North Carolina Pharmacists’ Support for Hormonal Contraception Prescription Status Change

Background Pharmacist-prescribed hormonal contraception (HC) may offer additional avenues of access for patients; however, it is unknown whether pharmacists would support over-the-counter access to contraception over pharmacist-prescribed models. Objective The objective of this study was to understand how North Carolina (NC) pharmacists believed HC should be classified and how pharmacist and pharmacy characteristics were associated with those beliefs. Methods This study was a secondary analysis of a cross-sectional, anonymous, online survey completed by 587 licensed NC pharmacists. The primary outcome of interest was how pharmacists believed HC should be classified: prescription-only, pharmacist-prescribed, behind-the-counter, or over-the-counter. Multinomial bivariate and multivariable regression analyses were conducted to describe the association between pharmacist and pharmacy characteristics with the outcomes of interest through odds ratios and adjusted odds ratios, respectively. Chi-square tests were used to examine the association of geographic location with distribution of attitudes toward HC classification. Results Fifty-one percent of NC pharmacists supported classification of HC as pharmacist-prescribed, while 23% supported non-prescription (behind- or over-the-counter) classification. Controlling for pharmacist demographics and pharmacy characteristics, completing residency training was significantly associated with supporting pharmacist-prescribed vs prescription-only classification (adjusted odds ratio (aOR) = 2.55, P = .02). Pharmacists had higher odds of supporting pharmacist-prescribed vs prescription-only HC if they agreed that they were well trained to do so (aOR = 3.14, P < .01). Distribution of attitudes about classification of HC did not significantly differ by geographic location (P = .14). Conclusions Most NC pharmacists support deviating from the current prescription-only classification of HC, with more support for pharmacist-prescribed classification. Continuing education programs should focus on training pharmacists to feel more confident prescribing HC

Bulk scalar field in brane-worlds with induced gravity inspired by the L(R){\cal L}(R) term

We obtain the effective field equations in a brane-world scenario within the framework of a DGP model where the action on the brane is an arbitrary function of the Ricci scalar, ${\cal L}(R)$, and the bulk action includes a scalar field in the matter Lagrangian. We obtain the Friedmann equations and acceleration conditions in the presence of the bulk scalar field for the $R^n$ term in four-dimensional gravity.Comment: 9 pages, to appear in JCA

Aspects of String-Gas Cosmology at Finite Temperature

We study string-gas cosmology in dilaton gravity, inspired by the fact that it naturally arises in a string theory context. Our main interest is the thermodynamical treatment of the string-gas and the resulting implications for the cosmology. Within an adiabatic approximation, thermodynamical equilibrium and a small, toroidal universe as initial conditions, we numerically solve the corresponding equations of motions in two different regimes describing the string-gas thermodynamics: (i) the Hagedorn regime, with a single scale factor, and (ii) an almost-radiation dominated regime, which includes the leading corrections due to the lightest Kaluza Klein and winding modes, with two scale factors. The scale factor in the Hagedorn regime exhibits very slow time evolution with nearly constant energy and negligible pressure. By contrast, in case (ii) we find interesting cosmological solutions where the large dimensions continue to expand and the small ones are kept undetectably small.Comment: 21 pages, 5 eps figure

The troublesome ticks research protocol: Developing a comprehensive, multidiscipline research plan for investigating human tick-associated disease in Australia

In Australia, there is a paucity of data about the extent and impact of zoonotic tick-related illnesses. Even less is understood about a multifaceted illness referred to as Debilitating Symptom Complexes Attributed to Ticks (DSCATT). Here, we describe a research plan for investigating the aetiology, pathophysiology, and clinical outcomes of human tick-associated disease in Australia. Our approach focuses on the transmission of potential pathogens and the immunological responses of the patient after a tick bite. The protocol is strengthened by prospective data collection, the recruitment of two external matched control groups, and sophisticated integrative data analysis which, collectively, will allow the robust demonstration of associations between a tick bite and the development of clinical and pathological abnormalities. Various laboratory analyses are performed including metagenomics to investigate the potential transmission of bacteria, protozoa and/or viruses during tick bite. In addition, multi-omics technology is applied to investigate links between host immune responses and potential infectious and non-infectious disease causations. Psychometric profiling is also used to investigate whether psychological attributes influence symptom development. This research will fill important knowledge gaps about tick-borne diseases. Ultimately, we hope the results will promote improved diagnostic outcomes, and inform the safe management and treatment of patients bitten by ticks in Australia

Out-of-equilibrium evolution of quantum fields in the hybrid model with quantum back reaction

The hybrid model with a scalar "inflaton" field coupled to a "Higgs" field with a broken symmetry potential is one of the promising models for inflation and (p)reheating after inflation. We consider the nonequilibrium evolution of the quantum fields of this model with quantum back reaction in the Hartree approximation, in particular the transition of the Higgs field from the metastable "false vacuum" to the broken symmetry phase. We have performed the renormalization of the equations of motion, of the gap equations and of the energy density, using dimensional regularization. We study the influence of the back reaction on the evolution of the classical fields and of the quantum fluctuations. We observe that back reaction plays an important role over a wide range of parameters. Some implications of our investigation for the preheating stage after cosmic inflation are presented.Comment: 35 pages, 16 eps figures, revtex4; v2: typos corrected and references added, accepted for publication in Physical Review

