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Nanomaterials (NMs) characterization by means single particle inductively coupled plasma mass spectrometry (spICP-MS) relies on assessing transport efficiency. To this end, different strategies have been proposed but contradictory reports could be found about which strategy provides the most accurate results since our knowledge about NMs transport through the sample introduction system is still limited. The goal of this work is to evaluate the role of aerosol transport on NMs characterization by means spICP-MS. To this end, a 70 nm platinum nanoparticles (PtNPs) suspension and a 10 ng mL−1 ionic Pt solution were analyzed under different operating conditions. Next, plasma and tertiary aerosol characteristics (i.e., drop size distribution and transport rate of solvent, PtNPs and Pt ions) were checked to explain experimental findings. Our results shows that the number of events, PtNPs event intensity and Pt ionic signal depend on both aerosol transport and plasma operating conditions. Interestingly, tertiary aerosol characterization reveals that NMs, ionic and solvent transport efficiencies differ significantly. Thus, irrespective of the nebulization conditions, transport efficiencies follow the order solvent > ionic Pt > PtNPs. For instance, when operating a nebulizer gas flow of 0.9 L min−1 and a sample uptake rate of 300 μL min−1, transport efficiency values were 5.77 ± 0.03, 3.89 ± 0.12 and 3.35 ± 0.06%, respectively. Similar results were observed operating different metallic NPs (i.e., 50/150 nm AuNPs) and spray chamber designs (i.e., Scott double pass/cyclonic spray chambers). These findings are of fundamental importance for spICP-MS metrology since some strategies for evaluating transport efficiency are based on assuming that the above-mentioned species are transported similarly into the plasma. The method based on the number of events seems the best approach since it is really based on NMs transport into the plasma. Both ionic and NMs pulse intensity ratios and solvent-based methodologies are, however, not based on NMs transport efficiency and, hence, they could lead to inaccurate NMs characterization in terms of particle size and concentration depending on spICP-MS operating conditions. For both approaches, because the dampening effect of cubic root when calculating particle size from transport efficiency, particle size distribution bias was less significant than particle concentration bias. [ABSTRACT FROM AUTHOR]

Context: A growing body of evidence supports over‐the‐counter access to oral contraceptives in the United States. An important consideration for over‐the‐counter approval is consumers' ability to understand key package label messages related to safety and effectiveness without clinician involvement. We developed a prototype over‐the‐counter Drug Facts Label for a combined oral contraceptive pill and conducted a pilot label comprehension study to evaluate consumer understanding of key messages for use. Methods: In November–December 2020, we conducted interviews with 163 adults and teens in the United States who were aged 12–49 years and identified as female or another gender but had a uterus and the ability to become pregnant. We developed 11 primary endpoints based on assessment of clinical risks that could occur if consumers fail to heed them, including messages about contraindications and directions for use; 11 secondary endpoints represented additional important information but with lower potential for clinical consequences if not understood. We evaluated endpoint comprehension by computing frequencies, percentages, and 2‐sided Exact (Clopper‐Pearson) 95% confidence intervals for observed proportions. Results: Ten of the 11 primary endpoints and 10 of the 11 secondary endpoints were each understood by ≥95% of participants. The remaining primary endpoint on use with prior blood clots was understood by 89% of participants. The remaining secondary endpoint on the product being designed for "people who have the ability to become pregnant" was understood by 83% of participants. Conclusion: Participants understood the key label information required for safe and effective combined oral contraceptive use without clinician involvement. [ABSTRACT FROM AUTHOR]

Background: To report our recommended methodology for extracting and then confirming research uncertainties - areas where research has failed to answer a research question - derived from previously published literature during a broad scope Priority Setting Partnership (PSP) with the James Lind Alliance (JLA).Methods: This process was completed in the UK as part of the PSP for "Common Conditions Affecting the Hand and Wrist", comprising of health professionals, patients and carers and reports the data (uncertainty) extraction phase of this. The PSP followed the robust methodology dictated by the JLA and sought to identify knowledge gaps, termed "uncertainties" by the JLA. Published Cochrane Systematic Reviews, Guidelines and Protocols, NICE (National Institute for Health and Care Excellence) Guidelines, and SIGN (Scottish Intercollegiate Guidelines Network) Guidelines were screened for documented "uncertainties". A robust method of screening, internally verifying and then checking uncertainties was adopted. This included independent screening and data extraction by multiple researchers and use of a PRISMA flowchart, alongside steering group consensus processes. Selection of research uncertainties was guided by the scope of the Common Conditions Affecting the Hand and Wrist PSP which focused on "common" hand conditions routinely treated by hand specialists, including hand surgeons and hand therapists limited to identifying questions concerning the results of intervention, and not the basic science or epidemiology behind disease.Results: Of the 2358 records identified (after removal of duplicates) which entered the screening process, 186 records were presented to the PSP steering group for eligibility assessment; 79 were deemed within scope and included for the purpose of research uncertainty extraction (45 full Cochrane Reviews, 18 Cochrane Review protocols, 16 Guidelines). These yielded 89 research uncertainties, which were compared to the stakeholder survey, and added to the longlist where necessary; before derived uncertainties were checked against non-Cochrane published systematic reviews.Conclusions: In carrying out this work, beyond reporting on output of the Common Conditions Affecting the Hand and Wrist PSP, we detail the methodology and processes we hope can inform and facilitate the work of future PSPs and other evidence reviews, especially those with a broader scope beyond a single disease or condition. [ABSTRACT FROM AUTHOR]

