Medication Abortion: A Sample Protocol for Increasing Access During a Pandemic and Beyond

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Precision and neuronal dynamics in the human posterior parietal cortex during evidence accumulation

Primate studies show slow ramping activity in posterior parietal cortex (PPC) neurons during perceptual decision-making. These findings have inspired a rich theoretical literature to account for this activity. These accounts are largely unrelated to Bayesian theories of perception and predictive coding, a related formulation of perceptual inference in the cortical hierarchy. Here, we tested a key prediction of such hierarchical inference, namely that the estimated precision (reliability) of information ascending the cortical hierarchy plays a key role in determining both the speed of decision-making and the rate of increase of PPC activity. Using dynamic causal modelling of magnetoencephalographic (MEG) evoked responses, recorded during a simple perceptual decision-making task, we recover ramping-activity from an anatomically and functionally plausible network of regions, including early visual cortex, the middle temporal area (MT) and PPC. Precision, as reflected by the gain on pyramidal cell activity, was strongly correlated with both the speed of decision making and the slope of PPC ramping activity. Our findings indicate that the dynamics of neuronal activity in the human PPC during perceptual decision-making recapitulate those observed in the macaque, and in so doing we link observations from primate electrophysiology and human choice behaviour. Moreover, the synaptic gain control modulating these dynamics is consistent with predictive coding formulations of evidence accumulation

Cannabis-induced hypodopaminergic anhedonia and cognitive decline in humans: Embracing putative induction of dopamine homeostasis

Over years, the regular use of cannabis has substantially increased among young adults, as indicated by the rise in cannabis use disorder (CUD), with an estimated prevalence of 8. 3% in the United States. Research shows that exposure to cannabis is associated with hypodopaminergic anhedonia (depression), cognitive decline, poor memory, inattention, impaired learning performance, reduced dopamine brain response-associated emotionality, and increased addiction severity in young adults. The addiction medicine community is increasing concern because of the high content of delta-9-tetrahydrocannabinol (THC) currently found in oral and vaping cannabis products, the cognitive effects of cannabis may become more pronounced in young adults who use these cannabis products. Preliminary research suggests that it is possible to induce \u27dopamine homeostasis,\u27 that is, restore dopamine function with dopamine upregulation with the proposed compound and normalize behavior in chronic cannabis users with cannabis-induced hypodopaminergic anhedonia (depression) and cognitive decline. This psychological, neurobiological, anatomical, genetic, and epigenetic research also could provide evidence to use for the development of an appropriate policy regarding the decriminalization of cannabis for recreational use

A review of DNA risk alleles to determine epigenetic repair of mRNA expression to prove therapeutic effectiveness in reward deficiency syndrome (RDS): Embracing Precision Behavioral Management

This is a review of research on Precision Behavioral Management of substance use disorder (SUD). America is experiencing a high prevalence of substance use disorder, primarily involving legal and illegal opioid use. A 3000% increase in treatment for substance abuse has occurred between 2000 and 2016. Unfortunately, present day treatment of opioid abuse involves providing replacement therapy with powerful opioids to, at best, induce harm reduction, not prophylaxis. These interventions do not enhance gene expression and restore the balance of the brain reward system\u27s neurotransmitters. We are proposing a generalized approach called Precision Behavioral Management . This approach includes 1) using the Genetic Addiction Risk Severity (GARS, a 10 candidate polymorphic gene panel shown to predict ASI-alcohol and drug severity) to assess early pre-disposition to substance use disorder; 2) using a validated reward deficiency syndrome (RDS) questionnaire; 3) utilization of the Comprehensive Analysis of Reported Drugs (CARD™) to assess treatment compliance and abstinence from illicit drugs during treatment, and, importantly; 4) utilization of a Pro-dopamine regulator (KB220) (via IV or oral [KB220Z] delivery systems) to optimize gene expression, restore the balance of the Brain Reward Cascade\u27s neurotransmitter systems and prevent relapse by induction of dopamine homeostasis, and; 5) utilization of targeted DNA polymorphic reward genes to direct mRNA genetic expression profiling during the treatment process. Incorporation of these events can be applied to not only the under-considered African-American RDS community, but all victims of RDS, as a demonstration of a paradigm shift that uniquely provides a novel putative standard of care based on DNA guided precision nutrition therapy to induce dopamine homeostasis and rebalance neurotransmitters in the Brain Reward Cascade. We are also developing a Reward Deficiency Syndrome Diagnostic Criteria (RDSDC) to assist in potential tertiary treatment