The Intentional Use of Service Recovery Strategies to Influence Consumer Emotion, Cognition and Behaviour

Service recovery strategies have been identified as a critical factor in the success of. service organizations. This study develops a conceptual frame work to investigate how specific service recovery strategies influence the emotional, cognitive and negative behavioural responses of . consumers., as well as how emotion and cognition influence negative behavior. Understanding the impact of specific service recovery strategies will allow service providers' to more deliberately and intentionally engage in strategies that result in positive organizational outcomes. This study was conducted using a 2 x 2 between-subjects quasi-experimental design. The results suggest that service recovery has a significant impact on emotion, cognition and negative behavior. Similarly, satisfaction, negative emotion and positive emotion all influence negative behavior but distributive justice has no effect

Can forest management based on natural disturbances maintain ecological resilience?

Given the increasingly global stresses on forests, many ecologists argue that managers must maintain ecological resilience: the capacity of ecosystems to absorb disturbances without undergoing fundamental change. In this review we ask: Can the emerging paradigm of natural-disturbance-based management (NDBM) maintain ecological resilience in managed forests? Applying resilience theory requires careful articulation of the ecosystem state under consideration, the disturbances and stresses that affect the persistence of possible alternative states, and the spatial and temporal scales of management relevance. Implementing NDBM while maintaining resilience means recognizing that (i) biodiversity is important for long-term ecosystem persistence, (ii) natural disturbances play a critical role as a generator of structural and compositional heterogeneity at multiple scales, and (iii) traditional management tends to produce forests more homogeneous than those disturbed naturally and increases the likelihood of unexpected catastrophic change by constraining variation of key environmental processes. NDBM may maintain resilience if silvicultural strategies retain the structures and processes that perpetuate desired states while reducing those that enhance resilience of undesirable states. Such strategies require an understanding of harvesting impacts on slow ecosystem processes, such as seed-bank or nutrient dynamics, which in the long term can lead to ecological surprises by altering the forest's capacity to reorganize after disturbance

17 -Estradiol and Tamoxifen Prevent Gastric Cancer by Modulating Leukocyte Recruitment and Oncogenic Pathways in Helicobacter Pylori-Infected INS-GAS Male Mice

Helicobacter pylori infection promotes male-predominant gastric adenocarcinoma in humans. Estrogens reduce gastric cancer risk and previous studies demonstrated that prophylactic 17β-estradiol (E2) in INS-GAS mice decreases H. pylori-induced carcinogenesis. We examined the effect of E2 and Tamoxifen, on H. pylori-induced gastric cancer in male and female INS-GAS mice. After confirming robust gastric pathology at 16 weeks post-infection (WPI), mice were implanted with E2, Tamoxifen, both E2 and Tamoxifen, or placebo pellets for 12 weeks. At 28 WPI, gastric histopathology, gene expression and immune cell infiltration were evaluated, and serum inflammatory cytokines measured. After treatment, no gastric cancer was observed in H. pylori-infected males receiving E2 and/or Tamoxifen, while 40% of infected untreated males developed gastric cancer. E2, Tamoxifen and their combination significantly reduced gastric precancerous lesions in infected males compared to infected untreated males (P<0.001, 0.01 and 0.01, respectively). However, Tamoxifen did not alter female pathology regardless of infection status. Differentially expressed genes from males treated with E2 or Tamoxifen (n=363 and n=144, Q<0.05) associated highly with cancer and cellular movement, indicating overlapping pathways in the reduction of gastric lesions. E2 or Tamoxifen deregulated genes associated with metastasis (PLAUR and MMP10) and Wnt inhibition (FZD6 and SFRP2). Compared to controls, E2 decreased gastric mRNA (Q<0.05) and serum levels (P<0.05) of CXCL1, a neutrophil chemokine, leading to decreased neutrophil infiltration (P<0.01). Prevention of H. pylori-induced gastric cancer by E2 and Tamoxifen may be mediated by estrogen signaling and is associated with decreased CXCL1, decreased neutrophil counts and downregulation of oncogenic pathways

Gene Expression Profiling Identifies Two Chordoma Subtypes Associated with Distinct Molecular Mechanisms and Clinical Outcomes

PURPOSE: Chordoma is a rare bone tumor with a high recurrence rate and limited treatment options. The aim of this study was to identify molecular subtypes of chordoma that may improve clinical management. EXPERIMENTAL DESIGN: We conducted RNA sequencing in 48 tumors from patients with Chinese skull-base chordoma and identified two major molecular subtypes. We then replicated the classification using a NanoString panel in 48 patients with chordoma from North America. RESULTS: Tumors in one subtype were more likely to have somatic mutations and reduced expression in chromatin remodeling genes, such as PBRM1 and SETD2, whereas the other subtype was characterized by the upregulation of genes in epithelial-mesenchymal transition and Sonic Hedgehog pathways. IHC staining of top differentially expressed genes between the two subtypes in 312 patients with Chinese chordoma with long-term follow-up data showed that the expression of some markers such as PTCH1 was significantly associated with survival outcomes. CONCLUSIONS: Our findings may improve the understanding of subtype-specific tumorigenesis of chordoma and inform clinical prognostication and targeted options