Background: The unintended pregnancy rate in the US military is higher than among civilians. While 42% of unintended pregnancies end in abortion among civilian women, there are no data on the prevalence of abortion in the military overall or by service branch.Objective: This analysis was conducted to estimate unintended pregnancy rates and the percentage of unintended pregnancies that resulted in abortion among active-duty US Navy members aged 44 years or younger reporting female gender in 2016.Design: Cross-sectional survey data from the 2016 Navy Pregnancy and Parenthood Survey, collected from August to November 2016.Participants: Our sample included 3,423 active-duty US Navy members aged 44 years or younger reporting female gender, generated from a stratified random sample of 38% of all active-duty Navy women in pay grades E2-E9 and O1-O5 in 2016; the survey had a 20% response rate for females.Main Measures: We calculated pregnancy and unintended pregnancy rates, the percentage of pregnancies that were unintended, and the percentage of unintended pregnancies resulting in birth and abortion in the prior fiscal year.Key Results: Overall, the self-reported unintended pregnancy rate was 52 per 1,000 participants and 38.1% of pregnancies were unintended. The adjusted unintended pregnancy rate accounting for abortion underreporting was 68 per 1,000 participants. Unintended pregnancy rates were highest among individuals who were younger (aged 18-24) and in enlisted pay grades, compared to their counterparts. Six percent reported their unintended pregnancy resulted in abortion. Six respondents reported becoming pregnant while deployed; none of these pregnancies resulted in abortion.Conclusions: In this first study to report on abortion prevalence among US servicemembers, we found the proportion of unintended pregnancies resulting in abortion among a sample of US Navy members in 2016 was much lower than civilians, yet unintended pregnancy rates were higher. [ABSTRACT FROM AUTHOR]

Microwave induced plasma optical emission spectrometry (MIP-OES) has gained widespread attention in the last few years for trace elemental analysis. Among the new generation of MIPs it is worth to mention the microwave-sustained inductively coupled atmospheric-pressure plasma (MICAP) for which previous works have shown similar detection capabilities to those afforded by ICP-OES. Nevertheless, this instrument has not been applied yet to complex matrix sample analysis. Therefore, the goal of this work is to evaluate MICAP-OES performance (e.g., analytical figures of merit, matrix effects, etc.) for elemental analysis of samples of different nature (e.g., environmental, food and polymers). To this end, both spectral and non-spectral interferences were investigated for 19 elements (Ag, Al, As, B, Ca, Cd, Co, Cr, Cu, Fe, Ga, In, Mg, Mn, Ni, Pb, Sr, Tl, Zn) in the presence of inorganic acid, organic and saline solutions and compared to a 5 % w w−1 HNO 3 solution. Unlike previous MIPs, experimental data showed that the optimum nebulizer gas flow rate for a given emission wavelength was mostly independent of matrix characteristics. Regarding matrix effects, this device was highly robust operating both inorganic acid and organic matrices. Interestingly, when operating saline matrices, changes on emission signal by easily ionizable elements were less significant than those early reported by alternative MIP cavities. Moreover, due to MICAP spectrometer design employed allows real-time simultaneous analysis, Rh, Pd, Sc and Y were suitable internal standards to minimize non-spectral interferences. Finally, MICAP-OES can be successfully applied to the elemental analysis of different complex matrix samples (i.e., CRM-DW1 Drinking water; BCR-146 Sewage sludge industrial; BCR-185 Bovine liver; BCR-278R Mussel tissue; NIST-1549 Non-fat milk powder; ERM-EC681k Polyethylene (high level) and BCR-483 Sewage sludge amended soil). [Display omitted] • MICAP-OES is a suitable technique for elemental analysis of complex matrix samples. • A single Q g can be used regardless of wavelength and the sample matrix nature. • Inorganic acid and organic solutions do not cause significant matrix effects. • MICAP-OES is still prone to easily ionizable elements (EIEs) matrix effects. • Real-time simultaneous internal standard can be used to mitigate EIEs matrix effects. [ABSTRACT FROM AUTHOR]

The Tsuji--Trost reaction of allylic acetates with nucleophiles is optimized using a task-specific ionic liquid (TSIL)-palladium complex in a very efficient manner. Several nucleophiles and allylic systems are studied obtaining very high yields of the corresponding products with total n-selectivity. The reaction is surveyed employing inexpensive allylic alcohols and 3-acyloxindole derivatives affording the expected allylated molecules after a deacylative process. The robustness of the catalytic system is assessed. The recovery and recycling of the whole catalytic system with the ionic liquid is also analyzed and the results are compared with previously reported articles in the literature. [ABSTRACT FROM AUTHOR]

We report on optical observations and modeling of HD96670, a single-line spectroscopic binary in the Carina OB2 association. We collected 10 epochs of optical spectroscopy, and optical photometry on 17 nonconsecutive nights on the source. We construct a radial velocity curve from the spectra, and update the orbital period of the binary to be P = 5.28388 ± 0.00046 days. The spectra show oxygen and helium absorption, consistent with an O-type primary. We see no evidence for spectral lines from the secondary star in the binary. We model the optical light curve and radial velocity curve simultaneously using the Wilson–Devinney code and find a best-fit mass of for the primary, and for the secondary. An object of this mass is consistent with either a B-type star, or a black hole. Given that we see no absorption lines from the secondary, in combination with an observed hard power-law X-ray spectrum with Γ = 2.6 detected past 10 keV that may have been produced by wind accretion onto the secondary, we conclude that the secondary is most likely a black hole. We see asymmetrical helium lines with a shape consistent with the presence of a third star. If the secondary is indeed a black hole, this system would add to the small sample of only four possible black hole high mass X-ray binaries in the galaxy. [ABSTRACT FROM AUTHOR]

This work explores, for the first time, the strengths and weaknesses of the Conical torch in ICP-OES operating methanol and 1-propanol solutions ranging from 30% to 100% w w−1. To this end, Conical torch performance has been evaluated considering: (i) plasma fundamental properties; (ii) plasma robustness; (iii) carbon-based background emission; and (iv) analytical figures of merit. For the sake of comparison, a Fassel torch has been employed as a reference. Results show that the discharge for the Conical torch is highly robust and plasma characteristics (i.e., excitation temperature and electron number density) are mostly unaffected by the introduction of pure and hydroalcoholic solutions of methanol and 1-propanol. In contrast, the discharge for the Fassel torch is severely affected by organics introduction and it is not feasible to operate methanol solutions above 30% w w−1. Because torch geometry and improved gas flow patterns, the Conical torch affords higher emission signal (2-fold) than the Fassel torch. Nevertheless, the detection limits for both torches are comparable, which is due to the increase in both (carbon-based) background emission and signal noise for the Conical torch. From these results and considering that the Conical torch requires less r.f. power (35%) and argon consumption (55%) than the Fassel one, it is beyond doubt that the former torch is more advantageous for those applications requiring the analysis of alcohol solutions (i.e. extraction procedures and chromatographic separations). [ABSTRACT FROM AUTHOR]

