Representativeness of samples from general practice lists in epidemiological studies: case-control study

Ethical constraints often prevent epidemiological studies from evaluating the impact of non-participation. Particular problems may arise when subjects fail to respond to an approach by researchers or when they cannot be contacted because of inaccurate contact details or a doctor's refusal to give permission for their patient to be approached. If these subjects differ from those subjects who agree or decline to participate then the validity and generalisability of the study may be compromised. We investigated these issues in a case-control study of acute leukaemia in England

Pressure dependence of the superconducting transition temperature in C6_6Yb and C6_6Ca

We have studied the evolution, with hydrostatic pressure, of the recently discovered superconductivity in the graphite intercalation compounds C$_6$Yb and C$_6$Ca. We present pressure-temperature phase diagrams, for both superconductors, established by electrical transport and magnetization measurements. In the range 0-1.2 GPa the superconducting transition temperature increases linearly with pressure in both materials with $dT_c/dP = +0.39 K/GPa$ and $dT_c/dP = +0.50 K/GPa$ for C$_6$Yb and C$_6$Ca respectively. The transition temperature in C$_6$Yb, which has beenmeasured up to 2.3 GPa, reaches a peak at around 1.8 GPa and then starts to drop. We also discuss how this pressure dependence may be explained within a plasmon pairing mechanism.Comment: 4 pages, 3 figure

Efficacy of pimobendan in the prevention of congestive heart failure or sudden death in doberman pinschers with preclinical dilated cardiomyopathy (the PROTECT study)

<p>Background: The benefit of pimobendan in delaying the progression of preclinical dilated cardiomyopathy (DCM) in Dobermans is not reported.</p> <p>Hypothesis: That chronic oral administration of pimobendan to Dobermans with preclinical DCM will delay the onset of CHF or sudden death and improve survival.</p> <p>Animals: Seventy-six client-owned Dobermans recruited at 10 centers in the UK and North America.</p> <p>Methods: The trial was a randomized, blinded, placebo-controlled, parallel group multicenter study. Dogs were allocated in a 1:1 ratio to receive pimobendan (Vetmedin capsules) or visually identical placebo.</p> <p>The composite primary endpoint was prospectively defined as either onset of CHF or sudden death. Time to death from all causes was a secondary endpoint.</p> <p>Results: The proportion of dogs reaching the primary endpoint was not significantly different between groups (P = .1). The median time to the primary endpoint (onset of CHF or sudden death) was significantly longer in the pimobendan (718 days, IQR 441–1152 days) versus the placebo group (441 days, IQR 151–641 days) (log-rank P = 0.0088). The median survival time was significantly longer in the pimobendan (623 days, IQR 491–1531 days) versus the placebo group (466 days, IQR 236–710 days) (log-rank P = .034).</p> <p>Conclusion and Clinical Importance: The administration of pimobendan to Dobermans with preclinical DCM prolongs the time to the onset of clinical signs and extends survival. Treatment of dogs in the preclinical phase of this common cardiovascular disorder with pimobendan can lead to improved outcome.</p&gt

Patient perspectives on cervical cancer screening interventions among underscreened women

Background Cervical cancer is highly preventable with regular screening, yet over 4,000 women die from it annually in the United States. Over half of new cervical cancer cases in the U.S. are attributable to insufficient screening. Methods Participants were 23 low-income, uninsured or Medicaid-insured women in North Carolina who were overdue for cervical cancer screening according to national guidelines. Semi-structured interviews examined perspectives on barriers to cervical cancer screening and on interventions to reduce these barriers. We also elicited feedback on three proposed evidence-based interventions: one-on-one education, coupons to reduce out-of-pocket costs, and self-collection of samples for detection of high-risk human papillomavirus (HPV) infection, the primary cause of cervical cancer. Results Reported barriers included high cost, inconvenient clinic hours, lack of provider recommendation, poor transportation, difficulty finding a provider, fear of pain, and low perceived need. Participants suggested interventions including reducing cost, improving convenience through community-based screening or extended clinic hours, strengthening provider recommendations, and providing one-on-one counseling and education outreach. HPV self-collection was most frequently selected as the “most helpful” of 3 proposed interventions (n = 11), followed by reducing out-of-pocket costs (n = 7) and one-on-one education (n = 5). Conclusion Cost was the most reported barrier to cervical cancer screening, although women experience multiple simultaneous barriers. Novel interventions such as HPV self-collection promise to reduce some, but not all, barriers to primary screening. Interventions that work on reducing multiple barriers, including obstacles to receiving follow-up care, may be most effective to prevent cervical cancer among these high-risk women

