3,332 research outputs found
High-Power Directional Emission from Microlasers with Chaotic Resonators
High-power and highly directional semiconductor cylinder-lasers based on an
optical resonator with deformed cross section are reported. In the favorable
directions of the far-field, a power increase of up to three orders of
magnitude over the conventional circularly symmetric lasers was obtained. A
"bow-tie"-shaped resonance is responsible for the improved performance of the
lasers in the higher range of deformations, in contrast to
"whispering-gallery"-type modes of circular and weakly deformed lasers. This
resonator design, although demonstrated here in midinfrared quantum-cascade
lasers, should be applicable to any laser based on semiconductors or other
high-refractive index materials.Comment: Removed minor discrepancies with published version in the text and in
Fig.
An analysis of likes and dislikes for history and geography of 3360 sixth grade children
Thesis (Ed.M.)--Boston Universit
Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial
Background
Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy
Examination of England’s New Medicine Service (NMS) of complex health care interventions in community pharmacy
Background: Community pharmacies are increasingly commissioned to deliver new, complex health interventions in response to the growing demands on family doctors and secondary health care services. Little is known about how these complex interventions are being accommodated and translated into the community pharmacy setting and whether their aims and objectives are realized in practice. The New Medicine Service (NMS) is a complex medicine management intervention that aims to support patients’ adherence to newly prescribed medicines for a long-term condition.
Objective: This study explores the recent implementation of the NMS in community pharmacies across England. It also seeks to understand how the service is becoming manifest in practice and what lessons can be learned for future service implementation.
Methods: Structured, organizational ethnographic observations and in situ workplace interviews with pharmacists and support staff were undertaken within 23 English community pharmacies. Additionally, one-toone, semi-structured interviews were carried out with 47 community pharmacists and 11 general practitioners (GPs). Observational and interview data were transcribed and analysed thematically and guided by Damschroder’s consolidated framework for implementation research.
Results: The NMS workload had been implemented and absorbed into pharmacists’ daily routines alongside existing responsibilities with no extra resources and little evidence of reduction in other responsibilities. Pharmacists were pragmatic, simplifying, and adapting the NMS to facilitate its delivery and using discretion to circumvent perceived non-essential paperwork. Pharmacist understanding of the NMS was found to impact on what they believed should be achieved from the service. Despite pharmacists holding positive views about the value of the NMS, not all were convinced of its perceived benefits and necessity, with reports that many consultations did not identify any problems with the patients’ medicines. GPs were generally supportive of the initiative but were unaware of the service or potential benefits. Poorly developed existing pharmacist-GP relationships impeded implementation.
Conclusions: This study identifies the multifaceted and complex processes involved in implementing a new community pharmacy service in England. Community pharmacy workflow, infrastructure, and public and professional relationships all affect NMS implementation. Greater prior engagement with the pharmacy workforce and GPs, robust piloting and a phased rollout together with ongoing support and updates, are potentials strategies to ensure future implementation of pharmacy services meet their intended aims in practice
Effects of noise exposure on young adults with normal audiograms II: Behavioral measures
An estimate of lifetime noise exposure was used as the primary predictor of performance on a range of behavioral tasks: frequency and intensity difference limens, amplitude modulation detection, interaural phase discrimination, the digit triplet speech test, the co-ordinate response speech measure, an auditory localization task, a musical consonance task and a subjective report of hearing ability. One hundred and thirty-eight participants (81 females) aged 18–36 years were tested, with a wide range of self-reported noise exposure. All had normal pure-tone audiograms up to 8 kHz. It was predicted that increased lifetime noise exposure, which we assume to be concordant with noise-induced cochlear synaptopathy, would elevate behavioral thresholds, in particular for stimuli with high levels in a high spectral region. However, the results showed little effect of noise exposure on performance. There were a number of weak relations with noise exposure across the test battery, although many of these were in the opposite direction to the predictions, and none were statistically significant after correction for multiple comparisons. There were also no strong correlations between electrophysiological measures of synaptopathy published previously and the behavioral measures reported here. Consistent with our previous electrophysiological results, the present results provide no evidence that noise exposure is related to significant perceptual deficits in young listeners with normal audiometric hearing. It is possible that the effects of noise-induced cochlear synaptopathy are only measurable in humans with extreme noise exposures, and that these effects always co-occur with a loss of audiometric sensitivity
FRAX (R): Prediction of Major Osteoporotic Fractures in Women from the General Population: The OPUS Study
Purposes: The aim of this study was to analyse how well FRAXH predicts the risk of major osteoporotic and vertebral
fractures over 6 years in postmenopausal women from general population.
