To compare two methods of minimizing cochlear implant artifact in cortical auditory evoked potential (CAEP) recordings.
Two experiments were conducted. In the first, we assessed the use of ...independent component analysis (ICA) as a pre-processing filter. In the second, we explored the use of an optimized differential reference (ODR) for minimizing artifacts.
Both ICA and the ODR can minimize the artifact and allow measurement of CAEP responses.
When using a large number of recording electrodes ICA can be used to minimize the implant artifact. When using a single electrode montage an optimized differential reference is adequate to minimize the artifact.
The use of an optimized differential reference could allow cortical evoked potentials to be used in routine clinical assessment of auditory pathway development in children and adults fit with cochlear implants.
In 2017, Chile decriminalized abortion on three grounds: (i) if the pregnant person's life is at risk, (ii) fetal nonviability, and (iii) rape or incest. This multicase study explores the experiences ...of pregnant people legally entitled to but denied access to legal abortion in Chile.
Through a snowball sampling approach, we recruited adult Chilean residents who sought, were eligible for, and were denied a legal abortion after September 2017. We conducted semistructured interviews with participants to explore their experiences in seeking and being denied legal abortions. We recorded and transcribed the interviews, then coded and analyzed the transcriptions to identify common themes.
We identified four women who met the eligibility criteria. The interviews revealed five common themes in their experiences: (i) disparate levels of social support in accessing abortion, (ii) abundant access barriers, (iii) forced pregnancy, (iv) abortion stigma, and (v) a failure of the law to provide access to abortion.
Although the 2017 law expanded legal access to abortion in Chile, significant barriers remain. Compounded with social stigma, and the socioeconomic disparities in abortion access, pregnant people continue to face insurmountable obstacles in obtaining legal abortions, even when their lives are at risk and the pregnancy is not viable. The state must prioritize equity of access to legal abortions. Future studies should continue to explore the challenges people face accessing legal abortion care to inform strategies to ensure people are able to obtain the quality care that they are legally entitled to.
Until December 2021, the United States Food and Drug Administration impeded abortion access by restricting pharmacists from dispensing mifepristone, one of two drugs used in medication abortion. This ...study aimed to explore pharmacists’ perspectives on dispensing mifepristone.
We conducted semistructured interviews with pharmacists before and after participating in a pilot project where mifepristone was dispensed from their pharmacies. We thematically coded all interview transcripts, then summarized emergent themes related to pharmacists’ support, comfort, experiences, and concerns around dispensing mifepristone.
Between May 2018 and July 2020, we interviewed 29 pharmacists (22 at baseline and 15 at follow-up, with 8 completing both interviews) from 5 pharmacies. At both baseline and follow-up, interviewees strongly supported pharmacists dispensing mifepristone, feeling it would improve quality of care by providing more convenient medication abortion access and streamlined service delivery and take advantage of pharmacists' expertise and availability. All pharmacists interviewed at follow-up reported dispensing mifepristone except two who were willing but did not have the opportunity. Pharmacists experienced few challenges dispensing mifepristone. Their main concern was perceived discomfort that other pharmacists and pharmacy staff may experience, particularly in conservative areas or small pharmacies where pharmacists’ refusal to dispense mifepristone could impede abortion access.
Most pharmacists supported dispensing mifepristone and were comfortable doing so after education on mifepristone and medication abortion. They dispensed mifepristone without difficulty, in a similar process as dispensing other medications. With the recent removal of U.S. Food and Drug Administration restrictions prohibiting it, our findings support the feasibility of pharmacists dispensing mifepristone.
Soil water repellency, infiltration, and fire severity were evaluated at 235 locations within a sagebrush-steppe ecosystem in southern Idaho, USA, after a 78,000ha wildfire. Fire frequency in the ...sagebrush-steppe has increased dramatically in the last century due to the proliferation of introduced annual weeds. Wildfire in shrub-steppe can increase runoff and erosion by decreasing vegetation cover and increasing soil hydrophobicity. Soil water repellency was measured with the water drop penetration time (WDPT) test and relative infiltration rates were measured by the mini-disc infiltrometer (MDI). Shrub-dominated locations showed highest water repellency in areas of moderate fire severity and infiltration rate was inversely related to distance from individual sagebrush plants. Highest water repellency in grass-dominated areas was also associated with moderate fire severity. Likewise, the lowest relative mean infiltration rates occurred in shrub-dominated or grass-dominated areas of moderate fire severity. These findings indicate that land management strategies should be targeted towards moderate fire severity areas.
Previous analyses of cosmic rays above 4
×
10
19 eV observed by the AGASA experiment have suggested that their arrival directions may be clustered. However, estimates of the chance probability of ...this clustering signal vary from 10
−2 to 10
−6 and beyond. It is essential that the strength of this evidence be well understood in order to compare it with anisotropy studies in other cosmic ray experiments. We apply two methods for extracting a meaningful significance from this data set: one can scan for the cuts which optimize the clustering signal, using simulations to determine the appropriate statistical penalty for the scan. This analysis finds a chance probability of about 0.3%. Alternatively, one can optimize the cuts with a first set of data, and then apply them to the remaining data directly without statistical penalty. One can extend the statistical power of this test by considering cross-correlation between the initial data and the remaining data, as long as the initial clustering signal is not included. While the scan is more useful in general, in the present case only splitting the data set offers an unbiased test of the clustering hypothesis. Using this test we find that the AGASA data is consistent at the 8% level with the null hypothesis of isotropically distributed arrival directions.
