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Previous studies have demonstrated that permanent loss of ribbon synapses can occur immediately following noise exposure, even in cases where threshold elevations are transient and hair cells survive 16,18,39

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Following this spike, prescribing was relatively stable from September through November (0.01 percentage points per month), before increasing again from November to December (+0.04 points) and accelerating from December 2025 through February 2026 (+0.12 percentage points per month)

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