Patients and methods: The OPUS study was conducted in European women aged above 55 years, recruited in 5 centers
from random population samples and followed over 6 years. The population for this study consisted of 1748 women (mean
age 74.2 years) with information on incident fractures. 742 (43.1%) had a prevalent fracture; 769 (44%) and 155 (8.9%) of
them received an antiosteoporotic treatment before and during the study respectively. We compared FRAXH performance
with and without bone mineral density (BMD) using receiver operator characteristic (ROC) c-statistical analysis with ORs and
areas under receiver operating characteristics curves (AUCs) and net reclassification improvement (NRI).
Results: 85 (4.9%) patients had incident major fractures over 6 years. FRAXH with and without BMD predicted these
fractures with an AUC of 0.66 and 0.62 respectively. The AUC were 0.60, 0.66, 0.69 for history of low trauma fracture alone,
age and femoral neck (FN) BMD and combination of the 3 clinical risk factors, respectively. FRAXH with and without BMD
predicted incident radiographic vertebral fracture (n = 65) with an AUC of 0.67 and 0.65 respectively. NRI analysis showed a
significant improvement in risk assignment when BMD is added to FRAXH.
Conclusions: This study shows that FRAXH with BMD and to a lesser extent also without FN BMD predict major osteoporotic
and vertebral fractures in the general population
Novel Associations between Common Breast Cancer Susceptibility Variants and Risk-Predicting Mammographic Density Measures.
Mammographic density measures adjusted for age and body mass index (BMI) are heritable predictors of breast cancer risk, but few mammographic density-associated genetic variants have been identified. Using data for 10,727 women from two international consortia, we estimated associations between 77 common breast cancer susceptibility variants and absolute dense area, percent dense area and absolute nondense area adjusted for study, age, and BMI using mixed linear modeling. We found strong support for established associations between rs10995190 (in the region of ZNF365), rs2046210 (ESR1), and rs3817198 (LSP1) and adjusted absolute and percent dense areas (all P < 10(-5)). Of 41 recently discovered breast cancer susceptibility variants, associations were found between rs1432679 (EBF1), rs17817449 (MIR1972-2: FTO), rs12710696 (2p24.1), and rs3757318 (ESR1) and adjusted absolute and percent dense areas, respectively. There were associations between rs6001930 (MKL1) and both adjusted absolute dense and nondense areas, and between rs17356907 (NTN4) and adjusted absolute nondense area. Trends in all but two associations were consistent with those for breast cancer risk. Results suggested that 18% of breast cancer susceptibility variants were associated with at least one mammographic density measure. Genetic variants at multiple loci were associated with both breast cancer risk and the mammographic density measures. Further understanding of the underlying mechanisms at these loci could help identify etiologic pathways implicated in how mammographic density predicts breast cancer risk.ABCFS: The Australian Breast Cancer Family Registry (ABCFR; 1992-1995) was supported by
the Australian NHMRC, the New South Wales Cancer Council, and the Victorian Health
Promotion Foundation (Australia), and by grant UM1CA164920 from the USA National
Cancer Institute. The Genetic Epidemiology Laboratory at the University of Melbourne has
also received generous support from Mr B. Hovey and Dr and Mrs R.W. Brown to whom we
are most grateful. The content of this manuscript does not necessarily reflect the views or
policies of the National Cancer Institute or any of the collaborating centers in the Breast
Breast Cancer Susceptibility Variants and Mammographic Density
5
Cancer Family Registry (BCFR), nor does mention of trade names, commercial products, or
organizations imply endorsement by the USA Government or the BCFR.
BBCC: This study was funded in part by the ELAN-Program of the University Hospital
Erlangen; Katharina Heusinger was funded by the ELAN program of the University Hospital
Erlangen. BBCC was supported in part by the ELAN program of the Medical Faculty,
University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg.
