6 research outputs found

    Pyramidal cell types drive functionally distinct cortical activity patterns during decision-making

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    Understanding how cortical circuits generate complex behavior requires investigating the cell types that comprise them. Functional differences across pyramidal neuron (PyN) types have been observed within cortical areas, but it is not known whether these local differences extend throughout the cortex, nor whether additional differences emerge when larger-scale dynamics are considered. We used genetic and retrograde labeling to target pyramidal tract, intratelencephalic and corticostriatal projection neurons and measured their cortex-wide activity. Each PyN type drove unique neural dynamics, both at the local and cortex-wide scales. Cortical activity and optogenetic inactivation during an auditory decision task revealed distinct functional roles. All PyNs in parietal cortex were recruited during perception of the auditory stimulus, but, surprisingly, pyramidal tract neurons had the largest causal role. In frontal cortex, all PyNs were required for accurate choices but showed distinct choice tuning. Our results reveal that rich, cell-type-specific cortical dynamics shape perceptual decisions

    Roxanol Prescription and Administration Practices in a Hospice Homecare Setting

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    Roxanol is a common hospice pain medication that can be prescribed under different regimens with varying doses and schedules. In home care settings, caregivers are not required to record when medication is administered to patients; therefore, little is known about home hospice-prescribed Roxanol regimens and whether specific prescribing practices are associated with actual administration of medication during patients\u27 final days of life. A retrospective review of patient care records of 227 deceased hospice patients who received routine home care between 2007 and 2020 was conducted. The overall amount of Roxanol administered to patients was examined by determining the doses prescribed as well as actual doses administered seven days prior to death and on the day of death. In addition, the extent to which Roxanol was administered based on prescribed regimen (i.e. scheduled, PRN, or combined scheduled plus PRN) and whether prescriptions were written with flexibility (i.e. varied doses, varied times, or varied doses and times) was also examined at both time points. Roxanol was prescribed to a large percentage (60.4%) of patients a week prior to death with even more (86.80%) on the day of death. The dose prescribed and the overall percentage of medication administered increased significantly during the last week of life; however, the overall quantity of Roxanol administered to patients remained relatively low seven days before death (23.40%) and on the day of death (30.68%). The most prevalent regimen prescribed shifted during the last week of life from PRN only (54.79%) to combined PRN/scheduled (57.14%) on the day of death. Nearly half of all prescriptions written contained some variability seven days before death (49.32%) and on the day of death (48.57%), and there was a greater likelihood that prescriptions were written with flexible dosing as opposed to varied time intervals. Administration rates were highest when prescriptions were more structured and did not vary by time or dose. The low overall Roxanol administration rates observed in this study suggest that certain regimens may not result in desired medication usage and that caregivers may need more clarity and guidance regarding when, how often, and how much Roxanol to administer
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