Self-management of first trimester medical termination of pregnancy: a qualitative study of women's experiences

Objective: To explore the experiences of women in Scotland who return home to complete medical termination of pregnancy (TOP) ≤63 days of gestation, after being administered with mifepristone and misoprostol at an NHS TOP clinic. Design: Qualitative interview study. Setting: One National Health Service health board (administrative) area in Scotland. Population or Sample: Women in Scotland who had undergone medical TOP ≤63 days, and self-managed passing the pregnancy at home; recruited from three clinics in on NHS health board area between January and July 2014. Methods: In-depth, semi-structured interviews with 44 women in Scotland who had recently undergone TOP ≤63 days of gestation, and who returned home to pass the pregnancy. Data were analysed thematically using an approach informed by the Framework method. Main Outcome Measures: Women's experiences of self-management of TOP ≤63 days of gestation. Results: Key themes emerging from the analysis related to self-administration of misoprostol in clinic; reasons for choosing home self-management; facilitation of self-management and expectation-setting; experiences of getting home; self-managing and monitoring treatment progress; support for self-management (in person and remotely); and pregnancy self-testing to confirm completion. Conclusions: Participants primarily found self-administration of misoprostol and home self-management to be acceptable and/or preferable, particularly where this was experienced as a decision made jointly with health professionals. The way in which home self-management is presented to women at clinic requires ongoing attention. Women could benefit from the option of home administration of misoprostol

Assessment of USDA-NRCS Rangeland Conservation Programs: Recommendation for an Evidence-Based Conservation Platform

The Conservation Effects Assessment Project (CEAP) was created in response to a request from the Office of Management and Budget that the U.S. Department of Agriculture, Natural Resource Conservation Service (USDA- NRCS) document the societal benefits anticipated to accrue from a major increase in conservation funding authorized by the 2002 Farm Bill. A comprehensive evaluation of the efficacy of rangeland conservation practices cost- shared with private landowners was unable to evaluate conservation benefits because outcomes were seldom documented. Four interrelated suppositions are presented to examine the causes underlying minimal documentation of conservations outcomes. These suppositions are (1) the benefits of conservation practices are considered a certainty so that documentation in not required, (2) there is minimal knowledge exchange between the USDA- NRCS and research organizations, (3) and a paucity of conservation- relevant science, as well as (4) inadequate technical support for land owners following implementation of conservation practices. We then follow with recommendations to overcome potential barriers to documentation of conservation outcomes identified for each supposition. Collectively, this assessment indicates that the existing conservation practice standards are insufficient to effectively administer large conservation investments on rangelands and that modification of these standards alone will not achieve the goals explicitly stated by CEAP. We recommend that USDA- NRCS modify its conservation programs around a more comprehensive and integrative platform that is capable of implementing evidence- based conservation. Collaborative monitoring organized around landowner–agency–scientist partnerships would represent the focal point of a Conservation Program Assessment Network (CPAN). The primary network objective would be to establish missing information feedback loops between conservation practices and their agricultural and environmental outcomes to promote learning, adaptive management, and innovation. Network information would be archived and made available to guide other, related conservation programs in relevant ecoregions. Restructuring conservation programs as we recommend would (1) provide site specific information, learning, and accountability that has been requested by CEAP and (2) further advance balanced delivery of agricultural production and environmental quality goals

The habitability of Proxima Centauri b I. Irradiation, rotation and volatile inventory from formation to the present

