Continuing medical education and firearm violence counseling

Firearm violence is a significant and increasing cause of mortality. Although physicians view firearm counseling as their professional obligation, few engage in the practice. This study examines medical education and firearm counseling among physicians in North Carolina. While 65 percent of physicians reported knowing how to counsel patients about gun safety, only 25 percent reported having conversations with patients about firearms or firearm safety often or very often. Physicians reporting continuing medical education (CME) attendance on gun safety, however, were more likely to report providing patients with firearm safety counseling and asking patients with depression about firearms. Increasing availability of and physician participation in firearm violence prevention CME could significantly increase physicians’ knowledge of and engagement in firearm counseling

Removing pose from face images

This paper proposes a novel approach to pose removal from face images based on the inherent symmetry that is present in faces. In order for face recognition systems and expression classification systems to operate optimally, subjects must look directly into the camera. The removal of pose from face images after their capture removes this restriction. To obtain a pose-removed face image, the frequency components at each position of the face image, obtained through a wavelet transformation, are examined. A cost function based on the symmetry of this wavelet transformed face image is minimized to achieve pose removal.Experimental results are presented that demonstrate that the proposed algorithm improves upon existing techniques in the literature

Assessing competency for concealed-weapons permits - The physician's role

Shortly after the shootings in Newtown, Connecticut, two of us received letters from our county sheriff in North Carolina asking whether one of our patients had medical or physical conditions that would preclude issuance of a permit to carry a concealed weapon. Uncomfortable with our limited knowledge about such permits and our expected role, and fearing that our participation could affect our relationships with patients, we began exploring the ethical, legal, and policy considerations regarding physician involvement in this process

Adolescents’ aided recall of targeted and non-targeted tobacco communication campaigns in the united states

We examined whether advertisements from two national tobacco control campaigns targeting adolescents (i.e., The Real Cost, Fresh Empire) and one campaign targeting adults (i.e., Tips from Former Smokers) were reaching adolescents. Data came from a national sample of adolescents aged 13 to 17 years (n = 975) surveyed by phone from August 2016 to May 2017. We assessed recall and attitudes toward five specific advertisements and three campaign slogans and examined differences by sub-groups. Almost all (95%) adolescents recalled seeing at least one campaign advertisement. Aided recall of The Real Cost and Tips from Former Smokers slogans was high (65.5% and 71.6%, respectively), while aided recall of Fresh Empire slogan was lower (15.3%) (χ2 p-value: p < 0.001); however, Black adolescents had higher odds of recalling the Fresh Empire ad (aOR: 2.28, 95% CI: 1.39, 3.73) and slogan (aOR: 2.64, 95% CI: 1.06, 6.54) compared to White adolescents. Increased exposure to the advertisements (i.e., recalling more advertisements) was significantly associated with higher odds of reporting negative feelings toward tobacco products in 4/5 models (aORs from 1.34 to 1.61). Large-scale national campaigns can have wide reach among both targeted and non-targeted audiences with added benefits for cumulative cross-campaign exposure to advertisements

Clinical and molecular characterization of HER2 amplified-pancreatic cancer

&lt;p&gt;Background: Pancreatic cancer is one of the most lethal and molecularly diverse malignancies. Repurposing of therapeutics that target specific molecular mechanisms in different disease types offers potential for rapid improvements in outcome. Although HER2 amplification occurs in pancreatic cancer, it is inadequately characterized to exploit the potential of anti-HER2 therapies.&lt;/p&gt; &lt;p&gt;Methods: HER2 amplification was detected and further analyzed using multiple genomic sequencing approaches. Standardized reference laboratory assays defined HER2 amplification in a large cohort of patients (n = 469) with pancreatic ductal adenocarcinoma (PDAC).&lt;/p&gt; &lt;p&gt;Results: An amplified inversion event (1 MB) was identified at the HER2 locus in a patient with PDAC. Using standardized laboratory assays, we established diagnostic criteria for HER2 amplification in PDAC, and observed a prevalence of 2%. Clinically, HER2- amplified PDAC was characterized by a lack of liver metastases, and a preponderance of lung and brain metastases. Excluding breast and gastric cancer, the incidence of HER2-amplified cancers in the USA is &#62;22,000 per annum.&lt;/p&gt; &lt;p&gt;Conclusions: HER2 amplification occurs in 2% of PDAC, and has distinct features with implications for clinical practice. The molecular heterogeneity of PDAC implies that even an incidence of 2% represents an attractive target for anti-HER2 therapies, as options for PDAC are limited. Recruiting patients based on HER2 amplification, rather than organ of origin, could make trials of anti-HER2 therapies feasible in less common cancer types.&lt;/p&gt

Physician attitudes and experience with permit applications for concealed weapons

To the Editor: Every U.S. state allows people to carry concealed weapons within certain limits and after varied approval processes. Although many states require physician participation to help determine competency, it is not known whether physicians are capable of assessing a patient’s competence to carry a concealed weapon

Decoupling in an expanding universe: boundary RG-flow affects initial conditions for inflation

