bluuebunny/crossref_metadata_2025 huggingface dataset:
Basics and applications of optical interferometers integrated by femtosecond laser
Authors: Zhang Jiawei , Sugioka Koji
Published: April 2022

Photonic chips have been recognized as a promising platform for information technology. On‐chip optical interferometers as fundamental building blocks of photonic chips are under extensive research with both conventional and novel fabrication techniques. Among them, recently, femtosecond laser has been attracting a great deal of attention as a powerful tool for directly writing micro‐optical devices in various materials due to its flexibility and three‐dimensional fabrication capability. This article gives a review on the working principles and recent achievements of on‐chip waveguides and interferometers fabricated by femtosecond laser, showing their potential applications in various scenarios.
New quinoxalin‐2(1H)‐one‐derived VEGFR‐2 inhibitors: Design, synthesis, in vitro anticancer evaluations, in silico ADMET, and docking studies
Authors: El‐Adl Khaled , Sakr Helmy M. , Yousef Reda G. , Mehany Ahmed B. M. , Abulkhair Hamada S. , Eissa Ibrahim. H.
Published: April 2022

More than 70% of cancer patients who are treated with chemotherapeutics do not show a durable response. As part of the global plan seeking new effective chemotherapeutics, here, we report the synthesis and in vitro and computational studies of new lenvatinib and sorafenib analog quinoxalines as vascular endothelial growth factor receptor II (VEGFR‐2) tyrosine kinase inhibitors. The central quinolone and pyridine moieties of the Food and Drug Administration‐approved anticancer agents lenvatinib and sorafenib were replaced with the versatile quinoxaline scaffold that has been exploited for developing potent cytotoxic agents. With some minor structural optimizations, all the other pharmacophoric features of lenvatinib and sorafenib were maintained. Accordingly, three new sets of quinoxalines were synthesized to evaluate their activity against liver, colorectal, and breast malignancies. The results obtained in the in vitro cytotoxicity evaluation study revealed the superior activity of three derivatives (20, 25, and 29) compared with that of doxorubicin and sorafenib. Absorption, distribution, metabolism, excretion, and toxicity (ADMET) profiling and docking of 20, 25, and 29 into the VEGFR‐2 receptor were also performed. Results of in silico studies showed the potential of the designed compounds to bind effectively with a number of key residues. The obtained in vitro cytotoxic activity and ADMET profiles of compounds 20, 25, and 29 suggested that they should be subjected to further structural optimizations to develop new candidates in cancer treatment protocols.
Fixed‐time synchronization of neural networks with time delay via quantized intermittent control
Authors: Yang Wenqiang , Huang Junjian , Wen Shiping , He Xing
Published: April 2022

This paper presents an approach for fixed‐time synchronization (FIXTS) of neural networks (NNs) by designing quantized intermittent controller. Under the intermittent controller, the synchronization between neural network systems with time delay can be realized. Based on intermittent strategy, FIXTs theory is proposed, and a sufficient condition is established to realize the FIXTS of the master–slave NNs. At the same time, the establishment time of FIXTS is estimated. Finally, the simulation of Gilli attractor to prove the validity of the proposed method.
Genauigkeitsgrenzen modularer Betontragwerke – Teil 1: Beschreibung von geometrischen Abweichungen infolge Schwinden
Authors: Stindt Jan , Frey Alex Maximilian , Forman Patrick , Lanza Gisela , Mark Peter
Published: April 2022