High-power microwave induced plasma optical emission spectrometry (MIP-OES) constitutes a serious alternative to inductively coupled plasma optical emission spectrometry (ICP-OES) for elemental analysis. To improve the analytical capabilities of MIP-OES, dispersive liquid–liquid microextraction (DLLME) procedures seems to be, a priori, a very promising choice for trace and ultra-trace analysis in complex matrices. Nevertheless, to date, DLLME has never been coupled to MIP-OES. The goal of the present work is to investigate the capability of MIP-OES as a detector in DLLME procedures. To this end, spectral and non-spectral interferences caused by the presence of common DLLME extractants (i.e., chloroform and supramolecular solvent based on 1-decanol and THF) in MIP-OES have been evaluated. Results reveal the occurrence of both spectral and non-spectral interferences due to carbon-based molecular bands emission in MIP-OES. Carbon-based molecular emission (i.e. C2 and CH) significantly affects analyte wavelengths above 328 nm. By the appropriate selection of experimental conditions (i.e. analyte wavelength and nebulizer gas flow rate), both spectral and non-spectral interferences could be mitigated allowing elemental analysis by means of DLLME-MIP-OES. Different DLLME methodologies have been developed for Cd determination in water samples (i.e., tap, sparkling and synthetic seawater) by MIP-OES. These methodologies afford an enrichment factor of 46 and 42 for chloroform and supramolecular-based solvent DLLME procedures, respectively, and a limit of detection (LoD) of 1 μg L−1. This LoD is 100-fold lower than that obtained by conventional MIP-OES (i.e. no DLLME) due to both analyte preconcentration and the beneficial effect of organics on aerosol generation and transport. These analytical figures of merit are equivalent to those previously reported for DLLME-ICP-OES and allows Cd determination in water samples according to current international policies. [ABSTRACT FROM AUTHOR]

Determination of As, Cd and Pb in food samples by means of inductively coupled plasma optical emission spectrometry (ICP-OES) is challenging due to detection limits being close to the maximum levels established by current international food security policies. This work evaluates the benefits and drawbacks of knotted reactor extraction (KR) and dispersive liquid–liquid microextraction (DLLME) for the simultaneous ultratrace determination of the above-mentioned elements by ICP-OES. To this end, ICP-OES experimental conditions were optimized to minimize the negative effects of organics on plasma characteristics. Next, both KR and DLLME were optimized using the experimental design for the simultaneous As, Cd and Pb preconcentration. KR- and DLLME-ICP-OES methods were compared and applied to the analysis of different food samples, representative of the commodities regulated by the EU policy. Results in this work show that both KR and DLLME allow successful toxic element analysis in foods according to current EU policies. Nevertheless, DLLME is a more attractive approach than KR. First, DLLME allows the simultaneous determination of As, Cd and Pb, while KR is just limited to the last two elements, since As-complexes are not efficiently retained within the system. When compared to conventional ICP-OES analysis (i.e., no preconcentration), DLLME improves limits of detection (LOD) on average by 40-fold for As, Cd and Pb, whereas KR improves it by just 10-fold. For both methodologies, LOD improvement is derived from the preconcentration procedure as well as the beneficial effect of organics on aerosol generation and transport to the plasma compared to aqueous samples. Finally, DLLME affords higher sample throughput and consumption index than KR. [ABSTRACT FROM AUTHOR]

Fundamental studies about non-spectral interferences in high-power microwave induced plasma optical emission spectrometry (MIP-OES) are very limited so far. The goal of this work is to investigate non-spectral interferences originating from calcium (0.5% w w−1 calcium nitrate), carbon (5.0% w w−1 glycerol) and sulfur (5.0% w w−1 sulfuric acid) matrices in commercial high-power MIP-OES based on a Hammer cavity. To this end, the influence of the nebulizer gas flow rate on the signal of several atomic and ionic lines of a total of 10 elements (As, Co, Cu, Mg, Mn, Mo, Sc, Se, Sr and Zn) has been studied for each matrix. Compared to the 1.0% w w−1 nitric acid reference solution, the emission signal for atomic lines with Esum values lower than 3.26 eV was enhanced in the presence of calcium but it was suppressed for the remaining atomic and ionic lines tested. Calcium matrix effects originate from changes in both plasma excitation conditions and ion–atom equilibrium. With regard to the 5.0% w w−1 glycerol and 5.0% w w−1 sulfuric acid solutions, no signal changes were noticed for the 1.0% w w−1 nitric acid solution since no significant differences were observed either in the aerosol size and transport or in the plasma excitation conditions. A comparison of matrix effects in MIP-OES with those obtained in inductively coupled plasma optical emission spectrometry (ICP-OES) under similar experimental conditions reveals that the former source is more sensitive to the presence of the calcium matrix. In contrast, MIP-OES is a more robust technique for elemental analysis when operating with 5.0% w w−1 glycerol and 5.0% w w−1 sulfuric acid solutions. In fact, matrix-based signal enhancements observed in ICP-OES for As and Se are eliminated when operating in MIP-OES. [ABSTRACT FROM AUTHOR]

The synthesis of a task‐specific ionic liquid (TSIL) based on a BMIM ionic liquid phosphane is achieved by modification of the original procedure. It is used as a ligand with AgOAc, and the resulting complex is fully characterized. This catalytic system promotes the 1,3‐dipolar cycloaddition of stabilized azomethine ylides and electrophilic alkenes using a green methodology. The green character was analyzed using an overall set of parameters finding the optimal conditions and individualized separation/purification methods for each cycloadduct. The determination of the most important green metrics is reported in this survey, demonstrating the value of this methodology on a laboratory scale or even at an industrial level. [ABSTRACT FROM AUTHOR]

