94 research outputs found

    Orienting Patients to Greater Opioid Safety: Models of Community Pharmacy-Based Naloxone

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    The leading cause of adult injury death in the USA is drug overdose, the majority of which involves prescription opioid medications. Outside of the USA, deaths by drug overdose are also on the rise, and overdose is a leading cause of death for drug users. Reducing overdose risk while maintaining access to prescription opioids when medically indicated requires careful consideration of how opioids are prescribed and dispensed, how patients use them, how they interact with other medications, and how they are safely stored. Pharmacists, highly trained professionals expert at detecting and managing medication errors and drug-drug interactions, safe dispensing, and patient counseling, are an under-utilized asset in addressing overdose in the US and globally. Pharmacies provide a high-yield setting where patient and caregiver customers can access naloxone—an opioid antagonist that reverses opioid overdose—and overdose prevention counseling. This case study briefly describes and provides two US state-specific examples of innovative policy models of pharmacy-based naloxone, implemented to reduce overdose events and improve opioid safety: Collaborative Pharmacy Practice Agreements and Pharmacy Standing Orders

    A randomized, open label trial of methadone continuation versus forced withdrawal in a combined US prison and jail: Findings at 12 months post-release

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    however, few jails and prisons in the United States initiate or continue people who are incarcerated on MMT. In the current study, the 12 month outcomes of a randomized control trial in which individuals were provided MMT while incarcerated at the Rhode Island Department of Corrections (RIDOC) are assessed. An as-treated analysis included a total of 179 participants—128 who were, and 51 who were not, dosed with methadone the day before they were released from the RIDOC. The results of this study demonstrate that 12 months post-release individuals who received continued access to MMT while incarcerated were less likely to report using heroin and engaging in injection drug use in the past 30 days. In addition, they reported fewer non-fatal overdoses and were more likely to be continuously engaged in treatment in the 12-month follow-up period compared to individuals who were not receiving methadone immediately prior to release. These findings indicate that providing incarcerated individuals continued access to MMT has a sustained, long-term impact on many opioid-related outcomes post-release.Recently incarcerated individuals are at increased risk of opioid overdose. Methadone maintenance treatment (MMT) is an effective way to address opioid use disorder and prevent overdos

    The Path to Implementation of HIV Pre-exposure Prophylaxis for People Involved in Criminal Justice Systems

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    The criminal justice (CJ)-involved population in the United States (US) is among the most vulnerable to and heavily impacted by HIV. HIV prevalence is three to five times higher among incarcerated populations than in the general population and one in seven people living with HIV (PLH) pass through CJ systems each year. Among racial and ethnic minorities, HIV and incarceration are even more closely intertwined: one of every five HIV-infected black or Hispanic/Latino adults passes through CJ systems annually

    Electric and magnetic charges in N=2 conformal supergravity theories

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    General Lagrangians are constructed for N=2 conformal supergravity theories in four space-time dimensions involving gauge groups with abelian and/or non-abelian electric and magnetic charges. The charges are encoded in the gauge group embedding tensor. The scalar potential induced by the gauge interactions is quadratic in this tensor, and, when the embedding tensor is treated as a spurionic quantity, it is formally covariant with respect to electric/magnetic duality. This work establishes a general framework for studying any deformation induced by gauge interactions of matter-coupled N=2 supergravity theories. As an application, full and residual supersymmetry realizations in maximally symmetric space-times are reviewed. Furthermore, a general classification is presented of supersymmetric solutions in AdS2×S2\mathrm{AdS}_2\times S^2 space-times. As it turns out, these solutions allow either eight or four supersymmetries. With four supersymmetries, the spinorial parameters are Killing spinors of AdS2\mathrm{AdS}_2 that are constant on S2S^2, so that they carry no spin, while the bosonic background is rotationally invariant.Comment: 49 pages, typos correcte

    Search for light resonances decaying to boosted quark pairs and produced in association with a photon or a jet in proton–proton collisions at √s=13 TeV with the ATLAS detector

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    This Letter presents a search for new light resonances decaying to pairs of quarks and produced in association with a high-pT photon or jet. The dataset consists of proton–proton collisions with an integrated luminosity of 36.1 fb−1at a centre-of-mass energy of √s=13TeV recorded by the ATLAS detector at the Large Hadron Collider. Resonance candidates are identified as massive large-radius jets with substructure consistent with a particle decaying into a quark pair. The mass spectrum of the candidates is examined for local excesses above background. No evidence of a new resonance is observed in the data, which are used to exclude the production of a lepto-phobic axial-vector Z boson

    ATLAS pixel detector electronics and sensors

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    The silicon pixel tracking system for the ATLAS experiment at the Large Hadron Collider is described and the performance requirements are summarized. Detailed descriptions of the pixel detector electronics and the silicon sensors are given. The design, fabrication, assembly and performance of the pixel detector modules are presented. Data obtained from test beams as well as studies using cosmic rays are also discussed

    Search for Higgs Bosons Decaying into b anti-b and Produced in Association with a Vector Boson in Proton-Antiproton Collisions at 1.8 TeV

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    We present a new search for H0VH^{0}V production, where H0H^0 is a scalar Higgs boson decaying into bbˉb\bar{b} with branching ratio β\beta, and VV is a Z0Z^{0} boson decaying into e+ee^{+}e^{-}, μ+μ\mu^{+}\mu^{-}, or ννˉ\nu\bar{\nu}. This search is then combined with previous searches for H0VH^{0}V where VV is a W±W^{\pm} boson or a hadronically decaying Z0Z^{0}. The data sample consists of 106±4106 \pm 4 pb1^{-1} of ppˉp\bar{p} collisions at s=1.8\sqrt{s}=1.8 TeV accumulated by the Collider Detector at Fermilab. Observing no evidence of a signal, we set 95% Bayesian credibility level upper limits on σ(ppˉH0V)×β\sigma(p\bar{p}\to H^{0}V)\times\beta. For H0H^0 masses of 90, 110 and 130 GeV/c2c^{2}, the limits are 7.8, 7.2, and 6.6 pb respectively.Comment: 6 pages, 3 figures, to be submiited to PR

    Measurement of dsigma/DM Forward-Backward Charge Asymmetry for High Mass Drell-Yan e+e- Pairs from p-pbar Collisions at sqrt(s)=1.8 TeV

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    We report on a measurement of the mass dependence of the forward-backward charge asymmetry, A_FB, and production cross section dsigma/dM for e+e- pairs with mass M_ee>40 GeV/c2. The data sample consists of 108 pb-1 of p-pbar collisions at sqrt(s)=1.8 TeV taken by the Collider Detector at Fermilab during 1992-1995. The measured asymmetry and dsigma/dM are compared with the predictions of the Standard Model and a model with an extra Z' gauge boson.Comment: 7 pages submitted to Phys. Rev. Lett. 1 figure, 2 Table

    The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

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    Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients
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