Modulares Bauen bietet gegenüber der Ortbetonbauweise ökonomische Vorteile. Die Module können qualitätsgesichert im Werk vorgefertigt und vor Ort montiert werden. Um eine störungsfreie Montage der Module zu ermöglichen, ist eine Tolerierung erforderlich, die die mehrdimensionale Aggregation von Maßabweichungen der Module in komplexen Tragwerken berücksichtigt. Eindimensionale arithmetische und statistische Methoden sind dafür nur bedingt geeignet. In der vorliegenden Arbeit wird eine Methode entwickelt, die modulare Wabenstrukturen mittels direkter Kinematik modelliert und sowohl translatorische als auch rotatorische Lageabweichungen berücksichtigt, die aus Maßabweichungen von Y‐förmigen Modulen infolge Schwindverformungen entstehen. Für ausgewählte Szenarien hinsichtlich Tragwerksgröße und verwendetem Beton werden damit die zur Verbindung der Module notwendigen Lochspiele und Gesamtabweichungen hergeleitet und mit den im Bauwesen gängigen Verfahren des Toleranzmanagements untersucht. Die geometrischen Abweichungen in horizontaler Richtung infolge der Schwinddehnungen unterschiedlicher Betone werden von den normativen Methoden z. T. unterschätzt, da keine Rotationen der Module berücksichtigt werden. Vertikale Abweichungen werden hingegen konservativ abgeschätzt. Die erforderlichen Nennlochspiele steigen mit zunehmender Strukturgröße, sodass Abmessungen von ca. 30 m des klassischen Hochbaus mit normalen Schraubverbindungen Δd ≤ 3 mm assembliert werden können.
Controllable Zeolite AST Crystallization: Between Classical and Reversed Crystal Growth
Authors: Yue Qiudi , Kutukova Kristina , Li Ang , Čejka Jiří , Zschech Ehrenfried , Opanasenko Maksym
Published: April 2022

Crystal growth mechanisms govern a wide range of properties of crystalline materials. Reversed crystal growth is one of the nonclassical mechanisms observed in many materials. However, the reversed crystallization starting from amorphous aggregates and the key factors driving this growth remain elusive. Here, we describe a characteristic model of reversed crystal growth representing the inner structure and crystallinity development of aggregates studied by microscopy and nano X‐ray computed tomography. By adjusting the synthesis conditions, the fundamental function of the structure‐directing agent, which determines the crystallization pathway, was revealed. As a result, the crystal growth mode can be “switched” from the classical route at a low ratio of SDA/framework elements to reversed growth at a high ratio. Our findings provide further insights into crystal growth control, which is crucial for improving synthesis protocols and designing various forms of crystalline materials.
Frailty and checkpoint inhibitor toxicity in older patients with melanoma
Authors: Bruijnen Cheryl P. , Koldenhof José J. , Verheijden Rik J. , van den Bos Frederiek , Emmelot‐Vonk Mariëlle H. , Witteveen Petronella O. , Suijkerbuijk Karijn P. M.
Published: April 2022

Background

Immune checkpoint inhibitors (ICIs) can cause immune‐related adverse events (irAEs) that range from mild to life‐threatening. Age itself does not seem to be a predictor for the occurrence of irAEs. It is unknown whether frailty plays a role in the occurrence of irAEs. Therefore, the authors assessed whether irAEs and their sequelae occur more often in frail patients than in fit patients according to the Geriatric 8 (G8) assessment.

Methods

Patients with melanoma aged 70 years and older who were about to start ICI therapy and were screened with the G8 assessment were enrolled in this prospective, observational study. Patients were classified by the G8 as either fit or frail. The primary outcome was the occurrence of grade ≥3 irAEs.

Results

In total, 92 patients were included for statistical analyses, 26 (29%) of whom were classified as frail. Grade ≥3 irAEs occurred in 20% of patients. There was no significant difference in the occurrence of grade ≥3 irAEs between fit and frail patients (17% vs 27%; P = .26). Frail patients were admitted to the hospital because of irAEs significantly more often than fit patients (29% vs 54%; P = .02) and showed a trend toward increased length of hospitalization (5 vs 8 days; P = .06) and more frequent use of immunosuppressants or ICI discontinuation for irAEs (36% vs 58%; P = .06).