Objective: To estimate the proportion of obstetrician-gynecologists (ob-gyns) who provided induced abortion in the prior year, disaggregated by surgical and medication methods, and document barriers to provision of medication abortion.Methods: In 2016-2017, we conducted a cross-sectional survey of a national sample of American College of Obstetricians and Gynecologists Fellows and Junior Fellows who were part of the Collaborative Ambulatory Research Network. We sent the survey by email, and mailed nonresponders paper surveys. We performed descriptive statistics, χ tests, and logistic regression analyses.Results: Sixty-seven percent (655/980) of Collaborative Ambulatory Research Network members responded. Ninety-nine percent reported seeing patients of reproductive age, and 72% reported having a patient in the prior year who needed or wanted an abortion. Among those seeing patients of reproductive age, 23.8% (95% CI 20.5%-27.4%) reported performing an induced abortion in the prior year; 10.4% provided surgical and medication abortion, 9.4% surgical only, and 4.0% medication only. In multivariable analysis, physicians practicing in the Midwest (adjusted odds ratio [AOR] 0.31, 95% CI 0.16-0.60) or South (AOR 0.22, 95% CI 0.11-0.42) had lower odds of provision compared with those practicing in the Northeast, whereas those practicing in an urban inner city (AOR 2.71, 95% CI 1.31-5.60) or urban non-inner-city area (AOR 2.89, 95% CI 1.48-5.64 vs midsize towns, rural areas, or military settings) had higher odds of provision. The most common reasons for not providing medication abortion were personal beliefs (34%) and practice restrictions (19%). Among those not providing medication abortion, 28% said they would if they could write a prescription for mifepristone.Conclusion: Compared with the previous national survey in 2008-2009, abortion provision may be increasing among practicing ob-gyns, although important geographic disparities persist. Few provide medication abortion, but uptake might increase if mifepristone could be prescribed. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine factors associated with modern contraceptive use and unintended pregnancy among young women and men in Accra, Ghana. From September-December 2013, we conducted a cross-sectional survey with 250 women and 100 men aged 18–24. We explored determinants of modern contraceptive use among males and females and unintended pregnancy among females. Descriptive statistics, chi-square tests, Fisher’s exact tests, and multivariable logistic regression were used. Participants had an average of three lifetime sexual partners, and 91% had one current partner. Overall, 44% reported current modern contraceptive use. In multivariate modeling, modern contraceptive use was associated with higher education compared to primary (AORs 2.1–4.3); ever talking with someone about contraception (AOR 4.7); feeling unsupported by a healthcare provider for contraception (AOR 2.2); and not feeling at risk of unintended pregnancy (AOR 2.7). While ≥70% of participants recognized most contraceptive methods, awareness of some methods was lacking. Nearly all respondents (91%) felt at least one modern method was unsafe. Nearly half of all females (45%) reported their last pregnancy was unintended, and 63% of females and 58% of males felt at risk for future unintended pregnancy. Women were more likely to experience unintended pregnancy if they had ever given birth (AOR 6.7), their sexual debut was 8–14 years versus 20–24 years (AOR 3.4), or they had 3–4 lifetime sexual partners versus 1–2 (AOR 2.4). Targeted interventions are needed to improve understanding of the safety of modern contraceptive methods, increase awareness of long-acting methods, and consequently increase modern contraceptive access and use. [ABSTRACT FROM AUTHOR]

This work explores chelating capabilities of 1-butyl-2-diphenylphosphino-3-methylimidazolium hexafluorophosphate (BDPPIMPF 6) as a task-specific ionic liquid (TSIL) for metal extraction/preconcentration procedures. To this end, metal extraction by BDPPIMPF 6 for 21 elements (Ag, Al, As, Au, Co, Cr, Cu, Fe, Ir, Mn, Ni, Pb, Pd, Pt, Re, Rh, Ru, Sc, Ti, V, and Zn) were evaluated. This TSIL specifically forms chelating complexes with several elements of Group 10 (Pd and Pt) and Group 11 (Ag and Cu) of the Periodic Table. Chelating capabilities of BDPPIMPF 6 has been exploited for developing a novel methodology for the simultaneous determination of Ag, Cu, Pd, and Pt by means of dispersive liquid-liquid microextraction and inductively coupled plasma optical emission spectrometry detection (DLLME-ICP-OES). This methodology afforded enrichment factors of 14 to 70 and limits of detection (LoD) of 0.2–2 μg L−1 for Ag, Cu, Pd and Pt. These LoD values were between 110 and 35-fold lower than those obtained by direct analyses with ICP-OES (i.e., no DLLME treatment). Finally, the proposed method has been applied to the analysis of Ag, Cu, Pd, and Pt in water and pharmaceutical products. Irrespective of matrix characteristics, quantitative recoveries were found for all the elements investigated thus highlighting methodology robustness. [Display omitted] • BDPPIMPF 6 shows a great affinity for Pd and Pt (Group 10) and Ag and Cu (Group 11). • Extraction of the different elements is mainly controlled by solution pH. • A new TSIL-DLLME-based methodology has been developed with ICP-OES detection. • TSIL has been successfully applied in the analysis of water and drug samples. [ABSTRACT FROM AUTHOR]

Wine contains significant amounts of Cd and Pb coming from different contamination sources. The analysis of these elements still means an enormous challenge due to its low concentration levels and the complexity of the wine matrix. Therefore, new highly sensitive analytical methods are currently required. The present work reports a new method based on the use of dispersive liquid–liquid microextraction (DLLME) and electrothermal atomic absorption spectrometry (ETAAS) determination. Results demonstrate that, under optimum DLLME experimental conditions, accurate Pb determination can be easily performed using external calibration. Cadmium determination requires a standard addition calibration strategy since its accuracy is strongly affected by the presence of Zn in the wine matrix. The limits of detection afforded by the method proposed were 0.01 and 0.08 μg L −1 for Cd and Pb, respectively. These values were around one order of magnitude lower than those previously reported for wine analysis by ETAAS. This simple methodology has been successfully employed for Cd and Pb analysis in different types of wines (i.e., white, red, rosé and sparkling wines). The results are in agreement with those obtained by Inductively Coupled Plasma – Mass Spectrometry after a time-consuming microwave-assisted acid digestion treatment. [ABSTRACT FROM AUTHOR]

