Effect of Exposure to Small Pharmaceutical Promotional Items on Treatment Preferences

Background: Policy discussions concerning pharmaceutical promotion often assume that small promotional items are unlikely to influence prescribing behavior. Our experiment measures whether exposure to these items results in more favorable attitudes toward marketed products and whether policies that restrict pharmaceutical marketing mitigate this effect. Methods: This is a randomized controlled experiment of 352 third- and fourth-year medical students at two US medical schools with differing policies toward pharmaceutical marketing. Participants assigned to treatment were exposed to small branded promotional items for Lipitor (atorvastatin) without knowledge that the exposure was part of the study. We measured differences in implicit (ie, unconscious) attitudes toward Lipitor and Zocor (simvastatin) in exposed and control groups with the Implicit Association Test (IAT). Self-reported attitudes were also measured, and a follow-up survey was administered measuring attitudes toward marketing. Results: Fourth-year students at the University of Miami Miller School of Medicine exposed to Lipitor promotional items had more favorable implicit attitudes about that brand-name drug compared to the control group (IAT effect: 0.66 vs 0.47; P = .05), while the effect was reversed at the University of Pennsylvania School of Medicine (IAT effect: 0.22 vs 0.52; P = .002) where restrictive policies are in place limiting pharmaceutical marketing (interaction effect: P = .003). No significant effect was observed among third-year students. On a “skepticism” scale, University of Miami students held more favorable attitudes toward pharmaceutical marketing compared to University of Pennsylvania students (0.55 vs 0.42; P Conclusions: Subtle exposure to small pharmaceutical promotional items influences implicit attitudes toward marketed products among medical students. We observed a reversal of this effect in the setting of restrictive policies and more negative school-level attitudes toward marketing

Gsx2 controls region-specific activation of neural stem cells and injury-induced neurogenesis in the adult subventricular zone

Neural stem cells (NSCs) reside in widespread regions along the lateral ventricle and generate diverse olfactory bulb (OB) interneuron subtypes in the adult mouse brain. Molecular mechanisms underlying their regional diversity, however, are not well understood. Here we show that the homeodomain transcription factor Gsx2 plays a crucial role in the region-specific control of adult NSCs in both persistent and injury-induced neurogenesis. In the intact brain, Gsx2 is expressed in a regionally restricted subset of NSCs and promotes the activation and lineage progression of stem cells, thereby controlling the production of selective OB neuron subtypes. Moreover, Gsx2 is ectopically induced in damaged brains outside its normal expression domains and is required for injury-induced neurogenesis in the subventricular zone (SVZ). These results demonstrate that mobilization of adult NSCs is controlled in a region-specific manner and that distinct mechanisms operate in continuous and injury-induced neurogenesis in the adult brain

The effect of protons on the performance of second generation Swept Charge Devices

The e2v technologies Swept Charge Device (SCD) was developed as a large area detector for X-ray Florescence (XRF) analysis, achieving near Fano-limited spectroscopy at -15 °C. The SCD was flown in the XRF instruments on board the European Space Agency's SMART-1 and the Indian Space Research Organisation's Chandrayaan-1 lunar missions. The second generation SCD, proposed for use in the soft X-ray spectrometer on the Chandrayaan-2 lunar orbiter and the soft X-ray imager on China's HXMT mission, was developed, in part, using the findings of the radiation damage studies performed for the Chandrayaan-1 X-ray Spectrometer. This paper discusses the factor of two improvement in radiation tolerance achieved in the second generation SCD, the different SCD sizes produced and their advantages for future XRF instruments, for example through reduced shielding mass or higher operating temperatures

Environmental Impact on Direct Neuronal Reprogramming In Vivo in the Adult Brain

Direct reprogramming of non-neuronal cells to generate new neurons is a promising approach to repair damaged brains. Impact of the in vivo environment on neuronal reprogramming, however, is poorly understood. Here we show that regional differences and injury conditions have significant influence on the efficacy of reprogramming and subsequent survival of newly generated neurons in the adult rodent brain. A combination of local exposure to growth factors and retrovirus-mediated overexpression of the neurogenic transcription factor Neurogenin2 (Neurog2) can induce new neurons from non-neuronal cells in the adult neocortex and striatum where neuronal turnover is otherwise very limited. These two regions respond to growth factors and Neurog2 differently and instruct new neurons to exhibit distinct molecular phenotypes. Moreover, ischemic insult differentially affects differentiation of new neurons in these regions. These results demonstrate strong environmental impact on direct neuronal reprogramming in vivo