Conclusions

Although frailty appears to be unrelated to the occurrence of severe irAEs, it is an indicator of irAE‐related adverse sequelae, such as hospital admission. Screening for frailty can be of added value in the shared decision‐making process for older patients who qualify for ICI treatment.
Effect of Food Intake on Pharmacokinetics of Oral Almonertinib: A Randomized Crossover Trial in Healthy Chinese Participants
Authors: Ji Wei , Jiang Yu , Wei Yilin , He Kun , Mu Hongli , Wen Qing , Zhang Xiaoran
Published: April 2022

The third‐generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) almonertinib (HS‐10296) targets both EGFR‐sensitizing and T790M resistance mutations. This randomized, open‐label, two‐period crossover trial investigated the effect of food intake on the single‐dose pharmacokinetic properties of almonertinib and its metabolite HAS‐719. Twenty healthy adults received a single dose of almonertinib tablets (110 mg) on days 1 and 22 under overnight fasting or fed conditions, respectively. Plasma samples were collected 216 hours post‐dosing and almonertinib and HAS‐719 concentrations were determined using liquid chromatography‐tandem mass spectrometry. For almonertinib, the geometric mean ratio (GMR, fed/fasting) and 90% confidence interval (CI) for the area under the curve (AUC) from time 0 to 216 hours and apparent oral clearance (CLz/F) were 119.9 (110.0–130.7) and 83.5 (76.6–90.9), respectively. Fasting and fed groups showed significant differences in these parameters, but not for maximum concentration (Cmax) and time to Cmax (Tmax). The Cmax GMR of HAS‐719 was 81.7 (75.8–88.0), which decreased significantly in the fed group. The drug‐related adverse reaction (AR) incidence was similar in the two groups, 50% in the fasting group and 52.6% in the fed group. ARs were mainly gastrointestinal diseases and abnormal laboratory test results, and all participants fully recovered. In conclusion, a high‐fat diet slightly affected the pharmacokinetic profile of almonertinib in healthy participants, but not the safety tolerance. Therefore, almonertinib is suitable for administration under fasting or fed conditions.
Structurally Constrained MUC1‐Tn Mimetic Antigen as Template for Molecularly Imprinted Polymers (MIPs): A Promising Tool for Cancer Diagnostics
Authors: Palladino Pasquale , Papi Francesco , Minunni Maria , Nativi Cristina , Scarano Simona
Published: April 2022

Abnormal glycoconjugates have distinctly been recognized as potential biomarkers for cancer diagnosis. A great deal of attention has been focused on Tn antigen, an oversimplified mucin‐1 O‐glycan, over‐expressed in different cancers. Herein, we investigate the possibility to replace the use of anti‐Tn monoclonal antibodies with an innovative class of catecholamine‐based Molecularly Imprinted Polymers (MIPs), emerging in recent years as promising tools for bioanalytical applications. MIPs are synthetic receptors characterized by high sensitivity and specificity towards the imprinted target. Here, original polynorepinephrine‐based MIPs coupled to Surface Plasmon Resonance biosensing for Tn antigen recognition are reported. We have verified the imprinting and binding capacity of these MIPs towards very small antigenic entities, represented by the natural Tn antigen and the TnThr mimetic 1 (conjugated to BSA or linked to a MUC1 hexapeptide analogue), and compared the biosensor performances with an anti‐Tn monoclonal antibody. The results clearly display the effectiveness of the pursued imprinting strategies.
The paradoxical tensions of leading and managing in academia — a love/hate relationship
Authors: Freebairn‐Smith Laura
Published: April 2022

In this column, each month we'll tackle a different management or leadership problem, situation, or case in academic settings, for both faculty and administrative leaders and managers. I'll introduce some conceptual models to help you make sense of what's happening, and provide specific tips to navigate this complex role you're in.
Graduate and professional students face obstacles, financial hardships during COVID‐19 pandemic
Authors: Hope Joan
Published: April 2022

Graduate and professional students with disabilities have faced significantly more obstacles to graduation and more financial hardships during the COVID‐19 pandemic than their nondisabled peers, according to two research briefs prepared by the National Center for College Students with Disabilities.
Left ventricular reverse remodelling and its predictors in non‐ischaemic cardiomyopathy
Authors: Hnat Tomas , Veselka Josef , Honek Jakub
Published: April 2022