Early adoption of the human papillomavirus vaccine among hispanic adolescent males in the united states

BACKGROUND: Human papillomavirus (HPV) infection is common among Hispanic males, but to the authors' knowledge little is known regarding HPV vaccination in this population. The authors examined the early adoption of the HPV vaccine among a national sample of Hispanic adolescent males.METHODS: The authors analyzed provider-verified HPV vaccination data from the 2010 through 2012 National Immunization Survey-Teen (NIS-Teen) for Hispanic males aged 13 years to 17 years (n=4238).Weighted logistic regression identified correlates of HPV vaccine initiation (receipt of ≥1 doses).RESULTS: HPV vaccine initiation was 17.1% overall, increasing from 2.8% in 2010 to 31.7% in 2012 (P<.0001). Initiation was higher among sons whose parents had received a provider recommendation to vaccinate compared with those whose parents had not (53.3% vs 9.0%; odds ratio, 8.77 [95% confidence interval, 6.05-12.70]). Initiation was also higher among sons who had visited a health care provider within the previous year (odds ratio, 2.42; 95% confidence interval, 1.39-4.23). Among parents with unvaccinated sons, Spanish-speaking parents reported much higher intent to vaccinate compared with English-speaking parents (means: 3.52 vs 2.54; P<.0001). Spanish-speaking parents were more likely to indicate lack of knowledge (32.9% vs 19.9%) and not having received a provider recommendation (32.2% vs 17.7%) as the main reasons for not intending to vaccinate (both P<.05).CONCLUSIONS: HPV vaccination among Hispanic adolescent males has increased substantially in recent years. Ensuring health care visits and provider recommendation will be key for continuing this trend. Preferred language may also be important for increasing HPV vaccination and addressing potential barriers to vaccination

Overcoming barriers to adolescent vaccination: perspectives from vaccine providers in North Carolina

To capture strategies for achieving high adolescent coverage of tetanus-diphtheria-acellular pertussis (Tdap), meningococcal conjugate (MenACWY), and human papillomavirus (HPV) vaccination, we surveyed employees of 20 North Carolina (N.C.) clinics that achieved adolescent vaccination coverage higher than the state average. One employee per clinic completed a surveysummarizing clinic practices regarding adolescent vaccination; perceived barriers and facilitators to Tdap/MenACWY/HPV vaccination; and the role of “champions” who made special efforts to promote adolescent vaccination. Common perceived barriers for all vaccinations were parental opposition and logistical barriers to receiving vaccination. For HPV vaccination, employees cited parental concerns about sexual behavior and injection site pain; no school vaccination requirement; and low-perceived benefit in boys. Most clinics (80%) implemented successful changes to increase adolescent vaccination: consistently offering vaccination, tracking vaccination status using existing data, providing appointment reminders, updating providers on vaccination recommendations, and expanding vaccination hours. Strategies to improve HPV vaccination included co-administration with Tdap and MenACWY, and providing reminders to complete the vaccination series. Vaccine champions strongly recommended vaccination to parents (55%) and educated parents on vaccination recommendations (36%). Clinics in N.C.and similar settings can implement these and other low-resource strategies to overcome adolescent vaccination barriers. Abbreviations: CDC=Centers for Disease Control and Prevention; EHR=Electronic health record; HPV=Human papillomavirus; Tdap=Tetanus-diphtheria-acellular pertussis vaccine; MenACWY=Meningococcal Conjugate Vaccine; NCIB=North Carolina Immunization Branch; NCIR=North Carolina Immunization Registry; ACIP=Advisory Committee on Immunization Practices

Pharmacist insights into adolescent human papillomavirus vaccination provision in the United States

