Scope of COVID-19 Funding Cuts Emerges as Debt Limit Flashpoint

Roll Call | By Aidan Quigley
 
Veterans health care funding clawback becomes a top Democratic talking point; GOP denies plan to cut benefits
 
​Democrats are jumping on the House GOP plan to recoup unspent pandemic aid in their debt limit bill, charging that the move will harm agencies counting on that funding, including the Department of Veterans Affairs. 
 
The bill, which Speaker Kevin McCarthy, R-Calif., is hoping to get on the floor this week, would rescind $72 billion in unobligated pandemic relief aid.
 
A new analysis compiled by House Appropriations Committee Democrats tallied up the major sources of untapped COVID-19 cash.
 
Nearly $17 billion is sitting in Department of Health and Human Services coffers for things like research and testing of vaccines and therapeutics, payments to hospitals and nursing homes, and genomic sequencing of COVID-19 samples to identify variants. Almost $6 billion would come out of unspent Transportation Department funds for highway, aviation and transit agencies.
 
“Rescinding this funding would eliminate critical resources for mayors and governors to keep their airports open, trains running, and buses operating to get their essential workers to and from their jobs to keep our economy and people alive,” the Democrats' memo states. 
 
But few issues carry the political resonance as potential cuts to veterans benefits, and Democrats have been aiming their fire particularly at over $2 billion sitting in VA health accounts that the debt limit bill would cancel.
 
Rescinding that money would “dramatically limit the ability for VA to provide healthcare services both within and outside of VA by clawing back needed funding for medical care,” according to the Democrats' memo.
 
“I do not understand what my House Republican colleagues are doing, and I am not sure they do either,” House Appropriations ranking member Rosa DeLauro, D-Conn., said in a statement.
 
Rep. Marie Gluesenkamp Perez, D-Wash., introduced an amendment to the debt limit bill Tuesday that would exempt VA funds from the rescission. Under her amendment, the funding would remain available through September 2024.
 
Perez is a freshman who flipped a GOP-held seat last November, winning the heavily contested race by less than 1 percentage point in a district former President Donald Trump carried by about 4 points two years earlier. Inside Elections with Nathan L. Gonzales rates her 2024 reelection bid a "Toss-up."
 
Republicans, however, see recouping the money as a layup opportunity to cut spending.
 
House Appropriations Chairwoman Kay Granger, R-Texas, said during the Rules Committee’s consideration of the debt limit bill that the pandemic spending is not needed and should be directed to other priorities.
 
“Now that the national emergency is officially over, we should be able to take back those resources,” Granger said.
 
'Serious questions'
 
Republicans are pushing back, vowing that veterans health care will be protected in the appropriations process despite the bill’s tight spending caps. They say they already had concerns about the VA’s handling of remaining pandemic funds, which were appropriated in 2020 and 2021. 
 
House Republicans “have serious questions about VA’s spending of this money in the first place,” House Veterans’ Affairs GOP spokeswoman Kathleen McCarthy said. . .

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Using Intelligent Neuroprostheses to Treat Motor Disorders

By University of Montreal

Scientists have long studied neurostimulation to treat paralysis and sensory deficits caused by strokes and spinal cord injuries, which in Canada affect some 380,000 people across the country.

A new study published in the journal Cell Reports Medicine demonstrates the possibility of autonomously optimizing the stimulation parameters of prostheses implanted in the brains of animals, without human intervention.

The work was done at Université de Montréal by neuroscience professors Marco Bonizzato, Numa Dancause and Marina Martinez, in collaboration with mathematics professor and Mila researcher Guillaume Lajoie.

The study grew out of an important interdisciplinary collaboration between researchers who combine expertise in neuroscience and artificial intelligence, two fields of expertise in which the UdeM stands out internationally.

'A very promising phase'

"Neuroprostheses—devices designed to restore connections between neurons following a loss of motor function—are entering a very promising phase of their development," said Lajoie. "We are demonstrating the benefits obtained by autonomously optimizing their parameters."