Adverse remodelling following an initial insult is the hallmark of heart failure (HF) development and progression. It is manifested as changes in size, shape, and function of the myocardium. While cardiac remodelling may be compensatory in the short term, further neurohumoral activation and haemodynamic overload drive this deleterious process that is associated with impaired prognosis. However, in some patients, the changes may be reversed. Left ventricular reverse remodelling (LVRR) is characterized as a decrease in chamber volume and normalization of shape associated with improvement in both systolic and diastolic function. LVRR might occur spontaneously or more often in response to therapeutic interventions that either remove the initial stressor or alleviate some of the mechanisms that contribute to further deterioration of the failing heart. Although the process of LVRR in patients with new‐onset HF may take up to 2 years after initiating treatment, there is a significant portion of patients who do not improve despite optimal therapy, which has serious clinical implications when considering treatment escalation towards more aggressive options. On the contrary, in patients that achieve delayed improvement in cardiac function and architecture, waiting might avoid untimely implantable cardioverter‐defibrillator implantation. Therefore, prognostication of successful LVRR based on clinical, imaging, and biomarker predictors is of utmost importance. LVRR has a positive impact on prognosis. However, reverse remodelled hearts continue to have abnormal features. In fact, most of the molecular, cellular, interstitial, and genome expression abnormalities remain and a susceptibility to dysfunction redevelopment under biomechanical stress persists in most patients. Hence, a distinction should be made between reverse remodelling and true myocardial recovery. In this comprehensive review, current evidence on LVRR, its predictors, and implications on prognostication, with a specific focus on HF patients with non‐ischaemic cardiomyopathy, as well as on novel drugs, is presented.
Verbascoside administered intrathecally attenuates hyperalgesia via activating mu‐opioid receptors in a rat chronic constriction injury model
Authors: Hara Koji , Haranishi Yasunori , Terada Tadanori
Published: April 2022

Background

Verbascoside, a representative phenylethanoid glycoside, is widely distributed in plants and has various activities beneficial for human health. Although systemically administered verbascoside has an antinociceptive effect, little is known about the site and mechanism of its activity. The aim of the present study was to determine whether verbascoside attenuates neuropathic pain in the spinal cord and which pain regulatory systems are involved.

Methods

Chronic constriction injury of the sciatic nerve was introduced to male Sprague Dawley rats. The effects of intrathecal administration of verbascoside and its components (caffeic acid and hydroxytyrosol) on mechanical hyperalgesia and cold hyperalgesia were examined using the electronic von Frey test and cold‐plate test, respectively. Several antagonists of spinal pain processing receptors were administered intrathecally to evaluate their effects on the antihyperalgesic action of verbascoside. A rotarod test was performed to assess the effects on motor coordination.

Results

Verbascoside attenuated mechanical and cold hyperalgesia and affected motor performance in a dose‐dependent manner. Caffeic acid suppressed hyperalgesia only at high doses, whereas hydroxytyrosol did not affect hyperalgesia. The inhibitory effects of verbascoside on hyperalgesia and motor coordination were reversed by naloxone, a µ‐opioid receptor antagonist.

Conclusions

These findings imply that verbascoside exerts an antihyperalgesic effect by activating µ‐opioid receptors in the spinal cord, and that neither caffeic acid nor hydroxytyrosol alone mediates its activity. Verbascoside shows promise for the treatment of neuropathic pain.

Significance

Currently available treatments for neuropathic pain have limited efficacy in most patients. Some natural products have favourable biological activities for long‐term administration such as antioxidative and neuroprotective effects. Verbascoside inhibits spinal nociceptive transmission without serious side effects to the same degree as gabapentin, a first‐line remedy for neuropathic pain. Natural products may be promising candidates for novel treatments of neuropathic pain.
Assessing karyotype diversity in the genus Lathyrus L. (Fabaceae)
Authors: Paul Suman , Banik Biplab , Dholakia Bhushan B. , Datta Badal Kumar
Published: April 2022