EPIC-Norfolk: This study was funded by research programme grant funding from Cancer
Research UK and the Medical Research Council with additional support from the Stroke
Association, British Heart Foundation, Department of Health, Research into Ageing and
Academy of Medical Sciences.
MCBCS: This study was supported by Public Health Service Grants P50 CA 116201, R01 CA
128931, R01 CA 128931-S01, R01 CA 122340, CCSG P30 CA15083, from the National Cancer
Institute, National Institutes of Health, and Department of Health and Human Services.
MCCS: Melissa C. Southey is a National Health and Medical Research Council Senior
Research Fellow and a Victorian Breast Cancer Research Consortium Group Leader. The
study was supported by the Cancer Council of Victoria and by the Victorian Breast Cancer
Research Consortium.
MEC: National Cancer Institute: R37CA054281, R01CA063464, R01CA085265, R25CA090956,
R01CA132839.
MMHS: This work was supported by grants from the National Cancer Institute, National
Institutes of Health, and Department of Health and Human Services. (R01 CA128931, R01 CA
128931-S01, R01 CA97396, P50 CA116201, and Cancer Center Support Grant P30 CA15083).
Breast Cancer Susceptibility Variants and Mammographic Density
6
NBCS: This study has been supported with grants from Norwegian Research Council
(#183621/S10 and #175240/S10), The Norwegian Cancer Society (PK80108002,
PK60287003), and The Radium Hospital Foundation as well as S-02036 from South Eastern
Norway Regional Health Authority.
NHS: This study was supported by Public Health Service Grants CA131332, CA087969,
CA089393, CA049449, CA98233, CA128931, CA 116201, CA 122340 from the National
Cancer Institute, National Institutes of Health, Department of Health and Human Services.
OOA study was supported by CA122822 and X01 HG005954 from the NIH; Breast Cancer
Research Fund; Elizabeth C. Crosby Research Award, Gladys E. Davis Endowed Fund, and the
Office of the Vice President for Research at the University of Michigan. Genotyping services
for the OOA study were provided by the Center for Inherited Disease Research (CIDR), which
is fully funded through a federal contract from the National Institutes of Health to The Johns
Hopkins University, contract number HHSN268200782096.
OFBCR: This work was supported by grant UM1 CA164920 from the USA National Cancer
Institute. The content of this manuscript does not necessarily reflect the views or policies of
the National Cancer Institute or any of the collaborating centers in the Breast Cancer Family
Registry (BCFR), nor does mention of trade names, commercial products, or organizations
imply endorsement by the USA Government or the BCFR.
SASBAC: The SASBAC study was supported by Märit and Hans Rausing’s Initiative against
Breast Cancer, National Institutes of Health, Susan Komen Foundation and Agency for
Science, Technology and Research of Singapore (A*STAR).
Breast Cancer Susceptibility Variants and Mammographic Density
7
SIBS: SIBS was supported by program grant C1287/A10118 and project grants from Cancer
Research UK (grant numbers C1287/8459).
COGS grant: Collaborative Oncological Gene-environment Study (COGS) that enabled the
genotyping for this study. Funding for the BCAC component is provided by grants from the
EU FP7 programme (COGS) and from Cancer Research UK. Funding for the iCOGS
infrastructure came from: the European Community's Seventh Framework Programme
under grant agreement n° 223175 (HEALTH-F2-2009-223175) (COGS), Cancer Research UK
(C1287/A10118, C1287/A 10710, C12292/A11174, C1281/A12014, C5047/A8384,
C5047/A15007, C5047/A10692), the National Institutes of Health (CA128978) and Post-
Cancer GWAS initiative (1U19 CA148537, 1U19 CA148065 and 1U19 CA148112 - the GAMEON
initiative), the Department of Defence (W81XWH-10-1-0341), the Canadian Institutes of
Health Research (CIHR) for the CIHR Team in Familial Risks of Breast Cancer, Komen
Foundation for the Cure, the Breast Cancer Research Foundation, and the Ovarian Cancer
Research Fund.This is the author accepted manuscript. The final version is available via American Association for Cancer Research at http://cancerres.aacrjournals.org/content/early/2015/04/10/0008-5472.CAN-14-2012.abstract
Role of Occult and Post-acute Phase Replication in Protective Immunity Induced with a Novel Live Attenuated SIV Vaccine