If the performance of these prostheses has increased, it's thanks to the autonomous learning algorithms put forward by the researchers, added Bonizzato. "Optimization algorithms allow us to design very refined neurostimulation protocols and personalize treatments according to the condition of each patient."

For his part, Dancause believes that although "there are several ways of stimulating the brain, the contribution of artificial intelligence is essential to make the most of the data collected and anticipate conditions that do not yet exist."

With these technological advances, scientists are closer to finding new neuroprosthetic solutions to improve the treatment of pathologies such as spinal cord injuries and strokes, or deep brain stimulation through neuromodulation to treat conditions such as Parkinson's disease.

 

The Potential Risks of ChatGPT and Other Generative AI

JDSpura | By Baker Hostetler

Shall we play a game?” Those innocuous words “spoken” by Matthew Broderick’s computer in John Badham’s sci-fi techno-thriller War Games stunned audiences at the time. A computer that could “talk” and “think” and engage in conversation?!? This was the height of science fiction. Well, with the recent release of generative artificial intelligence (AI) tools, specifically in the form of ChatGPT and other predictive natural language processing (NLP) algorithms, science fiction has once again become reality.

Companies from Microsoft to Google and Instacart to Kayak have begun to incorporate and build upon this technology, originally developed by OpenAI. These tools can be incredibly beneficial to businesses, but they also carry risks.

Before we dive in to how generative AI can assist brands and companies, let’s first peel back the layers and understand – at a basic level – what ChatGPT is.

ChatGPT stands for Chat Generative Pre-trained Transformer. Let’s break that down:

  • Chat refers to the interface that allows for interaction with the model using natural language prompts.
  • Generative refers to a category of AI model that produces new output based on a given input. In practice this means that the “input” of a user query can generate the “output” of text, images, and audio answers.
  • Pre-trained refers to the fact that the model has already been trained on a vast data set to teach it to predict the next word in a given sequence.
  • Transformer refers to the architecture of the neural network (machine learning algorithms) upon which ChatGPT is based. It is this architecture that allows the computer to process natural language.

Importantly, ChatGPT and other generative AI are not omniscient; they cannot think, understand, or feel. They are merely software – lines of computer code – programmed to generate natural language replies in response to text and image prompts. They work by predicting the next word in a given text string based on patterns “learned” from the data on which they have been trained.

In late March, OpenAI released an API (application programming interface) to select businesses to allow them to incorporate the AI technology into their own websites and apps via plugins. Using these plugins, brands have been able to harness the power of ChatGPT to help consumers book travelmake restaurant reservations, and create curated product recommendations.

Currently, the ChatGPT plugins have been tasked with relatively basic functions – essentially providing high-level search tools in the form of an interactive chatbot. See, for example, the video Expedia released on Twitter to show how its ChatGPT plugin operates.

Brands have also begun to use generative AI tools to help with:

  • Coding – generating and building source code and analyzing mistakes within the code
  • Content Creation – generating blog posts, social media posts, targeted email campaigns and video scripts
  • Data Analysis – analyzing large data sets and synthesizing the information into easily digestible bullet points
  • Market Research – generating a list of key players in any industry along with products and services
  • Product Descriptions – generating bulk descriptions for e-commerce sites where product catalogs are frequently updated
  • Search Engine Optimization (SEO) – generating copy that includes keywords and meta descriptions that search engines can look for when ranking pages

ChatGPT and other generative AI tools come with risks, and any business use of them should be done carefully and cautiously.

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Physical Therapists Use Different Motivational Strategies for Stroke Rehabilitation Tailored to an Individual’s Condition: A Qualitative Study 

Physical Therapy & Rehabilitation Journal | ByKazuaki Oyake, PT, PhD, Keita Sue, PT, MSc, Motofumi Sumiya, PhD, Satoshi Tanaka, PhD

Abstract

Objective
Various strategies are used to motivate individuals with stroke during rehabilitation. However, how physical therapists select the motivational strategies that they use for each individual is yet to be established. Therefore, this study aimed to explore how physical therapists use different motivational strategies for individuals in stroke rehabilitation programs.

