Utilization of Free Medication Samples in the United States in a Nationally Representative Sample: 2009-2013

Background—Manufacturers provide free sample medications as a means to increase use of branded medications. Sample use varies year-to-year as branded product patents expire and new products come to market. Objective—This study sought to describe the use of sample medications during 2009–2013 and assess individual characteristics associated with sample use. Methods—Data from the 2009–2013 U.S. Medical Expenditure Panel Survey (MEPS) were used. MEPS asks participants whether they received each medication they are taking as a sample. The top 10 medications and medication classes used each year by volume were identified as well as the proportion of people who used at least one sample medication. The proportion of new initiators of medications were also classified as the percent who received a sample for the specific medication. Logistic regression was used to assess individual demographics, insurance, and medication characteristics associated with use. Results—Prevalence of sample use ranged from 9.3% in 2009 to 6.2% in 2013. The most widely used sample medications included statins during 2009–2011, which changed to inhaled β-agonists in 2012–2013, as atorvastatin became available as a generic. The overall volume of the top 10 free sample medications decreased by one-third over this study period. In 2013, 12.6% of new insulin analog users and 11.0% of new oral contraceptive users receive these medications through samples. Regression analysis showed that U.S. Medicaid- and Medicare-insured persons were less likely to use samples compared to those with private insurance. Conclusions—Sample medication use has decreased as generic medications are becoming more used in the U.S

Double white dwarf mergers and elemental surface abundances in extreme helium and R Coronae Borealis stars

The surface abundances of extreme helium (EHe) and R Coronae Borealis (RCB) stars are discussed in terms of the merger of a carbon-oxygen white dwarf with a helium white dwarf. The model is expressed as a linear mixture of the individual layers of both constituent white dwarfs, taking account of the specific evolution of each star. In developing this recipe from previous versions, particular attention has been given to the inter-shell abundances of the asymptotic giant branch star which evolved to become the carbon-oxygen white dwarf. Thus the surface composition of the merged star is estimated as a function of the initial mass and metallicity of its progenitor. The question of whether additional nucleosynthesis occurs during the white dwarf merger has been examined. The high observed abundances of carbon and oxygen must either originate by dredge-up from the core of the carbon-oxygen white dwarf during a cold merger or be generated directly by alpha-burning during a hot merger. The presence of large quantities of O18 may be consistent with both scenarios, since a significant O18 pocket develops at the carbon/helium boundary in a number of our post-AGB models. The production of fluorine, neon and phosphorus in the AGB intershell produces n overabundance at the surface of the merged stars, but generally not in sufficient quantity. However, the evidence for an AGB origin for these elements points to progenitor stars with initial masses in the range 1.9 - 3 solar masses. There is not yet sufficient information to discriminate the origin (fossil or prompt) of all the abundance anomalies observed in EHe and RCB stars. Further work is required on argon and s-process elements in the AGB intershell, and on the predicted yields of all elements from a hot merger.Comment: 20 pages, 8 figures, 3 tables, MNRAS in pres

Complete Genomic Sequences of Three Salmonella enterica subsp. enterica Serovar Muenchen Strains from an Orchard in San Joaquin County, California.

We present here the complete genome sequences of three Salmonella enterica subsp. enterica serovar Muenchen strains, LG24, LG25, and LG26. All three strains were isolated from almond drupes grown in an orchard in San Joaquin County, California, in 2016. These genomic sequences are nonidentical and will contribute to our understanding of S. enterica genomics

Fault-tolerance techniques for hybrid CMOS/nanoarchitecture

The authors propose two fault-tolerance techniques for hybrid CMOS/nanoarchitecture implementing logic functions as look-up tables. The authors compare the efficiency of the proposed techniques with recently reported methods that use single coding schemes in tolerating high fault rates in nanoscale fabrics. Both proposed techniques are based on error correcting codes to tackle different fault rates. In the first technique, the authors implement a combined two-dimensional coding scheme using Hamming and Bose-Chaudhuri-Hocquenghem (BCH) codes to address fault rates greater than 5. In the second technique, Hamming coding is complemented with bad line exclusion technique to tolerate fault rates higher than the first proposed technique (up to 20). The authors have also estimated the improvement that can be achieved in the circuit reliability in the presence of Don-t Care Conditions. The area, latency and energy costs of the proposed techniques were also estimated in the CMOS domain

The WFC3 Galactic Bulge Treasury Program: Metallicity Estimates for the Stellar Population and Exoplanet Hosts

We present new UV-to-IR stellar photometry of four low-extinction windows in the Galactic bulge, obtained with the Wide Field Camera 3 on the Hubble Space Telescope (HST). Using our five bandpasses, we have defined reddening-free photometric indices sensitive to stellar effective temperature and metallicity. We find that the bulge populations resemble those formed via classical dissipative collapse: each field is dominated by an old (~10 Gyr) population exhibiting a wide metallicity range (-1.5 < [Fe/H] < 0.5). We detect a metallicity gradient in the bulge population, with the fraction of stars at super-solar metallicities dropping from 41% to 35% over distances from the Galactic center ranging from 0.3 to 1.2 kpc. One field includes candidate exoplanet hosts discovered in the SWEEPS HST transit survey. Our measurements for 11 of these hosts demonstrate that exoplanets in the distinct bulge environment are preferentially found around high-metallicity stars, as in the solar neighborhood, supporting the view that planets form more readily in metal-rich environments.Comment: Accepted for publication in The Astrophysical Journal Letters. Latex, 5 pages, ApJ forma

