Given a passage classify if the passage has a definite objective/aim/goal or not. Output '1' if the passage has a defininte objective/aim/goal and output '0' if the passage does not have a definite objective/aim/goal.

Q: Lack of insurance is associated with suboptimal receipt of diabetes preventive care. One known reason for this is an access barrier to obtaining healthcare visits; however, little is known about whether insurance status is associated with differential rates of receipt of diabetes care during visits.', 'To examine the association between health insurance and receipt of diabetes preventive care during an office visit.', 'This retrospective cohort study used electronic health record and Medicaid data from 38 Oregon community health centers. Logistic regression was used to test the association between insurance and receipt of four diabetes services during an office visit among patients who were continuously uninsured (n=1,117); continuously insured (n=1,466); and discontinuously insured (n=336) in 2006-2007. Generalized estimating equations were used to account for within-patient correlation. Data were analyzed in 2013.', 'Overall, continuously uninsured patients had lower odds of receiving services at visits when due, compared to those who were continuously insured (AOR=0.73, 95% CI=0.66, 0.80). Among the discontinuously insured, being uninsured at a visit was associated with lower odds of receipt of services due at that visit (AOR=0.77, 95% CI=0.64, 0.92) than being insured at a visit.

A: 1
****
Q: Inflammation triggered by infection or injury is tightly controlled by glucocorticoid hormones which signal via a dedicated transcription factor, the Glucocorticoid Receptor (GR), to regulate hundreds of genes. However, the hierarchy of transcriptional responses to GR activation and the molecular basis of their oftentimes non-linear dynamics are not understood.', 'We investigated early glucocorticoid-driven transcriptional events in macrophages, a cell type highly responsive to both pro- and anti-inflammatory stimuli. Using whole transcriptome analyses in resting and acutely lipopolysaccharide (LPS)-stimulated macrophages, we show that early GR target genes form dense networks with the majority of control nodes represented by transcription factors. The expression dynamics of several glucocorticoid-responsive genes are consistent with feed forward loops (FFL) and coincide with rapid GR recruitment. Notably, GR binding sites in genes encoding members of the KLF transcription factor family colocalize with KLF binding sites. Moreover, our gene expression, transcription factor binding and computational data are consistent with the existence of the GR-KLF9-KLF2 incoherent FFL. Analysis of LPS-downregulated genes revealed striking enrichment in multimerized Zn-fingers- and KRAB domain-containing proteins known to bind nucleic acids and repress transcription by propagating heterochromatin. This raises an intriguing possibility that an increase in chromatin accessibility in inflammatory macrophages results from broad downregulation of negative chromatin remodelers.

A: 0
****
Q: Behavioral measures of cochlear implant (CI) device stimulation levels can be difficult to obtain in individuals with limited or no hearing experience. Loudness measures are particularly challenging. It would therefore be useful to have a battery of objective and behavioral measures to determine CI stimulation levels in listeners with childhood deafness. In the present study, the authors characterized loudness growth in 20 adolescents: 8 with normal hearing and 12 CI participants with pre/perilingual bilateral sensorineural hearing loss. They asked (1) do adolescent CI users with childhood deafness experience similar increases in loudness as their peers with normal hearing? and (2) can loudness be predicted by objective measures of auditory activity? The authors hypothesized that loudness perception would be significantly different between CI and normal-hearing groups and that it would correlate with objective measures.', "CI users were recruited from the Cochlear Implant Program at The Hospital for Sick Children and all had used unilateral Nucleus CIs for at least 2 years. The dynamic range for each participant was defined as the difference between the behavioral threshold and the electrically evoked stapedius reflex (ESR) threshold. Loudness growth was assessed within this range behaviorally on a continuous visual scale and objectively with physiological measures. Auditory brainstem responses (ABRs) and ESRs were recorded in both groups and electrically evoked compound action potentials (ECAPs) of the auditory nerve were recorded in addition in CI listeners. The regression line slopes of ECAP and ABR amplitude growth functions were then calculated and compared with behavioral loudness growth slopes in the upper portion (40-100%) and lower portion (0-40%) of the dynamic range. Electrical pulse stimuli (in CI users) and acoustic clicks (in normal-hearing participants) were presented within each participant's dynamic range.", 'The mean dynamic range in CI listeners was more variable than in normal-hearing individuals. Despite this difference, loudness at the ESR threshold was not significantly different in CI adolescents from their normal-hearing peers, and CI users exhibited normal-like loudness growth. There was a significantly positive correlation between ECAP amplitude growth and loudness growth in CI users in the upper portion of the dynamic range, while ABR wave V amplitude growth was not related to loudness growth in either group.

A:
1
****