Methods
A criterion sample of 15 physical therapists who have worked in rehabilitation for over 10 years and were interested in an individual’s motivation participated in one-on-one semi-structured online interviews. The interviews explored their perspectives and experiences regarding the motivational strategies used depending on each individual’s condition. The collected data were analyzed with thematic analysis.

Results
A total of 9 themes emerged from the data upon thematic analysis and inductive coding. Participants used different strategies to encourage individuals’ active participation in physical therapy depending on (1) their mental health, (2) their physical difficulties, (3) their level of cognitive function, (4) their personality, (5) their activities and participation, (6) their age, (7) their human environment, and (8) the type of rehabilitation service where the individual underwent treatment. For example, in cases where an individual lost self-confidence, participants offered practice tasks that the individual could achieve with little effort to make them experience success. The interviews also revealed (9) motivational strategies used regardless of the individual’s condition. For instance, patient-centered communication was used to build rapport with individuals, irrespective of their condition.

Conclusions
This qualitative study suggests that physical therapists use different strategies depending on the individual’s mental health conditions, physical problems, level of cognitive function, personality, activities and participation, age, human environment, and the type of rehabilitation service where the individual undergoes treatment to motivate individuals with stroke during physical therapy.

Impact
The findings of this study can provide experience-based recommendations regarding the selection of motivational strategies for stroke rehabilitation.

 

Global Prevalence of Musculoskeletal Disorders Among Physiotherapists: a Systematic Review and Meta-Analysis

BMC Musculoskeletal Disorders | By Philippe Gorce & Julien Jacquier-Bret

Abstract

Background
Musculoskeletal disorders (MSD) are one of the most important problems among physiotherapists worldwide. However, there is no meta-analysis of the MSD prevalence in all body areas among physiotherapists.

Objectives
The purpose was to investigate and estimate the worldwide prevalence of MSD among physiotherapists using a systematic review-, meta-analysis and meta-regression.

Methods
The systematic review, meta-analysis and meta-regression were performed in 2022 using the PRISMA guidelines.

Data sources
The search was performed on PubMed/Medline, ScienceDirect, Google Scholar, Medeley and Science.gov databases.

Study appraisal
The quality appraisal of the included articles was assessed using the critical appraisal tool for cross-sectional studies AXIS.

Results
A total of 722 articles were found. After screening and comparison with the inclusion criteria, 26 studies were retained. Based on the random-effects model, the worldwide MSD prevalence in neck, upper back, mid back, lower back, shoulders, elbows, wrists/hands, thumb, hips/thighs, knees/legs, and ankles/feet was 26.4% (CI 95%: 21.0–31.9%), 17.7% (CI 95%: 13.2–22.2%), 14.9% (CI 95%: 7.7–22.1%), 40.1% (CI 95%: 32.2–48.0%), 20.8% (CI 95%: 16.5–25.1), 7.0% (CI 95%: 5.2–8.9), 18.1% (CI 95%: 14.7–21.5%), 35.4% (CI 95%: 23.0–47.8), 7.0% (CI 95%: 5.2–8.8), 13.0% (CI 95%: 10.3–15.8), and 5% (CI 95%: 4.0–6.9) respectively. The neck and shoulder prevalence of four continents were close to the world prevalence. No effect of continent was found on MSD prevalence. The heterogeneity of the results obtained in the meta-analysis and meta-regression was discussed.

Conclusions
Based on the random effects model, the results of the worldwide meta-analysis showed that lower back pain, thumb, neck and shoulder were the area most at risk for MSD and were therefore those to be monitored as a priority. Recommendations were proposed for future reviews and meta-analyses.

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