International audienceProxima b is a planet with a minimum mass of 1.3 MEarth orbiting within the habitable zone (HZ) of Proxima Centauri, a very low-mass, active star and the Sun's closest neighbor. Here we investigate a number of factors related to the potential habitability of Proxima b and its ability to maintain liquid water on its surface. We set the stage by estimating the current high-energy irradiance of the planet and show that the planet currently receives 30 times more EUV radiation than Earth and 250 times more X-rays. We compute the time evolution of the star's spectrum, which is essential for modeling the flux received over Proxima b's lifetime. We also show that Proxima b's obliquity is likely null and its spin is either synchronous or in a 3:2 spin-orbit resonance, depending on the planet's eccentricity and level of triaxiality. Next we consider the evolution of Proxima b's water inventory. We use our spectral energy distribution to compute the hydrogen loss from the planet with an improved energy-limited escape formalism. Despite the high level of stellar activity we find that Proxima b is likely to have lost less than an Earth ocean's worth of hydrogen before it reached the HZ 100-200 Myr after its formation. The largest uncertainty in our work is the initial water budget, which is not constrained by planet formation models. We conclude that Proxima b is a viable candidate habitable planet

Multiple and Multidimensional life transitions in the context of life-limiting health conditions:Longitudinal study focussing on perspectives of Young Adults, Families and Professionals

Background: There is a dearth of literature that investigates life transitions of young adults (YAs) with life-limiting conditions, families and professionals. The scant literature that is available has methodological limitations, including not listening to the voice of YAs, collecting data retrospectively, at one time point, from one group’s perspective and single case studies. The aim of this study was to address the gaps found in our literature review and provide a clearer understanding of the multiple and multi-dimensional life transitions experienced by YAs and significant others, over a period of time. Methods: This qualitative study used a longitudinal design and data were collected using semi-structured interviews over a 6-month period at 3 time points. Participants included 12 YAs with life-limiting conditions and their nominated significant others (10 family members and 11 professionals). Data were analysed using a thematic analysis approach. Results: Life transitions of YA and significant others are complex; they experience multiple and multi-dimensional transitions across several domains. The findings challenge the notion that all life transitions are triggered by health transitions of YAs, and has highlighted environmental factors (attitudinal and systemic) that can be changed to facilitate smoother transitions in various aspects of their lives. Conclusions: This study makes a unique and significant contribution to literature. It provides evidence and rich narratives for policy makers and service providers to change policies and practices that are in line with the needs of YAs with life-limiting conditions as they transition to adulthood. Families and professionals have specific training needs that have not yet been met fully

Tracking the Late Jurassic apparent (or true) polar shift in U-Pb-dated kimberlites from cratonic North America (Superior Province of Canada)

Different versions of a composite apparent polar wander (APW) path of variably selected global poles assembled and averaged in North American coordinates using plate reconstructions show either a smooth progression or a large (∼30°) gap in mean paleopoles in the Late Jurassic, between about 160 and 145 Ma. In an effort to further examine this issue, we sampled accessible outcrops/subcrops of kimberlites associated with high-precision U-Pb perovskite ages in the Timiskaming area of Ontario, Canada. The 154.9 ± 1.1 Ma Peddie kimberlite yields a stable normal polarity magnetization that is coaxial within less than 5° of the reverse polarity magnetization of the 157.5 ± 1.2 Ma Triple B kimberlite. The combined ∼156 Ma Triple B and Peddie pole (75.5°N, 189.5°E, A95 = 2.8°) lies about midway between igneous poles from North America nearest in age (169 Ma Moat volcanics and the 146 Ma Ithaca kimberlites), showing that the polar motion was at a relatively steady yet rapid (∼1.5°/Myr) pace. A similar large rapid polar swing has been recognized in the Middle to Late Jurassic APW path for Adria-Africa and Iran-Eurasia, suggesting a major mass redistribution. One possibility is that slab breakoff and subduction reversal along the western margin of the Americas triggered an episode of true polar wander