Although substantial information on the karyological measures of Lathyrus is available, no study has collected and analysed such data to assess the relationship among its taxa. Hence, the present study examined the degree and trends of chromosome diversity in this genus in congruence with Kupicha's sectional classification. Karyo‐morphological data for 74 species representing 11 sections of Lathyrus were collected through the literature survey. The karyological measures included were the total haploid chromosome length (THL), somatic chromosome number (2n), basic chromosome number (x), and five other parameters of karyotype asymmetry (CVCL, CVCI, MCA, A1, and A2). Basic chromosome number (x = 7) and somatic chromosome number (2n = 14) remained stable throughout the genus. Mean karyotypes revealed marked variations in karyotype structure among the 11 sections of Lathyrus. Further, key differences were identified during comparisons of various measures of karyotype asymmetry. Phylogenetic and principal coordinate analyses exhibited substantial variation among different sections of Lathyrus and out‐group genera. Overall, current findings indicated that the karyotype asymmetry measures can serve as an efficient tool to assess the relationship among different sections of Lathyrus.
Phosphoproteomics identifies pathways underlying the role of receptor‐interaction protein kinase 3 in alcohol‐associated liver disease and uncovers apoptosis signal‐regulating kinase 1 as a target
Authors: Singh Vaibhav , Huang Emily , Pathak Vai , Willard Belinda B. , Allende Daniela S. , Nagy Laura E.
Published: April 2022

Receptor‐interaction protein kinase 3 (RIP3), a critical determinant of the necroptotic pathway of programmed cell death, contributes to injury in murine models of alcohol‐associated liver disease (ALD); however, the underlying mechanisms are unknown. We investigated the effect of chronic ethanol feeding on the hepatic phosphoproteome in C57BL/6 and RIP3‐deficient (Rip3
−/−) mice, focusing on death receptor (DR) signaling pathways. C57BL/6 and Rip3
−/− mice were fed an ethanol‐containing liquid diet or pair‐fed control diet. A label‐free mass spectrometry‐based approach identified differentially phosphorylated proteins that were mapped to pathways affected by ethanol and Rip3 genotype. Identified targets were validated in both the murine model of ALD and in liver tissue from patients with alcohol‐associated hepatitis (AH) and healthy controls. Chronic ethanol dysregulated hepatic tumor necrosis factor‐induced DR signaling pathways. Of particular importance, chronic ethanol feeding to C57BL/6 mice decreased the phosphorylation of apoptosis signal‐regulating kinase 1 (ASK1) at serine (S)1036/S1040 (S1029/S1033 human), sites linked with the inhibition of ASK1 death‐promoting activity. This decrease in phosphorylation of inhibitory sites was muted in Rip3
−/− mice. Decreased phosphorylation at S1033 was also lower in liver of patients with severe AH compared to healthy controls, and phosphorylation at the ASK1 activation site (threonine [Thr]‐838) was increased in patients with AH. The net impact of these changes in phosphorylation of ASK1 was associated with increased phosphorylation of p38, a downstream target of ASK1, in patients with AH and C57BL/6 but not Rip3
−/− mice. Similarly, chronic ethanol feeding affected the c‐Jun N‐terminal kinase pathway in C57BL/6 but not Rip3
−/− mice. Taken together, our data indicate that changes in inhibitory phosphorylation of ASK1 are an important target in ALD and suggest the involvement of noncanonical functions of Rip3 in ALD.
Interaction of metabolic dysfunction‐associated fatty liver disease and nonalcoholic fatty liver disease with advanced fibrosis in the death and intubation of patients hospitalized with coronavirus disease 2019
Authors: Vázquez‐Medina Martín Uriel , Cerda‐Reyes Eira , Galeana‐Pavón Alberto , López‐Luna Carlos Enrique , Ramírez‐Portillo Patty Marlen , Ibañez‐Cervantes Gabriela , Torres‐Vázquez Julián , Vargas‐De‐León Cruz
Published: April 2022