A Mycobacterium ESX-1–Secreted Virulence Factor with Unique Requirements for Export

Specialized secretion systems of pathogenic bacteria commonly transport multiple effectors that act in concert to control and exploit the host cell as a replication-permissive niche. Both the Mycobacterium marinum and the Mycobacterium tuberculosis genomes contain an extended region of difference 1 (extRD1) locus that encodes one such pathway, the early secretory antigenic target 6 (ESAT-6) system 1 (ESX-1) secretion apparatus. ESX-1 is required for virulence and for secretion of the proteins ESAT-6, culture filtrate protein 10 (CFP-10), and EspA. Here, we show that both Rv3881c and its M. marinum homolog, Mh3881c, are secreted proteins, and disruption of RD1 in either organism blocks secretion. We have renamed the Rv3881c/Mh3881c gene espB for ESX-1 substrate protein B. Secretion of M. marinum EspB (EspBM) requires both the Mh3879c and Mh3871 genes within RD1, while CFP-10 secretion is not affected by disruption of Mh3879c. In contrast, disruption of Mh3866 or Mh3867 within the extRD1 locus prevents CFP-10 secretion without effect on EspBM. Mutants that fail to secrete only EspBM or only CFP-10 are less attenuated in macrophages than mutants failing to secrete both substrates. EspBM physically interacts with Mh3879c; the M. tuberculosis homolog, EspBT, physically interacts with Rv3879c; and mutants of EspBM that fail to bind Mh3879c fail to be secreted. We also found interaction between Rv3879c and Rv3871, a component of the ESX-1 machine, suggesting a mechanism for the secretion of EspB. The results establish EspB as a substrate of ESX-1 that is required for virulence and growth in macrophages and suggests that the contribution of ESX-1 to virulence may arise from the secretion of multiple independent substrates

Synthesis and Biological Evaluation of Coumarin Replacements of Novobiocin as Hsp90 Inhibitors

Since Hsp90 modulates all six hallmarks of cancer simultaneously, it has become an attractive target for the development of cancer chemotherapeutics. In an effort to develop more efficacious compounds for Hsp90 inhibition, novobiocin analogues were prepared by replacing the central coumarin core with naphthalene, quinolinone, and quinoline surrogates. These modifications allowed for modification of the 2-position, which was previously unexplored. Biological evaluation of these compounds suggests a hydrophobic pocket about the 2-position of novobiocin. Anti-proliferative activities of these analogues against multiple cancer cell lines identified 2-alkoxyquinoline derivatives to exhibit improved activity

Time Dependent Monte Carlo Radiative Transfer Calculations For 3-Dimensional Supernova Spectra, Lightcurves, and Polarization

We discuss Monte-Carlo techniques for addressing the 3-dimensional time-dependent radiative transfer problem in rapidly expanding supernova atmospheres. The transfer code SEDONA has been developed to calculate the lightcurves, spectra, and polarization of aspherical supernova models. From the onset of free-expansion in the supernova ejecta, SEDONA solves the radiative transfer problem self-consistently, including a detailed treatment of gamma-ray transfer from radioactive decay and with a radiative equilibrium solution of the temperature structure. Line fluorescence processes can also be treated directly. No free parameters need be adjusted in the radiative transfer calculation, providing a direct link between multi-dimensional hydrodynamical explosion models and observations. We describe the computational techniques applied in SEDONA, and verify the code by comparison to existing calculations. We find that convergence of the Monte Carlo method is rapid and stable even for complicated multi-dimensional configurations. We also investigate the accuracy of a few commonly applied approximations in supernova transfer, namely the stationarity approximation and the two-level atom expansion opacity formalism.Comment: 16 pages, ApJ accepte

Time-resolved FUSE Photometric and Spectroscopic Observations: PG1219+534, PG1605+072, and PG1613+426

We report on the detection of pulsations in the far ultraviolet (hereafter FUV) light curves of PG1219+534, PG1605+072, and PG1613+426 obtained with the Far Ultraviolet Spectroscopic Explorer (FUSE) in time-tagged mode (TTAG). Exposures of the order of a few Ksecs were sufficient to observe the main frequencies of PG1219+534 and PG1605+072 and confirm the detection of a pulsation mode at the surface of PG1613+426 as reported from ground. For the first time we derive time-resolved spectroscopic FUSE data of a sdB pulsator (PG1605+072) and comment its line profile variation diagram (hereafter lpv diagram). We observe the phase shift between the maximum luminosity and the maximum radius to be consistent with the model of an adiabatic pulsator. We also present evidence that the line broadening previously reported is not caused by rotation but is rather an observational bias due to the rapid Doppler shift of the lines with 17 km.s-1 amplitude. Thus our observations do not support the previous claim that PG1605+072 is (or will evolve into) an unusually fast rotating degenerate dwarf. These results demonstrate the asteroseismological potential of the FUSE satellite which should be viewed as another powerful means of investigation of stellar pulsations along with the MOST and COROT missions.Comment: 16 pages, 5 figures, in Referee format. Accepted for publication in Astronomy and Astrophysic