Purpose International data demonstrate association between clinical trial participation and reduced cancer mortality. Adolescents and young adults (AYA) have low clinical trial enrollment rates. We established a program to understand local barriers and develop targeted solutions that lead to greater AYA clinical trial participation. Methods A steering committee (SC) with expertise in adult and pediatric oncology, research ethics, and consumer representation was formed. The SC mapped barriers related to AYA trial access and established working groups (WGs) around three themes. Results The Regulatory Awareness WG identified a lack of understanding of processes that support protocol approval for clinical trials across the AYA age range.  https://www.selleckchem.com/products/p22077.html  A guideline to raise awareness was developed. The Access WG identified challenges for young adults (18-25 years) to access a pediatric hospital to enroll in a pediatric trial. A procedure was developed to streamline applications for access. The first six applications using this procedure have been successful. The Availability WG identified lack of pediatric-adult oncology reciprocal relationships as a barrier to awareness of open trials, and future collaboration. An AYA Craft Group Framework was established to grow relationships within tumor streams across institutions; two craft groups are now operating locally. An additional achievement was a successful request to the Therapeutic Goods Administration for Australian adoption of the Food and Drug Administration Guidance on Considerations for the Inclusion of Adolescent Patients in Adult Oncology Clinical Trials. Conclusion This multipronged approach to improving AYA clinical trial access has relevance for other health environments. Our knowledge products are available as an online toolkit.Background Breastfeeding is beneficial for both mothers and infants. Unfortunately, some infants are not breastfed for the recommended duration of time. Previous studies have identified several demographic, socioeconomic, biological, and behavioral factors that impact breastfeeding practices. Studies examining the influence of electronic nicotine delivery systems (ENDS) on breastfeeding practices are currently lacking. Materials and Methods This population-based, cross-sectional study used data from the 2016-2018 Pregnancy Risk Assessment and Monitoring System (n = 42,827). Chi-squared tests and multivariable logistic regression analyses were performed. Results The prevalence of prenatal ENDS use was 0.9%. Only 40.8% of women who used ENDS during pregnancy breastfed for at least 3 months compared with 68.5% of women who did not use ENDS during pregnancy. In the multivariable model, the odds of breastfeeding for at least 3 months were significantly lower in women who used ENDS during pregnancy compared with those who did not use ENDS; odds ratio (95% confidence interval) 0.63 (0.44-0.89; p = 0.010). Conclusion Prenatal exposure to ENDS is negatively associated with breastfeeding duration, independent of potential confounders. This finding suggests that screening for ENDS use during pregnancy can play a vital role in identifying women at-risk for suboptimal breastfeeding and offering ongoing support to improve breastfeeding practices.Background The emergence and wide global spread of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates are of great concern, and the aim of this study was to investigate drug resistance, molecular epidemiology, and genetic relationship of CRKP isolates from patients in Shanghai, China. Methods A retrospective study was conducted from April 2018 to July 2019, and a total of 133 CRKP isolates were collected. Antimicrobial susceptibility was determined by VITEK-2 automated microbiology analyzer platform (bioMérieux, France) and the broth microdilution method. Polymerase chain reaction assays were used to investigate the presence of drug resistance genes. A modified carbapenem inactivation method was performed to detect carbapenemases. Multilocus sequence typing and pulsed-field gel electrophoresis (PFGE) were conducted for genetic relatedness of 50 CRKP isolates selected. Results Among 670 isolates of K. pneumoniae, 133 (19.9%) strains were identified as CRKP, of which, 76.7% (102/133) strains were isolatpt for one strain collected in one outpatient. Conclusion The KPC-2-producing K. pneumoniae belonged to ST11 was widely disseminated in ICUs, and active and effective surveillance of infection control strategies was initiated to limit the spread of CRKP strains.Purpose The study examined psychologically meaningful language dimensions (i.e., social and emotional dimensions, health dimensions, and personal concerns) within online consumer reviews on hearing health care services using an automated textual analysis approach. Method Nine thousand six hundred twenty-two consumer reviews of hearing health care services, including an open-ended question (i.e., free text response to the prompt "share details of your own experience at this place") and an overall rating (on a 5-point scale ranging from "very good" to "very poor") were extracted from Google.com from 40 different cities across the United States. In addition, some metadata about the cities (i.e., region, population size, median age, percentage of older adults) were also recorded. Text responses were analyzed using the automated Linguistic Inquiry and Word Count software for selected language dimensions. The language dimensions of online hearing health care reviews were descriptively compared with language dimensiey rate their health care experiences. Automated linguistic analysis of consumer reviews appears helpful in identifying gaps in service delivery that may influence consumer experience.Purpose We examined how consonant perception is affected by a preceding speech carrier simulated in the same or a different room, for different classes of consonants. Carrier room, carrier length, and carrier length/target room uncertainty were manipulated. A phonetic feature analysis tested which phonetic categories are influenced by the manipulations in the acoustic context of the carrier. Method Two experiments were performed, each with nine participants. Targets consisted of 10 or 16 vowel-consonant (VC) syllables presented in one of two strongly reverberant rooms, preceded by a multiple-VC carrier presented in either the same room, a different reverberant room, or an anechoic room. In Experiment 1, the carrier length and the target room randomly varied from trial to trial, whereas in Experiment 2, they were fixed within a block of trials. Results Overall, a consistent carrier provided an advantage for consonant perception compared to inconsistent carriers, whether in anechoic or differently reverberant rooms.