposterior displacement with eyes closed (1.30-1.53 mm/s) (p = 0.025). Dry needling therapy application in FDB muscle reduces standing postural control with eyes closed.

Intra- and inter-session reliability and repeatability of an infrared thermography device designed for materials to measure skin temperature of the triceps surae muscle tissue of athletes.

Background: Infrared thermography devices have been commonly applied to measure superficial temperature in structural composites and walls. These tools were cheaper than other thermographic devices used to measure superficial human muscle tissue temperature. In addition, infrared thermography has been previously used to assess skin temperature related to muscle tissue conditions in the triceps surae of athletes. Nevertheless, the reliability and repeatability of an infrared thermography device designed for materials, such as the Manual Infrared Camera PCE-TC 30, have yet to be determined to measure skin temperature of the triceps surae muscle tissue of athletes. Objective: The purpose was to determine the procedure's intra- and inter-session reliability and repeatability to determine skin temperature within the Manual Infrared Camera PCE-TC 30 thermography device in the triceps surae muscle tissue of athletes, which was initially designed to measure the superficial temperature of materials. Methods: A total of 34 triceps surae muscles were bilaterally assessed from 17 healthy athletes using the Manual Infrared Camera PCE-TC 30 thermography device to determine intra- (at the same day separated by 1 h) and inter-session (at alternate days separated by 48 h) reliability and repeatability of the skin temperature of the soleus, medial and lateral gastrocnemius muscles. The triceps surae complex weas measured by a region of interest of 1 cm2 through five infrared thermography images for each muscle. Statistical analyses comprised intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change (MCD), systematic error of measurement, correlation (r), and Bland-Altman plots completed with linear regression models (R 2). Results: Intra- and inter-session measurements of the proposed infrared thermography procedure showed excellent reliability (ICC(1,2) = 0.968-0.977), measurement errors (SEM = 0.186-0.232 °C; MDC = 0.515-0.643 °C), correlations (r = 0.885-0.953), and did not present significant systematic error of measurements (P > 0.05). Adequate agreement between each pair of measurement moments was presented by the Bland-Altman plots according to the limits of agreement and non-significant linear regression models (R 2 = 0.000-0.019; P > 0.05). Conclusions: The proposed procedure to determine skin temperature within the Manual Infrared Camera PCE-TC 30 thermography device presented excellent intra- and inter-session reliability and repeatability in athletes' triceps surae muscle tissue. Future studies should consider the SEM and MDC of this procedure to measure the skin temperature of soleus, medial, and lateral gastrocnemius muscles to promote triceps surae muscle prevention and recovery in athletes.

Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort.

It is not known whether sequential outpatient parenteral antimicrobial (OPAT) is as safe and effective as conventional hospitalization in patients with S. aureus bacteremia (SAB). A post-hoc analysis of the comparative effectiveness of conventional hospitalization versus sequential OPAT was performed in two prospective Spanish cohorts of patients with S. aureus bacteremia. The PROBAC cohort is a national, multicenter, prospective observational cohort of patients diagnosed in 22 Spanish hospitals between October 2016 and March 2017. The DOMUS OPAT cohort is a prospective observational cohort including patients from two university hospitals in Seville, Spain from 2012 to 2021. Multivariate regression was performed, including a propensity score (PS) for receiving OPAT, stratified analysis according to PS quartiles, and matched pair analyses based on PS. Four hundred and thirteen patients were included in the analysis: 150 in sequential OPAT and 263 in the full hospitalization therapy group. In multivariate analysis, including PS and center effect as covariates, 60-day treatment failure was lower in the OPAT group than in the full hospitalization group (p < 0.001; OR 0.275, 95%CI 0.129−0.584). In the PS-based matched analyses, sequential treatment under OPAT was not associated with higher 60-day treatment failure (p = 0.253; adjusted OR 0.660; % CI 0.324−1.345). OPAT is a safe and effective alternative to conventional in-patient therapy for completion of treatment in well-selected patients with SAB, mainly those associated with a low-risk source and without end-stage kidney disease.

Differences in the semantic structure of the speech experienced by late talkers, late bloomers, and typical talkers.

The present study investigates the relation between language environment and language delay in 63 British-English speaking children (19 typical talkers (TT), 22 late talkers (LT), and 22 late bloomers (LB) aged 13 to 18 months. Families audio recorded daily routines and marked the new words their child produced over a period of 6 months. To investigate how language environments differed between talker types and how environments corresponded with children's developing lexicons, we evaluated contextual diversity-a word property that measures semantic richness-and network properties of language environments in tandem with developing vocabularies. The language environment experienced by the three talker types differed in their structural properties, with LT environments being least contextually diverse and least well-connected in relation to network properties. Notably, LBs' language environments were more like those of TTs. Network properties of language environments also correlate with the rate of vocabulary growth over the study period. By comparing differences between language environments and lexical network development, we also observe results consistent with contributions to lexical development from different learning strategies for expressive vocabularies and different environments for receptive vocabularies. We discuss the potential consequences that structural differences in parental speech might have on language development and the contribution of this work to the debate on quantity versus quality. (PsycInfo Database Record (c) 2023 APA, all rights reserved).