The High Resolution Fly's Eye (HiRes) experiment has observed the Greisen-Zatsepin-Kuzmin suppression (called the GZK cutoff) with a statistical significance of five standard deviations. HiRes' ...measurement of the flux of ultrahigh energy cosmic rays shows a sharp suppression at an energy of 6 x 10(19) eV, consistent with the expected cutoff energy. We observe the ankle of the cosmic-ray energy spectrum as well, at an energy of 4 x 10(18) eV. We describe the experiment, data collection, and analysis and estimate the systematic uncertainties. The results are presented and the calculation of the statistical significance of our observation is described.
The U.S. Food and Drug Administration (FDA) restricts dispensing of mifepristone for medication abortion to certified health care providers at clinical facilities, thus prohibiting pharmacist ...dispensing. Allowing mifepristone dispensing by pharmacists could improve access to medication abortion.
To assess the feasibility of pharmacists dispensing mifepristone to patients who have undergone evaluation for eligibility and counseling for medication abortion by a clinician.
Before providing a study training on medication abortion, we administered baseline surveys to pharmacists who participated in a multisite mifepristone-dispensing intervention. The survey assessed medication abortion knowledge—using a 15-item score—and perceptions about the benefits and challenges of the model. We administered follow-up surveys in the study’s final month that also assessed the pharmacists’ satisfaction and experiences with mifepristone dispensing. To investigate the association of the study intervention with the pharmacists’ knowledge, perceptions, and experiences dispensing mifepristone, we conducted multivariable linear regression analyses using generalized estimating equation models, accounting for clustering by individual.
Among the 72 pharmacists invited from 6 pharmacies, 47 (65%) completed the baseline surveys, and 56 (78%) received training. At the study’s end (mean 18 months later), 43 of the 56 pharmacists who received training (77%) completed the follow-up surveys. At follow-up, 36 (83%) respondents were very or somewhat satisfied with mifepristone dispensing, and 24 (56%) reported experiencing no challenges dispensing mifepristone. Four (6%) of the 72 pharmacists invited objected to participating in mifepristone dispensing. In regression analyses, average knowledge scores, perceived ease of implementation, and level of support for the pharmacist-dispensing model were higher at follow-up (P < 0.001).
Most pharmacists were willing to be trained, dispensed mifepristone with few challenges when given the opportunity, were satisfied with the model, and had higher knowledge levels at follow-up. Our findings support removal of FDA’s restriction on pharmacist dispensing of mifepristone.
We report studies of ultrahigh-energy cosmic-ray composition via analysis of depth of air shower maximum (X(max)), for air shower events collected by the High-Resolution Fly's Eye (HiRes) ...observatory. The HiRes data are consistent with a constant elongation rate d<X(max)>/dlog(E) of 47.9+/-6.0(stat)+/-3.2(syst) g/cm2/decade for energies between 1.6 and 63 EeV, and are consistent with a predominantly protonic composition of cosmic rays when interpreted via the QGSJET01 and QGSJET-II high-energy hadronic interaction models. These measurements constrain models in which the galactic-to-extragalactic transition is the cause of the energy spectrum ankle at 4x10(18) eV.
Successful conservation in the United States relies on collective stewardship by millions of private landowners, challenging those agencies and nongovernment organizations tasked with engagement and ...outreach. Perennially limited resources compound this challenge, highlighting a deep need for efficient social marketing. In the following research, we test the efficacy of two social marketing strategies—microtargeting and normative appeals—through a randomized controlled trial of an integrated social marketing campaign targeting riparian landowners in the Pennsylvania portion of the Chesapeake Bay Watershed. We used a microtargeting algorithm to predict landowners’ likelihood of responding to a conservation outreach campaign to create treatment groups of high-likelihood prospects versus random prospects (i.e., no microtargeting). A normative appeal was also included as an experimental factor in the campaign communicating that forested riparian buffer investments were common among similar landowners. Among microtargeted landowners, we observed a 66% increase in response to a riparian restoration survey compared to the control group. Additionally, we found a significant influence of a normative message among random (nonmicrotargeted) prospects, increasing response by 23% over the control group. We conclude conservation outcomes may be more efficiently achieved by deploying these marketing techniques on a wider scale to a variety of conservation challenges.
Pancreatic cancer (pcc) is one of the most lethal types of cancer, and surgery remains the optimal treatment modality for patients with resectable tumours. The objective of the present study was to ...examine and compare trends in the survival rate based on treatment modality in patients with pcc.
This population-based retrospective analysis included all patients with known-stage pcc in Ontario between 2007 and 2015. Flexible parametric models were used to conduct the survival analysis. Survival rates were calculated based on treatment modality, while adjusting for patient- and tumour-specific covariates.
The study included 6437 patients. We found no noticeable improvement in survival for patients with stage iii or iv tumours; however, for stage i disease, the 1-, 2-, and 5-year survival rates increased over time to 81% from 51%, to 71% from 35%, and to 61% from 22% respectively. Most improvements were seen for surgical modalities, with 2-year survivals increasing to 89% from 65% for distal pancreatectomy (dp) without radiation (rt) or chemotherapy (ctx), to 65% from 37% for dp plus rt or ctx, to 60% from 44% for Whipple-only, and to 50% from 36% for Whipple plus rt or ctx. Lastly, 5-year survival improved to 81% from 52% for dp only, to 41% from 12% for dp plus rt or ctx, to 49% from 25% for Whipple-only, and to 26% from 12% for Whipple plus rt or ctx.
Most cases of pcc continue to be diagnosed at a late stage, with poor short-term and long-term prognoses. After adjustment for patient age, sex, and year of diagnosis, the survival for stage i tumours and for surgical modalities increased over time. Further research is needed to identify the reasons for improvement in survival during the study period.
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