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Objectives To evaluate Utah community pharmacists' knowledge and attitudes toward recommendation of human papillomavirus (HPV) vaccine, to determine whether the knowledge and attitude of pharmacists regarding the HPV vaccine influence their recommendation behaviors, and to capture any self-identified barriers to recommending the HPV vaccine. Design A cross-sectional anonymous 73-item survey was developed and administered to community, outpatient, and ambulatory care pharmacists. Setting Utah. Participants Utah community pharmacists. Main outcome measures Recommendation of the HPV vaccine by the pharmacist, knowledge and attitude of pharmacists regarding HPV vaccine, and barriers to vaccine receipt. Results The mean HPV vaccine knowledge score was 7.45 ± 2.15 (out of 13), and scores were higher when pharmacists had 4 to 6 technicians per day in the pharmacy and when they were residency trained. The mean attitude score was 24.26 ± 3.16 (out of 30). Positive attitudes were found if they had more than 1 pharmacist and 4 to 6 pharmacy technicians working at any given time in the pharmacy. Those who identified with "other Christianity" had a more positive attitude than Latter Day Saints. Although positive attitude toward the HPV vaccine was a predictor for recommending the vaccine to both boys and girls, higher knowledge was a significant predictor only in recommending the HPV vaccine for boys. Female pharmacists were more likely to recommend the HPV vaccine. The top 3 reported barriers included lack of parental knowledge, parental concerns and opposition, and lack of educational materials to provide parents. Conclusion Although the majority of respondents perceived HPV vaccination as useful for preventing certain types of cancer, and more than one-half of respondents reported being comfortable in recommending the vaccine, only one-third actually recommended the vaccine for girls and for boys. The results indicate the need for improving knowledge about the HPV vaccine for pharmacists, patients, and parents.

Purpose To correlate the area of geographic atrophy (GA) and residual foveal sparing (FS), and to identify the minimum FS and maximum GA area allowing sufficient visual acuity (VA) for daily tasks. Design Prospective cohort study. Methods Thirty-six eyes of 25 patients with GA and FS were followed for 18 months using spectral-domain optical coherence tomography and VA tests. Volume scans were imported into software enabling grading of areas in B-scans and computing of planimetric measurements in complete volume scans. Correlation of areas 1 (complete atrophy), 2 (FS in the central millimeter), and 3 (FS in the central 3 mm) with each other and with best-corrected VA (BCVA) were evaluated. Results Baseline means of areas 1, 2, and 3 were 6.15 mm 2 , 0.49 mm 2 , and 3.08 mm 2 , respectively. At 1 year, area 1 increased by a mean of 1.33 mm 2 , while areas 2 and 3 were decreased by 0.12 mm 2 and 0.65 mm 2 , respectively. From baseline to 18 months and from visit to visit, all areas and BCVA changed progressively ( P 2 ; area 2: ≥0.48 mm 2 ; and area 3: ≥3.28 mm 2 ). Conclusion GA and FS changed inversely over time. In general, FS highly correlated with BCVA, while GA progression correlated with the central 3-mm FS regression, but not with BCVA. A threshold in GA and FS area could be determined for BCVA necessary for daily activity.

This paper demonstrates the potential of ocean ensemble forecasting in the Gulf of Mexico (GoM). The Bred Vector (BV) technique with one week rescaling frequency is implemented on a 9 km resolution version of the Regional Ocean Modelling System (ROMS). Numerical experiments are carried out by using the HYCOM analysis products to define the initial conditions and the lateral boundary conditions. The growth rates of the forecast uncertainty are estimated to be about 10% of initial amplitude per week. By carrying out ensemble forecast experiments with and without perturbed surface forcing, it is demonstrated that in the coastal regions accounting for uncertainties in the atmospheric forcing is more important than accounting for uncertainties in the ocean initial conditions. In the Loop Current region, the initial condition uncertainties, are the dominant source of the forecast uncertainty. The root-mean-square error of the Lagrangian track forecasts at the 15-day forecast lead time can be reduced by about 10 − 50 km using the ensemble mean Eulerian forecast of the oceanic flow for the computation of the tracks, instead of the single-initial-condition Eulerian forecast.

Purpose To evaluate spectral-domain optical coherence tomography (SD-OCT) in providing reliable and reproducible parameters for grading geographic atrophy (GA) compared with fundus autofluorescence (FAF) images acquired by confocal scanning laser ophthalmoscopy (cSLO). Design Prospective observational study. Participants A total of 81 eyes of 42 patients with GA. Methods Patients with atrophic age-related macular degeneration (AMD) were enrolled on the basis of total GA lesion size ranging from 0.5 to 7 disc areas and best-corrected visual acuity of at least 20/200. A novel combined cSLO-SD-OCT system (Spectralis HRA-OCT, Heidelberg Engineering, Heidelberg, Germany) was used to grade foveal involvement and to manually measure disease extent at the level of the outer neurosensory layers and retinal pigment epithelium (RPE) at the site of GA lesions. Two readers of the Vienna Reading Center graded all obtained volume stacks (20×20 degrees), and the results were correlated to FAF. Main Outcome Measures Choroidal signal enhancements and alterations of the RPE, external limiting membrane (ELM), and outer plexiform layer by SD-OCT. These parameters were compared with the lesion measured with severely decreased FAF. Results Foveal involvement or sparing was definitely identified in 75 of 81 eyes based on SD-OCT by both graders (inter-grader agreement: κ= 0.6, P κ= 0.3, P 2 for grader 1 (G1) and 9.54 mm 2 for grader 2 (G2), consistent with the mean SD-OCT quantification of the sub-RPE choroidal signal enhancement (8.9 mm 2 [G1] −9.4 mm 2 [G2]) and ELM loss with 8.7 mm 2 (G1) −10.2 mm 2 (G2). In contrast, complete morphologic absence of the RPE layer by SD-OCT was significantly smaller than the GA size in FAF (R 2 =0.400). Inter-reader agreement was highest regarding complete choroidal signal enhancement (0.98) and ELM loss (0.98). Conclusions Absence of FAF in GA lesions is consistent with morphologic RPE loss or advanced RPE disruption and is associated with alterations of the outer retinal layers as identified by SD-OCT. Lesion size is precisely determinable by SD-OCT, and foveal involvement is more accurate by SD-OCT than by FAF. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.