HPV vaccination coverage in the United States (US) falls short of the Healthy People 2020 goal of 80% coverage among 13–15 year-old adolescents. Pharmacies are a promising alternative vaccine delivery site that may increase access to HPV vaccination. Our objective was to assess pharmacists’ insights into HPV vaccination provision to adolescents. We recruited 40 licensed pharmacists in eight states with different pharmacy vaccination laws: Alabama, California, Indiana, Kentucky, Maine, Tennessee, Texas, and Washington. Eligible pharmacists either previously provided or were currently providing HPV, tetanus-diphtheria-pertussis, or meningococcal vaccines to adolescents aged 9–17 years. Pharmacists were administered a semi-structured survey to explore insights into HPV vaccination provision. Forty-five percent of surveyed pharmacies offered HPV vaccination to adolescents. Pharmacists’ reported challenges to providing HPV vaccination were parental consent (28%), tracking and patient recall (17%), perceived stigma of vaccination (17%), and education about or promotion of vaccination (17%). Pharmacists offering HPV vaccination sent patient reminders for vaccines with multiple doses (89%) and utilized telephone reminders (72%). Pharmacists informed patients’ primary care providers of HPV vaccination doses most commonly through fax (72%) and updating electronic medical records (22%). One-third of pharmacists reported vaccination provision using the state immunization information system (IIS). Seventy-five percent reported vaccination rates could be increased at their respective pharmacy. Pharmacies are underutilized, although highly accessible, for HPV vaccination in the US. National efforts should expand educational programs to improve public awareness of in-pharmacy HPV vaccination, and improve the utilization of state IIS for reporting immunization coverage of adolescents by pharmacists

Solving analytic differential equations in polynomial time over unbounded domains

In this paper we consider the computational complexity of solving initial-value problems de ned with analytic ordinary diferential equations (ODEs) over unbounded domains of Rn and Cn, under the Computable Analysis setting. We show that the solution can be computed in polynomial time over its maximal interval of de nition, provided it satis es a very generous bound on its growth, and that the function admits an analytic extension to the complex plane

Global QCD analysis and dark photons

Published: September 15, 2023We perform a global QCD analysis of high energy scattering data within the JAM Monte Carlo framework, including a coupling to a dark photon that augments the Standard Model (SM) electroweak coupling via kinetic mixing with the hypercharge B boson. We first set limits on the dark photon mass and mixing parameter assuming that the SM is the true theory of Nature, taking into account also the effect on g – 2 of the muon. If instead we entertain the possibility that the dark photon may play a role in deep-inelastic scattering (DIS), we find that the best fit is preferred over the SM at 6.5σ, even after accounting for missing higher order uncertainties. The improvement in χ² with the dark photon is stable against all the tests we have applied, with the improvements in the theoretical predictions spread across a wide range of x and Q². The largest improvement corresponds to the fixed target and HERA DIS data, while the best fit yields a value of g – 2 which significantly reduces the disagreement with the latest experimental determination.N. T. Hunt-Smith, a W. Melnitchouk, a, b N. Sato, b A. W. Thomas, a X. G. Wanga and M. J. Whitea on behalf of the Jefferson Lab Angular Momentum (JAM) collaboratio

Impact of human papillomavirus (HPV) self-collection on subsequent cervical cancer screening completion among under-screened US women: MyBodyMyTest-3 protocol for a randomized controlled trial

Background: Screening substantially reduces cervical cancer incidence and mortality. More than half of invasive cervical cancers are attributable to infrequent screening or not screening at all. The current study, My Body My Test (MBMT), evaluates the impact of mailed kits for self-collection of samples for human papillomavirus (HPV) testing on completion of cervical cancer screening in low-income, North Carolina women overdue for cervical cancer screening. Methods/design: The study will enroll at least 510 US women aged 25-64 years who report no Pap test in the last 4 years and no HPV test in the last 6 years. We will randomize participants to an intervention or control arm. The intervention arm will receive kits to self-collect a sample at home and mail it for HPV testing. In both the intervention and control arms, participants will receive assistance in scheduling an appointment for screening in clinic. Study staff will deliver HPV self-collection results by phone and assist in scheduling participants for screening in clinic. The primary outcome is completion of cervical cancer screening. Specifically, completion of screening will be defined as screening in clinic or receipt of negative HPV self-collection results. Women with HPV-negative self-collection results will be considered screening-complete. All other participants will be considered screening-complete if they obtain co-testing or Pap test screening at a study-affiliated institution or other clinic. We will assess whether the self-collection intervention influences participants' perceived risk of cervical cancer and whether perceived risk mediates the relationship between HPV self-collection results and subsequent screening in clinic. We also will estimate the incremental cost per woman screened of offering at-home HPV self-collection kits with scheduling assistance as compared to offering scheduling assistance alone. Discussion: If mailed self-collection of samples for HPV testing is an effective strategy for increasing cervical cancer screening among women overdue for screening, this method has the potential to reduce cervical cancer incidence and mortality in medically underserved women at higher risk of developing cervical cancer. Trial registration: ClinicalTrials.gov NCT02651883, Registered on 11 January 2016