Background A progestin-only pill may be the first pill formulation to become available over the counter in the United States; however, no research on over-the-counter (OTC) pill interest has focused on progestin-only pills or a representative sample of teens. The objective of this study was to assess U.S. women and teens’ interest in OTC progestin-only pill use. Methods In October 2015, we conducted a nationally representative, cross-sectional, online survey with 2,026 sexually active adult women aged 18 to 44 not currently desiring pregnancy, and 513 female teens aged 15 to 17. Logistic regression was used to identify characteristics associated with likely OTC progestin-only pill use. We also assessed reasons for use or nonuse, duration of use, and willingness to pay. Results Thirty-nine percent of adults and 29% of teens reported likely use, with a greater likelihood if covered by insurance. Adults were willing to pay $15 per month and teens $10 per month on average. Among adults, women who were never married or living alone (vs. married), uninsured (vs. privately insured), current pill or less effective method users (vs. ring, patch, injectable, or intrauterine device), tried to get a birth control prescription in the past year, or ever used an oral contraceptive pill or progestin-only pill had higher odds of likely use. Among teens, Spanish speakers and those who ever had sex had higher odds of likely use; Black teens (vs. White) had lower odds. Conclusions Teens and adults are interested in using an OTC progestin-only pill. These findings indicate a large pool of interested users and the potential for improved contraceptive access by making an OTC progestin-only pill available. [ABSTRACT FROM AUTHOR]

CONTEXT U.S. servicewomen have a higher rate of unintended pregnancy than civilian women, yet the military does not provide or cover abortion, except in limited circumstances. Servicewomen's experiences with abortion care have received little research attention. METHODS Twenty-one in-depth interviews with servicewomen who had had an abortion during active-duty service in the prior two years were conducted between January 2015 and July 2016. Women reported on their experiences accessing abortion, as well as their knowledge and opinions of the military's abortion policy. Data were analyzed thematically using inductive and deductive codes. RESULTS In regard to their pregnancy and abortion experiences, servicewomen cited concerns about confidentiality, stigma and negative effects on their career, which prevented half of participants from seeking care from the military. Of those who visited a military treatment facility during pregnancy, some reported feeling upset or abandoned by the lack of options counseling and referral. Women reported that the military's abortion policy had negative health and emotional consequences for servicewomen, and negative financial and logistical consequences for both servicewomen and the military. Most did not have accurate knowledge of the abortion policy. Upon learning the law, the majority believed that the military should provide and cover abortion; yet, servicewomen also expressed apprehension about the military's involvement in abortion care, because of concerns about privacy and negative effects on women's careers. CONCLUSIONS Policy recommendations to better meet the needs of servicewomen include wider dissemination of the military's abortion policy, establishing abortion referral and support guidelines, and improving confidentiality in military health services. [ABSTRACT FROM AUTHOR]

Objective: To compare the proportion of medical abortions with a clinically significant adverse event among telemedicine and in-person patients at a clinic system in Iowa during the first 7 years of the service.Methods: We conducted a retrospective cohort study. We analyzed data on clinically significant adverse events (hospital admission, surgery, blood transfusion, emergency department treatment, and death) for all medical abortions performed by telemedicine or in person at a clinic system in Iowa between July 1, 2008, and June 30, 2015. Data on adverse events came from required reporting forms submitted to the mifepristone distributor. We calculated the prevalence of adverse events and 95% CIs comparing telemedicine with in-person patients. The analysis was designed as a noninferiority study. Assuming the prevalence of adverse events to be 0.3%, telemedicine provision was considered to be inferior to in-person provision if the prevalence were 0.6% or higher. The required sample size was 6,984 in each group (one-sided α=0.025, power 90%). To explore whether patients with adverse events presented to emergency departments and were not reported, we conducted a survey of the 119 emergency departments in Iowa, asking whether they had treated a woman with an adverse event in the prior year.Results: During the study period, 8,765 telemedicine and 10,405 in-person medical abortions were performed. Forty-nine clinically significant adverse events were reported (no deaths or surgery; 0.18% of telemedicine patients with any adverse event [95% CI 0.11-0.29%] and 0.32% of in-person patients [95% CI 0.23-0.45%]). The difference in adverse event prevalence was 0.13% (95% CI -0.01% to 0.28%, P=.07). Forty-two emergency departments responded to the survey (35% response rate); none reported treating a woman with an adverse event after medical abortion.Conclusion: Adverse events are rare with medical abortion, and telemedicine provision is noninferior to in-person provision with regard to clinically significant adverse events. [ABSTRACT FROM AUTHOR]

The application of Directive 2008/98/CE on Municipal Solid Waste (MSW) implies the need to introduce technologies to generate energy from waste. Incineration, the most widely used method, is difficult to implement in low populated areas because it requires a large amount of waste to be viable (100,000 tons per year). This paper analyses the economic and environmental costs of different MSW-to-Energy technologies (WtE) in an area comprising of 13 municipalities in southern Spain. We analyse anaerobic digestion (Biomethanization), the production of solid recovered fuel (SRF) and gasification, and compare these approaches to the present Biological Mechanical Treatment (BMT) with elimination of the reject in landfill, and incineration with energy recovery. From an economic standpoint the implementation of WtE systems reduces the cost of running present BMT systems and incineration; gasification presents the lowest value. From the environmental standpoint, Life Cycle Assessment shows that any WtE alternatives, including incineration, present important advantages for the environment when compared to BMT. Finally, in order to select the best alternative, a multi-criteria method is applied, showing that anaerobic digestion is the optimal solution for the area studied. [ABSTRACT FROM AUTHOR]

Introduction Since 2011, Planned Parenthood of the Great Northwest and the Hawaiian Islands has been providing medical abortion via telemedicine at several clinics in Alaska. The purpose of this study was to evaluate providers' experiences with telemedicine provision of medical abortion in Alaska using qualitative methods. In particular, we aimed to learn more about the impacts of telemedicine on patients, staff, and clinic operations and potential lessons for other service delivery settings. Methods Between October and November 2013, eight in-depth interviews were conducted with clinic providers and staff who were involved with the provision of medical abortion using telemedicine at Planned Parenthood of the Great Northwest and the Hawaiian Islands clinics in Alaska. All interviews were digitally recorded and transcribed verbatim, and data were analysed qualitatively with inductive coding using grounded theory methods. Results Providers reported that telemedicine provision of medical abortion facilitated a more patient-centred approach to care where women were able to be seen sooner, have greater choice in abortion procedure type, and could be seen closer to their home. Providers felt that it was easy to integrate the new technology into clinic operations, and that a telemedicine visit largely required the same overall processes and clinic flow as an in-person visit, with minor additions related to technological set-up for the doctor interface. Discussion These findings are consistent with previously published literature on medical abortion provided via telemedicine, and indicate high acceptability among providers and the appropriateness for telemedicine application to this healthcare service. [ABSTRACT FROM AUTHOR]