In order to evaluate the role of persisting virus replication during occult phase immunisation in the live attenuated SIV vaccine model, a novel SIVmac239Δnef variant (SIVrtTA) genetically engineered to replicate in the presence of doxycycline was evaluated for its ability to protect against wild-type SIVmac239. Indian rhesus macaques were vaccinated either with SIVrtTA or with SIVmac239Δnef. Doxycycline was withdrawn from 4 of 8 SIVrtTA vaccinates before challenge with wild-type virus. Unvaccinated challenge controls exhibited ~107 peak plasma viral RNA copies/ml persisting beyond the acute phase. Six vaccinates, four SIVmac239Δnef and two SIVrtTA vaccinates exhibited complete protection, defined by lack of wild-type viraemia post-challenge and virus-specific PCR analysis of tissues recovered post-mortem, whereas six SIVrtTA vaccinates were protected from high levels of viraemia. Critically, the complete protection in two SIVrtTA vaccinates was associated with enhanced SIVrtTA replication in the immediate post-acute vaccination period but was independent of doxycycline status at the time of challenge. Mutations were identified in the LTR promoter region and rtTA gene that do not affect doxycycline-control but were associated with enhanced post-acute phase replication in protected vaccinates. High frequencies of total circulating CD8+T effector memory cells and a higher total frequency of SIV-specific CD8+ mono and polyfunctional T cells on the day of wild-type challenge were associated with complete protection but these parameters were not predictive of outcome when assessed 130 days after challenge. Moreover, challenge virus-specific Nef CD8+ polyfunctional T cell responses and antigen were detected in tissues post mortem in completely-protected macaques indicating post-challenge control of infection. Within the parameters of the study design, on-going occult-phase replication may not be absolutely required for protective immunity
LET’s CONNECT community mentorship program for youths with peer social problems: Preliminary findings from a randomized effectiveness trial
This study examined the effectiveness of LET’s CONNECT (LC), a community mentorship program for youths who report peer social problems, which is based on a positive youth development framework. Participants were 218 youths (66.5% girls), aged 12 to 15 years, who were recruited from an urban medical emergency department and screened positive for bullying victimization, bullying perpetration, and/or low social connectedness. Youths were randomized to LC (n = 106) or the control condition (n = 112). Six‐month outcomes were assessed with self‐report measures of youth social connectedness, community connectedness, thwarted belongingness, depression, self‐esteem, and suicidal ideation. LC was associated with a significant increase in only one of these outcomes, social connectedness (effect size = 0.4). It was associated consistently with trend‐level positive changes for thwarted belongingness (decreased), depression (decreased), community connectedness, and self‐esteem (effect sizes = 0.2). There was no effect on suicidal ideation (effect size = 0.0), and although not a primary outcome, eight youths in the LC condition and seven youths in the control condition engaged in suicidal behavior between baseline and follow‐up. Although LC effect sizes are consistent with those from previous studies of community mentorship, there were multiple challenges to LC implementation that affected dosage and intervention fidelity, and that may account for the lack of stronger positive effects.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145529/1/jcop21979.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145529/2/jcop21979_am.pd
Search for Pair Production of Third-Generation Leptoquarks and Top Squarks in pp Collisions at √s=7 TeV
Results are presented from a search for the pair production of third-generation scalar and vector leptoquarks, as well as for top squarks in R-parity-violating supersymmetric models. In either scenario, the new, heavy particle decays into a τ lepton and a b quark. The search is based on a data sample of pp collisions at √s=7 TeV, which is collected by the CMS detector at the LHC and corresponds to an integrated luminosity of 4.8 fb[superscript -1]. The number of observed events is found to be in agreement with the standard model prediction, and exclusion limits on mass parameters are obtained at the 95% confidence level. Vector leptoquarks with masses below 760 GeV are excluded and, if the branching fraction of the scalar leptoquark decay to a τ lepton and a b quark is assumed to be unity, third-generation scalar leptoquarks with masses below 525 GeV are ruled out. Top squarks with masses below 453 GeV are excluded for a typical benchmark scenario, and limits on the coupling between the top squark, τ lepton, and b quark, λ333′ are obtained. These results are the most stringent for these scenarios to date
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