We study decoupling in FRW spacetimes, emphasizing a Lagrangian description throughout. To account for the vacuum choice ambiguity in cosmological settings, we introduce an arbitrary boundary action representing the initial conditions. RG flow in these spacetimes naturally affects the boundary interactions. As a consequence the boundary conditions are sensitive to high-energy physics through irrelevant terms in the boundary action. Using scalar field theory as an example, we derive the leading dimension four irrelevant boundary operators. We discuss how the known vacuum choices, e.g. the Bunch-Davies vacuum, appear in the Lagrangian description and square with decoupling. For all choices of boundary conditions encoded by relevant boundary operators, of which the known ones are a subset, backreaction is under control. All, moreover, will generically feel the influence of high-energy physics through irrelevant (dimension four) boundary corrections. Having established a coherent effective field theory framework including the vacuum choice ambiguity, we derive an explicit expression for the power spectrum of inflationary density perturbations including the leading high energy corrections. In accordance with the dimensionality of the leading irrelevant operators, the effect of high energy physics is linearly proportional to the Hubble radius H and the scale of new physics L= 1/M.Comment: LaTeX plus axodraw figures. v2: minor corrections; refs added. JHEP style: 34 pages + 18 pages appendi

Impact and mechanisms of cigarillo flavor descriptors on susceptibility to use among young adult nonusers of tobacco

Evidence suggests that flavoring may impact reactions to tobacco products. In the present research, we tested the impact and mechanisms of cigarillo flavor descriptors on susceptibility to use in order to determine whether exposure to cigarillos with characterizing flavors increases susceptibility in young adult nonusers of tobacco and, if so, why susceptibility increases. Nonsmoking, 18–26 years old U.S. residents were recruited for an online randomized controlled trial with two conditions: cigarillos with characterizing flavors (experimental condition) versus cigarillos with tobacco flavors (control condition). Experimental condition participants (n = 49) were presented with five cigarillo pack images with characterizing flavors (e.g., “Sweet”), whereas control condition participants (n = 53) were presented with five standard, tobacco-flavored images (e.g., “Air-Cured”). Each presented cigarillo image included a description of the pack flavor. Approach bias to the cigarillos was measured using the Implicit Association Test, and participants reported their perceptions of taste, smell, social acceptability, enjoyment, and harm in relation to each cigarillo pack. Finally, participants indicated their susceptibility to using cigarillos. Susceptibility to cigarillo use was significantly greater for participants exposed to the cigarillo packs with characterizing flavors. Taste perceptions both mediated and moderated the relationship between cigarillo flavor descriptors and susceptibility to use. Characterizing flavors increased susceptibility to cigarillo use via two routes: (1) by enhancing perceptions of taste and (2) by increasing the strength of association between perceptions of taste and susceptibility. These findings have implications for public health and policy decisions regarding banning or limiting characterizing flavors in cigarillos

Recipient IL28B polymorphism is an important independent predictor of posttransplant diabetes mellitus in liver transplant patients with chronic hepatitis C

IL28B polymorphisms are strongly associated with response to treatment for HCV infection. IL28B acts on interferon-stimulated genes via the JAK-STAT pathway, which has been implicated in development of insulin resistance. We investigated whether IL28B polymorphisms are associated with posttransplant diabetes mellitus (DM). Consecutive HCV patients who underwent liver transplantation between 1-1995 and 1-2011 were studied. Genotyping of the polymorphism rs12979860 was performed on DNA collected from donors and recipients. Posttransplant DM was screened for by fasting blood glucoses every 1-3 months. Of 221 included patients, 69 developed posttransplant DM (31%). Twenty-two patients with recipient IL28B genotype TT (48%), 25 with IL28B genotype CT (25%) and 22 with IL28B genotype CC (29%) developed posttransplant DM. TT genotype was statistically significantly associated with posttransplant DM over time (log rank p = 0.012 for TT vs. CT and p = 0.045 for TT vs. CC). Multivariate Cox regression analysis correcting for donor age, body mass index, baseline serum glucose, baseline serum cholesterol, recipient age and treated rejection, showed that recipient IL28B genotype TT was independently associated with posttransplant DM (hazard ratio 2.51; 95% confidence interval 1.17-5.40; p = 0.011). We conclude that the risk of developing posttransplant DM is significantly increased in recipients carrying the TT polymorphism of the IL28B gene. An analysis of liver transplant recipients with hepatitis C virus infection finds that the risk of developing posttransplant diabetes mellitus is significantly increased in recipients carrying the TT polymorphism of the IL28B gene

Quantum Criticality via Magnetic Branes

Holographic methods are used to investigate the low temperature limit, including quantum critical behavior, of strongly coupled 4-dimensional gauge theories in the presence of an external magnetic field, and finite charge density. In addition to the metric, the dual gravity theory contains a Maxwell field with Chern-Simons coupling. In the absence of charge, the magnetic field induces an RG flow to an infrared AdS$_3 \times {\bf R}^2$ geometry, which is dual to a 2-dimensional CFT representing strongly interacting fermions in the lowest Landau level. Two asymptotic Virasoro algebras and one chiral Kac-Moody algebra arise as {\sl emergent symmetries} in the IR. Including a nonzero charge density reveals a quantum critical point when the magnetic field reaches a critical value whose scale is set by the charge density. The critical theory is probed by the study of long-distance correlation functions of the boundary stress tensor and current. All quantities of major physical interest in this system, such as critical exponents and scaling functions, can be computed analytically. We also study an asymptotically AdS$_6$ system whose magnetic field induced quantum critical point is governed by a IR Lifshitz geometry, holographically dual to a D=2+1 field theory. The behavior of these holographic theories shares important similarities with that of real world quantum critical systems obtained by tuning a magnetic field, and may be relevant to materials such as Strontium Ruthenates.Comment: To appear in Lect. Notes Phys. "Strongly interacting matter in magnetic fields" (Springer), edited by D. Kharzeev, K. Landsteiner, A. Schmitt, H.-U. Ye