In the last years, besides traffic safety, two aspects of road tunnels have become really critical: energy consumption of the lighting installations and landscape integration of the portal gate. However, both aspects have been considered from different perspectives, and their development and advances seem to follow separate paths. In this work, energy consumption and landscape integration, together with the cost of portal construction, are proven to be strongly related when considered from the common framework of sustainability and its implications in a necessary global Policy for road tunnels. Departing from the evaluation of real tunnels in a real highway, three quantitative parameters ranged from 0 to 5 (energy consumption parameter, landscape integration parameter and construction cost parameter) are proposed to build a more general tool, the sustainability vector, that gives account of the degree of sustainability and highlights the necessity of corrective actions when necessary. Depending on the values of its module and director angle, a labeling system ranging from A to D, is proposed for the use of Regulatory Bodies and Public Administrations in matter of tunnel classification and sustainability requirements. According to this system, two of the tubes analyzed reach the “A” labeling, whereas two are “B” and six are “D”. [ABSTRACT FROM AUTHOR]

Single particle inductively coupled plasma mass spectrometry (spICP-MS) has been explored for the determination of metallic nanoparticles (NPs) in air. Different extraction strategies (i.e., direct immersion, hard cap espresso, ultrasound-assisted and microwave-assisted extraction) and extracting solvents (i.e., citric acid, trisodium citrate, potassium nitrate, sodium nitrate, thiourea, disodium pyrophosphate and ammonium hydroxide) were investigated for platinum and gold NPs recovery from glass and microquartz fiber filters with a nominal size cut-off of 300 nm. Results show that metallic NPs are preserved and quantitatively extracted from the filter in 4 min inside an 800 W microwave oven by using 40 mL of a 2.0% w w−1 NH 4 OH solution. For the remaining extraction procedures, either incomplete recoveries or NPs degradation occur. As regards the influence of filter material, microquartz fiber affords better NPs capturing performance than glass fiber ones, enabling the quantification of NPs with diameters above 28 nm. This methodology has been successfully applied to determine PtNPs in filters from environmental monitoring stations and to gain insight into NPs transport through ICP-MS sample introduction system. Care should be taken during spICP-MS calibration since biased results might be obtained due to differences on NPs transport efficiency between standards and samples. [Display omitted] • A novel methodology is proposed for characterizing metallic NPs in aerosols. • Metallic NPs above 28 nm are efficiently collected by means microquartz filters. • NPs are extracted from filters using a microwave-assisted extraction treatment. • Accurate determination of PtNPs in environmental filters is feasible. • NPs transport efficiency in spICP-MS is successfully investigated. [ABSTRACT FROM AUTHOR]

Objective: The objective was to investigate public funding policies for abortion in countries with liberal or liberally interpreted laws (defined as permitting abortion for economic or social reasons or upon request).Study Design: In May 2011-February 2012 and June 2013-December 2014, we researched online resources and conducted an email-based survey among reproductive health experts to determine countries' public funding policies for abortion. We categorized countries as follows: full funding for abortion (provided for free at government facilities, covered under state-funded health insurance); partial funding (partially covered by the government, covered for certain populations based on income or nonincome criteria, or less expensive in public facilities); funding for exceptional cases (rape/incest/fetal impairment, health/life of the woman or other limited cases) and no public funding.Results: We obtained data for all 80 countries meeting inclusion criteria. Among the world's female population aged 15-49 in countries with liberal/liberally interpreted abortion laws, 46% lived in countries with full funding for abortion (34 countries), 41% lived in countries with partial funding (25 countries), and 13% lived in countries with no funding or funding for exceptional cases only (21 countries). Thirty-one of 40 high-income countries provided full funding for abortion (n=20) or partial funding (n=11); 28 of 40 low- to middle-income countries provided full (n=14) or partial funding for abortion (n=14). Of those countries that did not provide public funding for abortion, most provided full coverage of maternity care.Conclusion: Nearly half of countries with liberal/liberally interpreted abortion laws had public funding for abortion, including most countries that liberalized their abortion law in the past 20 years. Outliers remain, however, including among developed countries where access to abortion may be limited due to affordability.Implications: Since cost of services affects access, country policies regarding public funding for services should be monitored, and advocacy should prioritize ensuring the affordability of care for low-income women. [ABSTRACT FROM AUTHOR]

The article presents a 2015 qualitative study conducted to explore the impact of contraceptive stockouts on women, providers and policymakers in the Kamuli and Mbarara districts in Uganda. Topics covered include the methods used in collecting and analyzing data, the noted characteristics of study participants, and details relating to the perceived causes of stockouts in the subject districts in Uganda. It also discusses the strategies used by women and providers in coping with a stockout.

Objective: To estimate unintended pregnancy rates among a representative sample of 7,225 active-duty women in the U.S. military in 2008 and to compare these rates with 2005 and with the U.S. population.Methods: Cross-sectional data came from the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel (Health Related Behaviors Survey). For all women and by key subgroups, unintended pregnancy rates per 1,000 women were calculated and compared with rates reported in the 2005 Health Related Behaviors Survey. Univariable and multivariable logistic regression to test for associations between unintended pregnancy and key subgroups was also performed. Finally, an age-standardized unintended pregnancy rate was calculated to adjust for differences in age composition between the military and U.S. populations for better comparison with the general U.S. rate.Results: Eleven percent of women reported an unintended pregnancy in the prior 12 months. The 2008 self-reported unintended pregnancy rate was 105 per 1,000 women, an increase from 2005 (97/1,000 women). Younger, less educated, nonwhite, and married or cohabitating women had significantly higher rates of unintended pregnancy compared with their counterparts. Rates did not differ between women deployed in the prior 12 months and nondeployed women. The age-standardized rate was 78 per 1,000 women (95% confidence interval 77-79), which is 50% higher than the general U.S. population (52/1,000 women).Conclusion: Unintended pregnancy rates in the military are high and have increased in most key subgroups since the 2005 survey. Efforts are needed to help servicewomen prevent unintended pregnancy, including during deployment.Level Of Evidence: II. [ABSTRACT FROM AUTHOR]

