Datasets collected during Pacific '93 enable us to construct a three-dimensional view of the atmosphere over the Fraser Valley (southwest British Columbia), and to examine relationships between ...conditions aloft and those in the boundary layer. Herein, vertical and horizontal profiles of the atmosphere obtained from a ground based Doppler lidar are examined in conjunction with data from an airborne downward looking lidar, meteorological soundings of temperature and wind profiles, synoptic charts and surface pressure analyses. These data sets aid understanding of the flow structure at a number of levels through the boundary layer and the spatial and temporal variability of topographically-induced flow.
There are multiple issues that arise when researchers focus on and only report "statistical significance" of study findings. An important element that is often not included in reports is a discussion ...of clinical relevance.
The authors address issues related to significance, the use of effect sizes, confidence or credible intervals, and the inclusion of clinical relevance in reports of research findings.
Measures of magnitude, precision, and relevance such as effect sizes, confidence intervals (CIs), and clinically relevant effects are described in detail. In addition, recommendations for reporting and evaluating effect sizes and CIs are included. Example scenarios are presented to illustrate the interplay of statistical significance and clinical relevance.
There are several issues that may arise when significance is the focus of clinical research reporting. One issue is the lack of attention to nonsignificant findings in published works although findings show clinical relevance. Another issue is that significance is interpreted as clinical relevance. As well, clinically relevant results from small-sample studies are often not considered for publication, and thus, findings might not be available for meta-analysis.
Findings in research reports should address effect sizes and clinical relevance and significance. Failure to publish clinically relevant effects and CIs may preclude the inclusion of clinically relevant studies in systematic reviews and meta-analyses, thereby limiting the advancement of evidence-based practice. Several accessible resources for researchers to generate, report, and evaluate measures of magnitude, precision, and relevance are included in this article.
Sampling distortion product otoacoustic emissions (DPOAEs) at multiple f
2
/f
1
ratios and f
2
frequency values produces a DPOAE "map." This study examined the efficacy of DPOAE mapping compared with ...pure tone audiometry and standard DPOAEs for detecting noise effects in subjects exposed to loud sound.
A map significance score was developed as a single measure of map change. Significance scores were evaluated before and after exposure to: loud music (LM), controlled noise (CN), and firing range noise (FR) in three separate sets of subjects. Scores were compared to audiometry and standard DPOAE results in the LM study.
The LM and CN exposure studies involved 22, and 20 healthy young subjects respectively with normal hearing. Eight Marines were studied before and after FR exposure.
After LM exposure, audiometry showed significant changes at 1, 2, 4, and 6 kHz. Standard DPOAE measures were also significantly different at several frequencies. Map significance scores detected changes more effectively and showed the distribution of DPOAE alterations.
Map significance scores detected changes after noise exposure more reliably than audiometry and standard DPOAEs. Additionally, maps showed a diffuse response to sound exposure perhaps explaining why individual DP-grams appear less sensitive.
Environmental Impacts---Atmospheric Chemistry Simpson, David; Bartnicki, Jerzy; Jalkanen, Jukka-Pekka ...
Second Assessment of Climate Change for the Baltic Sea Basin,
2015
Book Chapter
Open access
This chapter addresses sources and trends of atmospheric pollutants and deposition in relation to the Baltic Sea region. Air pollution is shown to have important effects, including significant ...contributions to nitrogen loading of the Baltic Sea area, ecosystem impacts due to acidifying and eutrophying pollutants and ozone, and human health impacts. Compounds such as sulphate and ozone also have climate impacts. Emission changes have been very significant over the past 100 years, although very different for land-and sea-based sources. Land-based emissions generally peaked around 1980-1990 and have since reduced due to emissions control measures. Emissions from shipping have been steadily increasing for decades, but recent measures have reduced sulphur and particulate emissions. Future developments depend strongly on policy developments. Changes in concentration and deposition of the acidifying components generally follow emission changes within the European area. Mean ozone levels roughly doubled during the twentieth century across the northern hemisphere, but peak levels have reduced in many regions in the past 20 years. The main changes in air pollution in the Baltic Sea region are due to changes in emissions rather than to climate change.
Nirmatrelvir/ritonavir (N/R) reduces severe outcomes from coronavirus disease 2019 (COVID-19); however, rebound after treatment has been reported. We compared symptom and viral dynamics in ...individuals with COVID-19 who completed N/R treatment and similar untreated individuals.
We identified symptomatic participants who tested severe acute respiratory syndrome coronavirus 2-positive and were N/R eligible from a COVID-19 household transmission study. Index cases from ambulatory settings and their households contacts were enrolled. We collected daily symptoms, medication use, and respiratory specimens for quantitative polymerase chain reaction for 10 days during March 2022-May 2023. Participants who completed N/R treatment (treated) were propensity score matched to untreated participants. We compared symptom rebound, viral load (VL) rebound, average daily symptoms, and average daily VL by treatment status measured after N/R treatment completion or 7 days after symptom onset if untreated.
Treated (n = 130) and untreated participants (n = 241) had similar baseline characteristics. After treatment completion, treated participants had greater occurrence of symptom rebound (32% vs 20%; P = .009) and VL rebound (27% vs 7%; P < .001). Average daily symptoms were lower among treated participants without symptom rebound (1.0 vs 1.6; P < .01) but not statistically lower with symptom rebound (3.0 vs 3.4; P = .5). Treated participants had lower average daily VLs without VL rebound (0.9 vs 2.6; P < .01) but not statistically lower with VL rebound (4.8 vs 5.1; P = .7).
Individuals who completed N/R treatment experienced fewer symptoms and lower VL but rebound occured more often compared with untreated individuals. Providers should prescribe N/R, when indicated, and communicate rebound risk to patients.
The advent of intra-arterial neurothrombectomy (IAT) for acute ischemic stroke opens a potentially transformative opportunity to improve neuroprotection studies. Combining a putative neuroprotectant ...with recanalization could produce more powerful trials but could introduce heterogeneity and adverse event possibilities. We sought to demonstrate feasibility of IAT in neuroprotectant trials by defining IAT selection criteria for an ongoing neuroprotectant clinical trial.
The study drug, 3K3A-APC, is a pleiotropic cytoprotectant and may reduce thrombolysis-associated hemorrhage. The NeuroNEXT trial NN104 (RHAPSODY) is designed to establish a maximally tolerated dose of 3K3A-APC. Each trial site provided their IAT selection criteria. An expert panel reviewed site criteria and published evidence. Finally, the trial leadership designed IAT selection criteria.
Derived selection criteria reflected consistency among the sites and comparability to published IAT trials. A protocol amendment allowing IAT (and relaxed age, National Institutes of Health Stroke Scale, and time limits) in the RHAPSODY trial was implemented on June 15, 2015. Recruitment before and after the amendment improved from 8 enrolled patients (601 screened, 1.3%) to 51 patients (821 screened, 6.2%; odds ratio 95% confidence limit of 4.9 2.3-10.4; P<0.001). Gross recruitment was 0.11 patients per site month versus 0.43 patients per site per month, respectively, before and after the amendment.
It is feasible to include IAT in a neuroprotectant trial for acute ischemic stroke. Criteria are presented for including such patients in a manner that is consistent with published evidence for IAT while still preserving the ability to test the role of the putative neuroprotectant.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT02222714.
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