Predicting pharmacy naloxone stocking and dispensing following a statewide standing order, Indiana 2016

BACKGROUND: While naloxone, the overdose reversal medication, has been available for decades, factors associated with its availability through pharmacies remain unclear. Studies suggest that policy and pharmacist beliefs may impact availability. Indiana passed a standing order law for naloxone in 2015 to increase access to naloxone. OBJECTIVE: To identify factors associated with community pharmacy naloxone stocking and dispensing following the enactment of a statewide naloxone standing order. METHODS: A 2016 cross-sectional census of Indiana community pharmacists was conducted following a naloxone standing order. Community, pharmacy, and pharmacist characteristics, and pharmacist attitudes about naloxone dispensing, access, and perceptions of the standing order were measured. Modified Poisson and binary logistic regression models attempted to predict naloxone stocking and dispensing, respectively. RESULTS: Over half (58.1%) of pharmacies stocked naloxone, yet 23.6% of pharmacists dispensed it. Most (72.5%) pharmacists believed the standing order would increase naloxone stocking, and 66.5% believed it would increase dispensing. Chain pharmacies were 3.2 times as likely to stock naloxone. Naloxone stocking was 1.6 times as likely in pharmacies with more than one full-time pharmacist. Pharmacies where pharmacists received naloxone continuing education in the past two years were 1.3 times as likely to stock naloxone. The attempted dispensing model yielded no improvement over the constant-only model. CONCLUSIONS: Pharmacies with larger capacity took advantage of the naloxone standing order. Predictors of pharmacist naloxone dispensing should continue to be explored to maximize naloxone access

Cosmological Constraints from calibrated Yonetoku and Amati relation implies Fundamental plane of Gamma-ray bursts

We consider two empirical relations using data only from the prompt emission of Gamma-Ray Bursts (GRBs), peak energy ($E_p$) - peak luminosity ($L_p$) relation (so called Yonetoku relation) and $E_p$-isotropic energy ($E_{\rm iso}$) relation (so called Amati relation). We first suggest the independence of the two relations although they have been considered similar and dependent. From this viewpoint, we compare constraints on cosmological parameters, $\Omega_m$ and $\Omega_{\Lambda}$, from the Yonetoku and Amati relations calibrated by low-redshift GRBs with $z < 1.8$. We found that they are different in 1-$\sigma$ level, although they are still consistent in 2-$\sigma$ level. This and the fact that both Amati and Yonetoku relations have systematic errors larger than statistical errors suggest the existence of a hidden parameter of GRBs. We introduce the luminosity time $T_L$ defined by $T_L\equiv E_{\rm iso}/L_p$ as a hidden parameter to obtain a generalized Yonetoku relation as $(L_p/{10^{52} \rm{erg s^{-1}}}) = 10^{-3.88\pm0.09}(E_p/{\rm{keV}})^{1.84\pm0.04} (T_L/{\rm{s}})^{-0.34\pm0.04}$. The new relation has much smaller systematic error, 30%, and can be regarded as "Fundamental plane" of GRBs. We show a possible radiation model for this new relation. Finally we apply the new relation for high-redshift GRBs with $1.8 < z < 5.6$ to obtain $(\Omega_m,\Omega_{\Lambda}) = (0.16^{+0.04}_{-0.06},1.20^{+0.03}_{-0.09})$, which is consistent with the concordance cosmological model within 2-$\sigma$ level.Comment: 5 pages, 6 figures, published in JCA

Accuracy and Limitations of Fitting and Stereoscopic Methods to Determine the Direction of Coronal Mass Ejections from Heliospheric Imagers Observations

Using data from the Heliospheric Imagers (HIs) onboard STEREO, it is possible to derive the direction of propagation of coronal mass ejections (CMEs) in addition to their speed with a variety of methods. For CMEs observed by both STEREO spacecraft, it is possible to derive their direction using simultaneous observations from the twin spacecraft and also, using observations from only one spacecraft with fitting methods. This makes it possible to test and compare different analyses techniques. In this article, we propose a new fitting method based on observations from one spacecraft, which we compare to the commonly used fitting method of Sheeley et al. (1999). We also compare the results from these two fitting methods with those from two stereoscopic methods, focusing on 12 CMEs observed simultaneously by the two STEREO spacecraft in 2008 and 2009. We find evidence that the fitting method of Sheeley et al. (1999) can result in significant errors in the determination of the CME direction when the CME propagates outside of 60deg \pm 20 deg from the Sun-spacecraft line. We expect our new fitting method to be better adapted to the analysis of halo or limb CMEs with respect to the observing spacecraft. We also find some evidence that direct triangulation in the HI fields-of-view should only be applied to CMEs propagating approximatively towards Earth (\pm 20deg from the Sun-Earth line). Last, we address one of the possible sources of errors of fitting methods: the assumption of radial propagation. Using stereoscopic methods, we find that at least seven of the 12 studied CMEs had an heliospheric deflection of less than 20deg as they propagated in the HI fields-of-view, which, we believe, validates this approximation.Comment: 17 pages, 6 figures, 2 tables, accepted to Solar Physic