Patients with pre‐existing liver diseases are considered to have an increased risk of morbidity and mortality from any type of infection, including viruses. The aim of this work was to explore the implications of metabolic dysfunction‐associated fatty liver disease (MAFLD) and nonalcoholic fatty liver disease (NAFLD) definitions in coronavirus disease 2019 (COVID‐19) and to study the interaction between advanced fibrosis (AF) and each of these diseases in the death and intubation of patients hospitalized with COVID‐19. We performed a retrospective study with 359 patients hospitalized with confirmed COVID‐19 infection in a tertiary referral hospital who were admitted between April and June 2020. A multivariate Cox model was performed regarding the interaction of AF with MAFLD and NAFLD in the mortality and intubation of patients with COVID‐19. The death rate was statistically significantly higher in the MAFLD group compared to the control group (55% vs. 38.3%, p = 0.02). No significant difference was seen in the death rate between the NAFLD and control group. The MAFLD (44.09% vs. 20%, p = 0.001) and NAFLD (40.51% vs. 20%, p = 0.01) groups had statistically significantly higher intubation rates than the control group. A statistically significant interaction between NAFLD and AF was associated with an increase in mortality (p = 0.01), while a statistically significant interaction between MAFLD and AF was associated with an increased risk of mortality (p = 0.006) and intubation (p = 0.049). In the case of patients hospitalized with COVID‐19, our results indicate that the death rate was higher in the MAFLD group but not the NAFLD group compared to that in the control group. The intubation rates were higher in the NAFLD and MAFLD groups compared to rates in the control group, suggesting that both could be associated with COVID‐19 severity. In addition, we found interactions between AF with MAFLD and NAFLD.
Association of the IRAK4 rs4251545 genetic polymorphism with severity of enterovirus‐71 infection in Chinese children
Authors: Song Jie , Liu Yedan , Guo Ya , Liu Peipei , Li Fei , Yang Chengqing , Pan Xiaoyu , Yi Liping , Fan Fan , Zhao Han , Chen Zongbo
Published: April 2022

Introduction

This study aimed to explore the association between the IRAK4 polymorphism rs4251545 and the severity of enterovirus 71 (EV71) infection in Chinese children.

Methods

We analyzed the IRAK4 polymorphism rs4251545 in 617 EV71‐infected patients and 410 controls using the improved multiplex ligation detection reaction. IRAK4 mRNA expression was tested by qRT‐PCR. Serum concentrations of IL‐6 and NF‐κB were detected using ELISA.

Results

The frequencies of the GA + AA genotype and A allele in the mild EV71 infection group and in the severe EV71 infection group were significantly higher than those in the normal control group. The frequency of the GA + AA genotype and A allele in severely infected EV71 patients was markedly higher than that in mildly infected EV71 patients. IRAK4 mRNA expression in mildly infected EV71 patients and severely infected patients was significantly higher than that in the control group. IRAK4 mRNA expression in GA + AA genotypes in both mild and severe EV71 infection groups was significantly higher than that in patients with the GG genotype. IL‐6 concentration and the ratio of IL‐6/NF‐κB in severe EV71 cases were significantly lower in patients with the GA + AA genotype than in those with the GG genotype. The ratio of IL‐6/NF‐κB was distinctly higher in severely infected EV71 patients than in mildly infected and control subjects.

Conclusions

The IRAK4 polymorphism rs4251545 was associated with the susceptibility and severity of EV71 infection. The A allele is a susceptible factor in the development of severe EV71 infection in Chinese children.
Pharmacy student perception of a remote hypertension and drug information simulation‐based learning experience in response to the SARS‐CoV‐2 pandemic
Authors: Cowart Kevin , Updike Wendy H.
Published: April 2022

Introduction

Severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) has required pharmacy educators to redesign or create new simulation‐based learning (SBL) activities to ensure achievement of accreditation standards and ensure practice‐ready pharmacists. Little is known regarding student perception of SBL activities conducted across the Doctor of Pharmacy (Pharm.D.) curricula during the SARS‐CoV‐2 pandemic.

Objective

To assess first‐year Pharm.D. students' confidence in performing manual blood pressure techniques, drug information, and communication skills through a remote SBL.

Methods

A pre‐ and post‐simulation survey was administered to Pharm.D. students enrolled in a first‐year pharmaceutical skills course who completed a remote SBL activity. The students' perception of their confidence performing manual blood pressure technique, utilizing drug information resources, and communication skills was assessed in addition to overall experience and challenges with conducting a remote SBL activity.