A reassuring presence: An evaluation of Bradford District Hospice at Home service

Within the United Kingdom, a developing role for primary care services in cancer and palliative care has resulted in an increase in palliative home care teams. The provision of professional care in the home setting seeks to provide necessary services and enhanced choice for patients whose preference is to die at home. A mismatch between patient preference for home death and the actual number of people who died at home was identified within Bradford, the locality of this study. In response to this mismatch, and reflecting the policy environment of wishing to enhance community service provision, the four Primary Care Trusts (PCTs) in the city sought to offer support to patients who wished to remain in their own homes through the final stages of a terminal illness. To offer this support they set up a dedicated hospice at home team. This would provide services and support for patients in achieving a dignified, symptom free and peaceful death, allowing families to maximise time spent together. The aim of the study was to evaluate the Bradford hospice at home service from the perspective of carers, nurses and General Practitioners. Postal questionnaires were sent to carers (n = 289), district nurses (n = 508) and GP's (n = 444) using Bradford's hospice at home service. Resulting quantitative data was analysed using the Statical Package for Social Sciences (SPSS) and qualitative data was analysed using grounded theory techniques. The data from carers, district nurses and GPs provide general support for the Bradford hospice at home service. Carers valued highly the opportunity to 'fulfil a promise' to the individual who wished to be cared for at home. District nurses and GPs cited the positive impact of access to specialist expertise. This was a 'reassuring presence' for primary healthcare teams and offered 'relief of carer anxiety' by providing prompt, accessible and sensitive care. Carers and health professionals welcomed the increased possibility of patients being cared for at home. The study identified the need to focus on improving skill levels of staff and on ensuring continuity of care

Multiscale investigation of adsorption properties of novel 3D printed UTSA-16 structures

Structuring MOF materials is a fundamental step towards their commercialization. Herein we report intensive characterization of 3D-printed UTSA-16 monoliths, facilitated by the development of a new non-aqueous ink formulation, employing hydroxypropyl cellulose and boehmite to adjust the rheology of the ink. What makes this formulation and printing process different from the printed adsorbents and catalysts published previously, is that the resulting structures in this work were not sintered. The presence of the binder matrix not only produced the physical properties for printability but also ensured a homogeneous dispersion of UTSA-16 in the structures, as well as gas adsorption characteristics. The monoliths were tested for the adsorption of different gases (N2, CH4, CO2 and H2O) in order to apply them into separation processes that contribute to defossilizing energy and fuels production. Water is strongly adsorbed in this material (~14 mol/kg at 293 K) and is competing with CO2 for adsorption sites. Breakthrough curves showed that the retention time of CO2 decreases significantly when the feed stream is saturated with water. In this study, synchrotron XRD-CT data were collected in situ, in a non-destructive way, and phase distribution maps were reconstructed to, for the first time, gain insight into the spatial and temporal evolution of the UTSA-16 containing phases in the operating 3D printed monolith during the exposure to CO2.publishedVersio

Efficient multi-fidelity computation of blood coagulation under flow

Clot formation is a crucial process that prevents bleeding, but can lead to severe disorders when imbalanced. This process is regulated by the coagulation cascade, a biochemical network that controls the enzyme thrombin, which converts soluble fibrinogen into the fibrin fibers that constitute clots. Coagulation cascade models are typically complex and involve dozens of partial differential equations (PDEs) representing various chemical species’ transport, reaction kinetics, and diffusion. Solving these PDE systems computationally is challenging, due to their large size and multi-scale nature. We propose a multi-fidelity strategy to increase the efficiency of coagulation cascade simulations. Leveraging the slower dynamics of molecular diffusion, we transform the governing PDEs into ordinary differential equations (ODEs) representing the evolution of species concentrations versus blood residence time. We then Taylor-expand the ODE solution around the zero-diffusivity limit to obtain spatiotemporal maps of species concentrations in terms of the statistical moments of residence time, , and provide the governing PDEs for . This strategy replaces a high-fidelity system of N PDEs representing the coagulation cascade of N chemical species by N ODEs and p PDEs governing the residence time statistical moments. The multi-fidelity order (p) allows balancing accuracy and computational cost providing a speedup of over N/p compared to high-fidelity models. Moreover, this cost becomes independent of the number of chemical species in the large computational meshes typical of the arterial and cardiac chamber simulations. Using a coagulation network with N = 9 and an idealized aneurysm geometry with a pulsatile flow as a benchmark, we demonstrate favorable accuracy for low-order models of p = 1 and p = 2. The thrombin concentration in these models departs from the high-fidelity solution by under 20% (p = 1) and 2% (p = 2) after 20 cardiac cycles. These multi-fidelity models could enable new coagulation analyses in complex flow scenarios and extensive reaction networks. Furthermore, it could be generalized to advance our understanding of other reacting systems affected by flow.MGH, MGV and OF have been partially supported by the Spanish Research Agency and the European Regional Development Fund, under grant number PID2019-107279RB-I00. MGH, MGV, PML, JB and OF have been partially supported by the Comunidad de Madrid and the European Regional Development Fund, under grant number Y2018/BIO-4858 PREFI-CM, and by the Instituto de Salud Carlos III and the European Regional Development Fund, under grant numbers PI15/02211-ISBITAMI and DTS/1900063-ISBIFLOW. AG, EMcV, AK and JCdA have been partially supported by the US National Institutes of Health, under grant 1R01HL160024. JCdA has been partially supported by the US National Insitutes of Health, under grant number 1R01HL158667