O adsorption and incipient oxidation of the Mg(0001) surface

First principles density functional calculations are used to study the early oxidation stages of the Mg(0001) surface for oxygen coverages 1/16 <= Theta <= 3 monolayers. It is found that at very low coverages O is incorporated below the topmost Mg layer in tetrahedral sites. At higher oxygen-load the binding in on-surface sites is increased but at one monolayer coverage the on-surface binding is still about 60 meV weaker than for subsurface sites. The subsurface octahedral sites are found to be unfavorable compared to subsurface tetrahedral sites and to on-surface sites. At higher coverages oxygen adsorbs both under the surface and up. Our calculations predict island formation and clustering of incorporated and adsorbed oxygen in agreement with previous calculations. The calculated configurations are compared with the angle-scanned x-ray photoelectron diffraction experiment to determine the geometrical structure of the oxidized Mg(0001) surface.Comment: 10 pages, 5 figure

Speeds and arrival times of solar transients approximated by self-similar expanding circular fronts

The NASA STEREO mission opened up the possibility to forecast the arrival times, speeds and directions of solar transients from outside the Sun-Earth line. In particular, we are interested in predicting potentially geo-effective Interplanetary Coronal Mass Ejections (ICMEs) from observations of density structures at large observation angles from the Sun (with the STEREO Heliospheric Imager instrument). We contribute to this endeavor by deriving analytical formulas concerning a geometric correction for the ICME speed and arrival time for the technique introduced by Davies et al. (2012, ApJ, in press) called Self-Similar Expansion Fitting (SSEF). This model assumes that a circle propagates outward, along a plane specified by a position angle (e.g. the ecliptic), with constant angular half width (lambda). This is an extension to earlier, more simple models: Fixed-Phi-Fitting (lambda = 0 degree) and Harmonic Mean Fitting (lambda = 90 degree). This approach has the advantage that it is possible to assess clearly, in contrast to previous models, if a particular location in the heliosphere, such as a planet or spacecraft, might be expected to be hit by the ICME front. Our correction formulas are especially significant for glancing hits, where small differences in the direction greatly influence the expected speeds (up to 100-200 km/s) and arrival times (up to two days later than the apex). For very wide ICMEs (2 lambda > 120 degree), the geometric correction becomes very similar to the one derived by M\"ostl et al. (2011, ApJ, 741, id. 34) for the Harmonic Mean model. These analytic expressions can also be used for empirical or analytical models to predict the 1 AU arrival time of an ICME by correcting for effects of hits by the flank rather than the apex, if the width and direction of the ICME in a plane are known and a circular geometry of the ICME front is assumed.Comment: 15 pages, 5 figures, accepted for publication in "Solar Physics

Heliospheric Observations of STEREO-Directed Coronal Mass Ejections in 2008--2010: Lessons for Future Observations of Earth-Directed CMEs

We present a study of coronal mass ejections (CMEs) which impacted one of the STEREO spacecraft between January 2008 and early 2010. We focus our study on 20 CMEs which were observed remotely by the Heliospheric Imagers (HIs) onboard the other STEREO spacecraft up to large heliocentric distances. We compare the predictions of the Fixed-Phi and Harmonic Mean (HM) fitting methods, which only differ by the assumed geometry of the CME. It is possible to use these techniques to determine from remote-sensing observations the CME direction of propagation, arrival time and final speed which are compared to in situ measurements. We find evidence that for large viewing angles, the HM fitting method predicts the CME direction better. However, this may be due to the fact that only wide CMEs can be successfully observed when the CME propagates more than 100 deg from the observing spacecraft. Overall eight CMEs, originating from behind the limb as seen by one of the STEREO spacecraft can be tracked and their arrival time at the other STEREO spacecraft can be successfully predicted. This includes CMEs, such as the events on 4 December 2009 and 9 April 2010, which were viewed 130 deg away from their direction of propagation. Therefore, we predict that some Earth-directed CMEs will be observed by the HIs until early 2013, when the separation between Earth and one of the STEREO spacecraft will be similar to the separation of the two STEREO spacecraft in 2009--2010.Comment: 21 pages, accepted to Solar Physic