Results

A total of 87 students completed the SBL activity. The response rate for the pre‐ and post‐simulation survey were 95% (n = 83) and 62% (n = 54), respectively. Significant improvements in perceived confidence in performing manual blood pressure techniques, utilizing drug information resources, and communication skills were observed. A majority of students agreed or strongly agreed that the remote SBL activity was valuable and allowed for the application of didactic content. Qualitative feedback was analyzed using thematic analysis and indicated that the remote setting was challenging to perform manual blood pressure assessment and to interact with a standardized patient, although the feedback was positive for improving drug information and communication skills. Only five students (9%) who completed the post‐simulation survey reported technology issues.

Conclusion

The introduction of a remote SBL activity for first‐year Pharm.D. students improved confidence in ability to perform many essential tasks to provide optimal care for patients with hypertension. This included an improvement in confidence in manual blood pressure assessment, the ability to use drug information resources, and communication skills. We could not conclude whether the improvement in confidence was a direct result of the remote SBL activity. Overall, technology did not appear to be a barrier to the implementation of a remote SBL activity.
Competency‐based clinical pharmacogenomics activities during an advanced pharmacy practice experience
Authors: Cicali Emily J. , Cook Kelsey J. , Arwood Meghan J. , Elchynski Amanda , Wiisanen Kristin
Published: April 2022

Introduction

Clinical pharmacogenomics is a required element in the Doctor of Pharmacy (Pharm.D.) curriculum. However, pharmacogenomics is not widely adopted into clinical practice and as such, considerable variability in clinical teaching and learning activities within pharmacogenomic advanced pharmacy practice experiences (APPE) exist. Among other places in the University of Florida's Pharm.D. curriculum, practical applications of clinical pharmacogenomics are covered during the APPE year through an elective 6‐week Clinical Pharmacogenomics APPE.

Objectives

Describe our analysis of clinical pharmacogenomics competency statements and our process of matching these statements with learning activities in our APPE to: (a) identify unmet needs, and (b) identify essential activities for a clinical pharmacogenomics APPE for students to meet pharmacogenomics competencies.

Methods

We reviewed previous APPE syllabi to identify APPE activities, conducted a literature search to identify recommendations on clinical pharmacogenomics competencies, and then aligned these two components. A gap analysis was conducted by preceptors to determine the need for additional activities.

Results

Twenty APPE activities and 42 competency statements were identified. Eighty‐six percent of competency statements were matched to one or more APPE activities. Three activities were added to our Clinical Pharmacogenomics APPE.

Conclusion

We refined our Clinical Pharmacogenomics APPE to ensure students meet all of the identified competency statements and provided an essential list of APPE activities that, if implemented, will meet these competency statements.
Adapting clinical pharmacy staffing models during the COVID‐19 pandemic: Lessons learned and considerations for future disaster planning
Authors: Thompson Bastin Melissa L. , Berger Karen , Adams Christopher D. , Altshuler Jerry , Dixit Deepali , Effendi Muhammad K. , Johnston Jackie P. , Lemieux Diana G. , Lemieux Steven M. , Littlefield Audrey J. , Owusu Kent A. , Rose Christina , Rouse Ginger E. , Heavner Mojdeh S.
Published: April 2022

Introduction

In response to the coronavirus disease 2019 (COVID‐19) pandemic, health care institutions have faced challenges necessitating operational agility to facilitate provision of optimal patient care. This research was performed to elucidate how pharmacy departments adapted their staffing models, and the impact on frontline staff satisfaction.

Methods

Critical care pharmacists in the American College of Clinical Pharmacy (ACCP) and the American Society of Health‐System Pharmacists list‐serves were electronically invited to participate in a 28‐question survey between April and May 2020. Likert‐like questions used a 1 to 5 (strongly agree to strongly disagree) scale, and responses were compared based on the degree of satisfaction with implemented pharmacy leadership strategies. Practice model changes were compared before and during the COVID‐19 pandemic. Multivariate logistic regression was used to assess the effects of independent variables on the primary outcome ‐ satisfaction with pharmacy leadership response.