U.S. servicewomen's ability to plan pregnancies is of concern to the military in terms of troop readiness and cost and is an important public health issue. Contraception access and use are crucial, particularly given the high prevalence of sexual assault in the military and the benefits of menstrual suppression for deployment. We systematically searched for publications on contraception, unintended pregnancy, and abortion in the military. Pregnancy and unintended pregnancy rates are higher among servicewomen than the general U.S. population. Contraceptive use may be somewhat higher than the nonmilitary population, although use decreases during deployment. Reported use of hormonal methods for menstrual suppression is lower than interest. There are limited data on these topics; more large, representative studies and longitudinal data from all branches are needed, along with qualitative research to explore findings more deeply. Emergency contraception and abortion are particularly underresearched. [ABSTRACT FROM AUTHOR]

Background: Access to contraception is a vital component of preventing unintended pregnancies. This study was conducted to assess the prevalence of and factors associated with U.S. women's difficulty accessing prescription contraception (pill, patch, or ring). Materials and Methods: We performed a nationally representative survey of adult women at risk of unintended pregnancy (aged 18-44, not pregnant or seeking pregnancy, sexually active, not sterilized) using a probability-based web panel. In November to December 2011, 2046 women completed the survey. Weighted proportions were calculated and logistic regression was used to identify covariates associated with difficulty obtaining or refilling prescription contraception. Results: A total of 1385 (68%) women had ever tried to get a prescription for hormonal contraception. Among this population, 29% reported ever having problems obtaining a prescription or refills. In multivariable regression, uninsured (vs. privately insured) and Spanish-speaking (vs. English-speaking) women were significantly more likely to report difficulties; women with a high school degree and those with some college (vs. a college degree or higher) were significantly less likely to report difficulty. Difficulties included cost barriers or lack of insurance (14%), challenges obtaining an appointment or getting to a clinic (13%), the clinician requiring a clinic visit, exam, or Pap smear (13%), not having a regular doctor/clinic (10%), difficulty accessing a pharmacy (4%), and other reasons (4%). Conclusions: One-third of adult U.S. women who have ever tried to obtain prescription contraception reported access barriers. While the Affordable Care Act may resolve some of these issues, these data indicate that additional factors may still need to be addressed. [ABSTRACT FROM AUTHOR]

Children comprise 19% of the Australian population. Children are at risk of higher morbidity and mortality in disaster events than adults; however, there is a paucity of paediatric-specific disaster preparedness in Australia. Paediatric disaster plans should be developed, tested and renewed regularly. Plans need to address unaccompanied and unidentified children, medical and psychosocial needs and family reunification. Specific management is required for chemical, biological and radiological events. [ABSTRACT FROM AUTHOR]

In this work, the influence of carbon-, sulfur-, and phosphorus-based charge transfer reactions on the emission signal of 34 elements (Ag, Al, As, Au, B, Ba, Be, Ca, Cd, Co, Cr, Cu, Fe, Ga, Hg, I, In, Ir, K, Li, Mg, Mn, Na, Ni, P, Pb, Pd, Pt, S, Sb, Se, Sr, Te, and Zn) in axially viewed inductively coupled plasma–atomic emission spectrometry has been investigated. To this end, atomic and ionic emission signals for diluted glycerol, sulfuric acid, and phosphoric acid solutions were registered and results were compared to those obtained for a 1% w w − 1 nitric acid solution. Experimental results show that the emission intensities of As, Se, and Te atomic lines are enhanced by charge transfer from carbon, sulfur, and phosphorus ions. Iodine and P atomic emission is enhanced by carbon- and sulfur-based charge transfer whereas the Hg atomic emission signal is enhanced only by carbon. Though signal enhancement due to charge transfer reactions is also expected for ionic emission lines of the above-mentioned elements, no experimental evidence has been found with the exception of Hg ionic lines operating carbon solutions. The effect of carbon, sulfur, and phosphorus charge transfer reactions on atomic emission depends on (i) wavelength characteristics. In general, signal enhancement is more pronounced for electronic transitions involving the highest upper energy levels; (ii) plasma experimental conditions. The use of robust conditions (i.e. high r.f. power and lower nebulizer gas flow rates) improves carbon, sulfur, and phosphorus ionization in the plasma and, hence, signal enhancement; and (iii) the presence of other concomitants (e.g. K or Ca). Easily ionizable elements reduce ionization in the plasma and consequently reduce signal enhancement due to charge transfer reactions. [ABSTRACT FROM AUTHOR]

Objectives: To estimate unintended pregnancy rates among a representative sample of active-duty women in the U.S. military aged 18-44 years in 2011.Study Design: Cross-sectional data came from the 2011 Department of Defense Health Related Behaviors Survey of Active Duty Military Personnel; 9038 women provided data on unintended pregnancy. Unintended pregnancy rates were calculated for all women and by available background characteristics, including military branch, marital status (married versus unmarried), pay grade (enlisted versus officer) and deployment in the previous 12 months. Multivariable logistic regression testing for associations between unintended pregnancy and subgroups was also performed.Results: The unintended pregnancy rate was 72/1000 women. Married women (odds ratio (OR) 1.30, 95% confidence interval (CI) 1.11-1.54) and enlisted women (OR 2.71, 95% CI 1.99-3.69) had higher odds of reporting unintended pregnancy compared to their counterparts, as did women in the Navy (OR 1.51, 95% CI 1.19-1.91) and Marine Corps (OR 2.38, 95% CI 1.92-2.95) compared to women in the Air Force. Unintended pregnancy rates did not differ between women who were deployed in the previous 12 months and nondeployed women. Additionally, 10% of women who were deployed for 11-12 months in 2011 reported an unintended pregnancy in the previous year, suggesting that their pregnancies occurred during deployment.Conclusion: Unintended pregnancy is higher in the military, including during deployment, compared to the general U.S. population (52/1000 women). All branches need to address the issue in a comprehensive manner including evidence-based provision of contraception and education among servicemembers.Implications: Unintended pregnancy is high in the military, including during deployment; further efforts to improve evidence-based provision of contraception and education are needed. [ABSTRACT FROM AUTHOR]