Effect of Solar Wind Drag on the Determination of the Properties of Coronal Mass Ejections from Heliospheric Images

The Fixed-\Phi (F\Phi) and Harmonic Mean (HM) fitting methods are two methods to determine the average direction and velocity of coronal mass ejections (CMEs) from time-elongation tracks produced by Heliospheric Imagers (HIs), such as the HIs onboard the STEREO spacecraft. Both methods assume a constant velocity in their descriptions of the time-elongation profiles of CMEs, which are used to fit the observed time-elongation data. Here, we analyze the effect of aerodynamic drag on CMEs propagating through interplanetary space, and how this drag affects the result of the F\Phi and HM fitting methods. A simple drag model is used to analytically construct time-elongation profiles which are then fitted with the two methods. It is found that higher angles and velocities give rise to greater error in both methods, reaching errors in the direction of propagation of up to 15 deg and 30 deg for the F\Phi and HM fitting methods, respectively. This is due to the physical accelerations of the CMEs being interpreted as geometrical accelerations by the fitting methods. Because of the geometrical definition of the HM fitting method, it is affected by the acceleration more greatly than the F\Phi fitting method. Overall, we find that both techniques overestimate the initial (and final) velocity and direction for fast CMEs propagating beyond 90 deg from the Sun-spacecraft line, meaning that arrival times at 1 AU would be predicted early (by up to 12 hours). We also find that the direction and arrival time of a wide and decelerating CME can be better reproduced by the F\Phi due to the cancellation of two errors: neglecting the CME width and neglecting the CME deceleration. Overall, the inaccuracies of the two fitting methods are expected to play an important role in the prediction of CME hit and arrival times as we head towards solar maximum and the STEREO spacecraft further move behind the Sun.Comment: Solar Physics, Online First, 17 page

The T2K ND280 Off-Axis Pi-Zero Detector

The Pi-Zero detector (P{\O}D) is one of the subdetectors that makes up the off-axis near detector for the Tokai-to-Kamioka (T2K) long baseline neutrino experiment. The primary goal for the P{\O}D is to measure the relevant cross sections for neutrino interactions that generate pi-zero's, especially the cross section for neutral current pi-zero interactions, which are one of the dominant sources of background to the electron neutrino appearance signal in T2K. The P{\O}D is composed of layers of plastic scintillator alternating with water bags and brass sheets or lead sheets and is one of the first detectors to use Multi-Pixel Photon Counters (MPPCs) on a large scale.Comment: 17 pages, submitted to NIM

Organizational and Leadership Implications for Transformational Development

Transformational development is a concept of change that originated in the Christian context but has now become generally used in the work of both secular and faith-based organizations. The growing use of the concept by organizations that are fundamentally different has naturally led to some confusion about what the concept means and what it takes to effectively implement it. In this article, we describe the key features of the concept and how they are important in determining the organizational requirements for its effective implementation. Drawing on a few cases, the paper highlights the centrality of faith in transformational development work

Study of the B^0 Semileptonic Decay Spectrum at the Upsilon(4S) Resonance

We have made a first measurement of the lepton momentum spectrum in a sample of events enriched in neutral B's through a partial reconstruction of B0 --> D*- l+ nu. This spectrum, measured with 2.38 fb**-1 of data collected at the Upsilon(4S) resonance by the CLEO II detector, is compared directly to the inclusive lepton spectrum from all Upsilon(4S) events in the same data set. These two spectra are consistent with having the same shape above 1.5 GeV/c. From the two spectra and two other CLEO measurements, we obtain the B0 and B+ semileptonic branching fractions, b0 and b+, their ratio, and the production ratio f+-/f00 of B+ and B0 pairs at the Upsilon(4S). We report b+/b0=0.950 (+0.117-0.080) +- 0.091, b0 = (10.78 +- 0.60 +- 0.69)%, and b+ = (10.25 +- 0.57 +- 0.65)%. b+/b0 is equivalent to the ratio of charged to neutral B lifetimes, tau+/tau0.Comment: 14 page, postscript file also available at http://w4.lns.cornell.edu/public/CLN