Objectives To assess perceptions of student pharmacists in their final year of pharmacy education on providing clinical services in the community pharmacy setting. Primary objectives evaluated students' perceived opportunities, importance, readiness, and barriers to providing clinical services. Methods An online survey was administered to students attending fully accredited pharmacy school in the United States. Results Nine-hundred sixty-seven students completed the survey (20.7% response). Students believe that opportunities exist to provide clinical services (87.2%), clinical services are important (95%), and they plan to provide clinical services after graduation. Lack of time, lack of support staff, and lack of privacy were identified barriers. Student readiness and interest were the greatest positive predictors for planning to provide clinical services. Conclusion Students' perceived readiness is critical for them to plan to provide clinical services in the future. Exposing students to clinical opportunities in pharmacy education and practice is essential to ensure expansion of clinical services in community pharmacy.

A new step for complete experiments in photoionization (PI) of linear molecules is achieved when the electron-ion vector correlation method, based on imaging and time-of-flight resolved electron-ion coincidence techniques, is combined with the use of elliptically polarized light. The molecular frame photoelectron angular distributions (MFPADs), as well as the s1 and s2 Stokes parameters characterizing the polarization state of the light, can be derived from a single experiment performed with undefined elliptically polarized light. Using this method, we report and discuss MFPADs for site selective K-shell ionization of the NO and N2O linear molecules in the region of the N 1s and O 1s shape resonances. A large molecular frame circular dichroism is observed, well predicted by the multi-channel Schwinger configuration interaction calculations reported for PI of NO. We also present recent experimental results for PI of non-linear molecules like CH3Cl measured above the Cl 2p and C 1s ionization thresholds: the recoil frame photoelectron angular distributions (RFPADs) obtained by the vector correlation method may be influenced both by the molecular frame photoemission pattern and the fragmentation process.

The analysis of the molecular-frame photoelectron angular distributions (MFPADs) is discussed within the dipole approximation. The general expressions are reviewed and strategies for extracting the maximum amount of information from different types of experimental measurements are considered. The analysis of the N 1s photoionization of NO is given to illustrate the method.

A new mixed L2 basis set, built from multicenter STOs and single-center radial B-Splines, is proposed to evaluate the differential photoionization cross section of molecules. As a first comparison we report the results for nitrogen and acetylene molecules, whose photoionization cross sections, since they have been the object of very numerous studies both experimentally and theoretically, represent a reliable test. The theoretical approach utilized to evaluate the continuum is based upon the K-Matrix (KM) determination in the interacting channels random phase approximation framework (IC-RPA) and the results obtained with the new basis set are in good agreement with the experiment and with the best calculations available. Thus the mixed basis employed appears very adequate to describe the electronic continuum and the present calculations are helpful in the assignment of some fine details in the low energy portion of the spectrum. In the high energy region, although the rough behaviour agrees with the experiment, the limitations of the KM-RPA method are such as to not account for a more detailed description of the spectrum.

The convenience afforded by the use of L 2 functions in the calculation of the photoionization cross-section and of others properties depending upon the electronic continuum has prompted the examination of particular basis sets that, among those derived, could be able to mimic the continuum states in an extended region of space. Here results are reported for the differential photoionization cross-section of the Li 2 molecule, where a mixed L 2 basis set comprising multi-center STOs plus single-center radial B-Splines times spherical harmonics was employed.

Purpose To compare choroidal thickness of different areas on swept-source optical coherence tomography (SSOCT) line and cube scans for their interchangeable use. Design Validity analysis. Methods SSOCT line and cube scans were obtained from 21 patients with various choroidal thicknesses. Subfoveal center point choroidal thickness, mean central millimeter choroidal thickness, and mean 6-mm-area choroidal thicknesses were obtained from both eyes by 2 independent graders in a reading center setting. Cross-correlations were performed using Passing and Bablok regression models. A 95% confidence interval of slope that included 1 was considered to indicate no significant difference. Average choroidal thickness of center point, Early Treatment Diabetic Retinopathy Study grid subfields, and total grid area of 6 mm on both scans and the correlation between different areas served as main outcome measures. Results No significant difference between line scans/corresponding subfields of cube scans (outer nasal 0.92–1.11, inner nasal 0.88–1.06, central 0.94–1.11, inner temporal 0.95–1.12, outer temporal 0.93–1.17). No significant difference between subfoveal center point measurement/mean of choroidal thickness in the central millimeter of cube scans (0.89–1.08). Significant difference of subfoveal center point measurement or mean of central millimeter area of cube scans to entire 6-mm area of cube scans (1.01–1.53 and 1.03–1.38). Conclusions Measurements on a single SSOCT horizontal line scan can represent the entire choroid but subfoveal center point measurements are only indicative for the central millimeter area. There is a consistent overestimation of choroidal thickness when trying to estimate overall choroidal thickness from any central measurement.