Context: Removing the prescription requirement and making oral contraceptive pills available over the counter (OTC) could increase contraceptive access in the United States. Despite current efforts to make a progestin‐only pill (POP) available OTC, there are no qualitative data exploring the experiences of POP users and their perspectives on making POPs available OTC. Methods: We conducted six online, asynchronous focus group discussions with 36 POP users between July and November 2020. We stratified focus group discussion placement based on three reasons for POP use: breastfeeding, having a contraindication to estrogen (for a reason other than breastfeeding), and for any other reason. We thematically analyzed these data using inductive and deductive coding. Results: The majority of participants described their overall POP experience as positive, mostly because they experienced minor or no side effects and thought the pill was effective. Participants overwhelmingly supported OTC availability of POPs and expressed interest in purchasing an OTC POP. Over one‐third of participants had very limited knowledge or held inaccurate assumptions about POPs before they started using this method and many stressed the need to disseminate accurate information and resources about POPs to the public. Conclusions: Most focus group discussion participants were satisfied with POPs and supported OTC access. While misconceptions and concerns about POPs should be addressed, an OTC POP has the potential to be a safe, effective, and convenient contraceptive option in the United States. [ABSTRACT FROM AUTHOR]

Background Long-acting reversible contraception (LARC) and sterilization are popular contraceptive methods. However, they have been associated with safety concerns and coercive practices. We aimed to understand women's opinions and experiences related to these methods, including whether the methods' fraught histories influence use or interest. Methods Between May and July 2013, we conducted an online survey with a convenience sample of 520 women aged 14 to 45. We used quota sampling to ensure women of color were at least 60% of our sample. Descriptive statistics, χ 2 tests, and multivariable logistic regression were used to estimate participants' awareness of, interest in, and experiences with LARCs and sterilization. Findings Overall, 30% of women reported current LARC use and 67% interest in future LARC use. Four percent reported sterilization use and 48% interest in future sterilization. In multivariate analyses, current LARC use was lower among Asian women versus White women (odds ratio [OR], 0.24), and interest in future use was higher among women aged 14 to 24 versus 35 to 45 (OR, 5.49). Interest in sterilization was higher among women aged 14 to 24 and 25 to 34 versus 35 to 45 (ORs, 3.29–3.66) and women with disabilities (OR, 1.64), and lower among Black compared with White women (OR, 0.41). Method misperceptions were evident, and concerns about contraceptive coercion were reported. Conclusions Concerns about contraceptive coercion were not predominant reasons for noninterest in LARCs and sterilization, but were reported by some participants. Lower sterilization interest among Black women and higher sterilization interest among women with disabilities warrant further research. Efforts to address misperceptions about LARCs and sterilization, including their safety and efficacy, are needed. [ABSTRACT FROM AUTHOR]

Results of a systematic study concerning non-spectral interferences from sulfuric acid containing matrices on a large number of elements in inductively coupled plasma–mass spectrometry (ICP-MS) are presented in this work. The signals obtained with sulfuric acid solutions of different concentrations (up to 5% w w − 1 ) have been compared with the corresponding signals for a 1% w w − 1− nitric acid solution at different experimental conditions (i.e., sample uptake rates, nebulizer gas flows and r.f. powers). The signals observed for 128 Te + , 78 Se + and 75 As + were significantly higher when using sulfuric acid matrices (up to 2.2-fold for 128 Te + and 78 Se + and 1.8-fold for 75 As + in the presence of 5 w w -1 sulfuric acid) for the whole range of experimental conditions tested. This is in agreement with previously reported observations. The signal for 31 P + is also higher (1.1-fold) in the presence of sulfuric acid. The signal enhancements for 128 Te + , 78 Se + , 75 As + and 31 P + are explained in relation to an increase in the analyte ion population as a result of charge transfer reactions involving S + species in the plasma. Theoretical data suggest that Os, Sb, Pt, Ir, Zn and Hg could also be involved in sulfur-based charge transfer reactions, but no experimental evidence has been found. The presence of sulfuric acid gives rise to lower ion signals (about 10–20% lower) for the other nuclides tested, thus indicating the negative matrix effect caused by changes in the amount of analyte loading of the plasma. The elemental composition of a certified low-density polyethylene sample (ERM-EC681K) was determined by ICP-MS after two different sample digestion procedures, one of them including sulfuric acid. Element concentrations were in agreement with the certified values, irrespective of the acids used for the digestion. These results demonstrate that the use of matrix-matched standards allows the accurate determination of the tested elements in a sulfuric acid matrix. [ABSTRACT FROM AUTHOR]

This work explores the multi-element capabilities of inductively coupled plasma-mass spectrometry with collision/reaction cell technology (CCT-ICP-MS) for the simultaneous determination of both spectrally interfered and non-interfered nuclides in wine samples using a single set of experimental conditions. The influence of the cell gas type (i.e. He, He+H2 and He+NH3), cell gas flow rate and sample pre-treatment (i.e. water dilution or acid digestion) on the background-equivalent concentration (BEC) of several nuclides covering the mass range from 7 to 238 u has been studied. Results obtained in this work show that, operating the collision/reaction cell with a compromise cell gas flow rate (i.e. 4 mL min-1) improves BEC values for interfered nuclides without a significant effect on the BECs for non-interfered nuclides, with the exception of the light elements Li and Be. Among the different cell gas mixtures tested, the use of He or He+H2 is preferred over He+NH3 because NH3 generates new spectral interferences. No significant influence of the sample pre-treatment methodology (i.e. dilution or digestion) on the multi-element capabilities of CCT-ICP-MS in the context of simultaneous analysis of interfered and non-interfered nuclides was observed. Nonetheless, sample dilution should be kept at minimum to ensure that light nuclides could be quantified in wine. Finally, a direct 5-fold aqueous dilution is recommended for the simultaneous trace and ultra-trace determination of spectrally interfered and non-interfered elements in wine by means of CCT-ICP-MS. The use of the CCT is mandatory for interference-free ultra-trace determination of Ti and Cr. Only Be could not be determined when using the CCT due to a deteriorated limit of detection when compared to conventional ICP-MS. [ABSTRACT FROM AUTHOR]