Thermal behaviour of Cu and Au nanoparticles grown on CeO2 thin films

RM and FG acknowledge funding from EPSRC grants (RM: EP/506631/1; FG: EP/M029077/1). JAvdB and AKR acknowledge the EPSRC funding for the use of the MEIS facility at the University of Huddersfield within grant EP/M029077/1. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior -Brasil (CAPES) - Finance Code 001, by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), and PRONEX-FAPERGS16/2551-0000479-0.Bimetallic catalysts are often more active and/or selective than their monometallic counterparts. The behaviour of such catalysts is frequently strongly dependent on the molar ratio of the two elements as well as nanoparticle size and the interaction with the support material. X-ray photoelectron spectroscopy (XPS) is an excellent surface analytical technique for probing the electronic properties of catalytic systems. When a mixture of pure and alloyed particles is present, it is more difficult to extract information from XPS given that it is a spatial averaging technique. Recently, the technique of medium energy ion scattering (MEIS) has been exploited to investigate the depth-dependent composition of nanoparticles on planar surfaces. Herein, we combine the two techniques to investigate the nature of Cu and Au nanoparticles deposited onto ultrathin CeO2 films on Si(111) examining their morphology and chemical composition as a function of annealing temperature for samples that have been maintained in an ultrahigh vacuum environment and exposed to air. The Cu/Au/CeO2/Si(111) is chosen as a model system in order to provide insight into how the catalytic properties of Cu/Au/CeO2 depend on the presence of discrete Cu and Au particles versus fully intermixed Cu/Au systems.PostprintPeer reviewe

Pulmonary vein flow split effects in patient-specific simulations of left atrial flow

Disruptions to left atrial (LA) blood flow, such as those caused by atrial fibrillation (AF), can lead to thrombosis in the left atrial appendage (LAA) and an increased risk of systemic embolism. LA hemodynamics are influenced by various factors, including LA anatomy and function, and pulmonary vein (PV) inflow conditions. In particular, the PV flow split can vary significantly among and within patients depending on multiple factors. In this study, we investigated how changes in PV flow split affect LA flow transport, focusing for the first time on blood stasis in the LAA, using a high-fidelity patient-specific computational fluid dynamics (CFD) model. We use an Immersed Boundary Method, simulating the flow in a fixed, uniform Cartesian mesh and imposing the movement of the LA walls with a moving Lagrangian mesh generated from 4D Computerized Tomography images. We analyzed LA anatomies from eight patients with varying atrial function, including three with AF and either a LAA thrombus or a history of Transient Ischemic Attacks (TIAs). Using four different flow splits (60/40% and 55/45% through right and left PVs, even flow rate, and same velocity through each PV), we found that flow patterns are sensitive to PV flow split variations, particularly in planes parallel to the mitral valve. Changes in PV flow split also had a significant impact on blood stasis and could contribute to increased risk for thrombosis inside the LAA, particularly in patients with AF and previous LAA thrombus or a history of TIAs. Our study highlights the importance of considering patient-specific PV flow split variations when assessing LA hemodynamics and identifying patients at increased risk for thrombosis and stroke. This knowledge is relevant to planning clinical procedures such as AF ablation or the implementation of LAA occluders.This work was partially supported by Comunidad de Madrid (Synergy Grant Y2018/BIO-4858 PREFI-CM), Spanish Research Agency (AEI, grant number PID2019-107279RB-I00), Instituto de Salud Carlos III (grant numbers PI15/02211-ISBITAMI and DTS/1900063-ISBIFLOW), and by the EU-European Regional Development Fund . Funding for open access charge: Universidad de Málaga / CBUA