Results

Respondents (N = 168) representing 40 states in the United States participated. Forty percent of respondents experienced a surge, 68% experienced a staffing model change, and 65% were satisfied overall with their pharmacy leadership's response to the COVID‐19 pandemic. Both specialists (50% vs 21%, P = .013) and unit‐based generalists (65% vs 35%, P < .001) rounded less frequently in response to the COVID‐19 pandemic. Disagreement with “Satisfied with leadership efforts to protect staff (limiting in‐person meetings, changing code response)” decreased the odds of satisfaction by 96% (odds ratio [OR] 0.043 [95% confidence interval (CI) 0.005‐0.336], P = .003). Disagreement with “Satisfied with voice of front‐line staff” was associated with an 84% reduction in satisfaction (OR 0.165 [95% CI 0.049‐0.549], P = .003). Eliminating in‐person rounds was associated with a 95% decrease in satisfaction with pharmacy leadership (OR 0.053 [95% CI 0.007‐0.392], P = .004). Disagreement with “I believe I am at increased risk for COVID‐19 due to departmental staffing decisions” increased satisfaction (OR 3.8, 95% CI [1.06‐13.91], P = .041).

Conclusion

Frontline staff perceptions can inform practice model changes to improve employee satisfaction while providing safe, reliable, and responsible patient care.
Examining student self‐awareness of performance on entrustable professional activities given context of preceptor evaluations
Authors: Fuller Kathryn A. , Donahue Brian , Kruse Abbey
Published: April 2022

Introduction

In experiential learning, student self‐evaluation is used to determine students' self‐awareness. At our institution, we ask students to self‐assess their performance on Entrustable Professional Activities (EPAs) on Direct Patient Care rotations.

Objectives

The purpose of this study is to investigate if students can accurately self‐evaluate performance on EPAs during patient care practice experiences and if their accuracy and therefore, self‐awareness, improves over time.

Methods

This is a retrospective study using data that was collected from both student and preceptor final evaluations at three time points: T1 or Direct Patient Care Introductory Pharmacy Practice Experience (IPPE) (second or third year), T2 or the First Direct Patient Care Advanced Pharmacy Practice Experience (APPE) (fourth year), and T3 or the Last Direct Patient Care APPE (fourth year). The primary end point examined change in accuracy over time across all EPAs (global accuracy). The secondary end point examined bias or the under‐/overconfidence. The tertiary end point examined if student accuracy for individual EPAs changes over time.

Results

For the primary end point, global accuracy, accuracy significantly improved over time (P < .001) with time point one (T1 = 0.52) being more inaccurate than time point two (T2 = 0.26) and time point three (T3 = 0.027). For the secondary end point, bias (degree of under‐/overconfidence), there was no significant difference over time. When examining each individual EPA for changes in accuracy over time, we found individual EPAs showed the same significant trend (P < .001) as global scores.

Conclusion

Students' self‐assessment accuracy and therefore self‐awareness of their performance on EPAs improves over time. In all EPAs, the significant improvement in accuracy occurs between the students' Direct Patient Care IPPE (T1) and their first Patient Care APPE (T2). This evidence suggests the importance of early exposure of students to direct patient care activities, and that self‐evaluation of EPAs is beneficial to student development and leads to improved self‐awareness of their performance over time.
Digital health implications for clinical pharmacists services: A primer on the current landscape and future concerns
Authors: D. Aungst Timothy , Franzese Chris , Kim Yoona
Published: April 2022

Digital health has seen a rapid expansion across the health care space, impacting many health professions with recent advances in technology. Due to widespread internet access via smartphones and data collection via mobile apps, home assistants, and wearables, there is now a considerable platform to use technology to drive positive patient care impact. Clinical pharmacists may be at the center of developments related to medication adherence, remote patient monitoring, telehealth, digital therapeutics, artificial intelligence, digital biomarkers, and real‐world evidence (RWE), and will need to continually adapt their practice to incorporate these innovations. This primer aims to help clinical pharmacists gain insight into the current and future developments in this area and their implications for the pharmacy profession.
Zooming forward: An advanced pharmacy practice experience utilizing virtual case‐based learning in response to COVID‐19
Authors: Singh Harleen , Olberding Lauren , Al Jammali Zain , Steinkopf Miranda , Bookman Nicholas , Ostrogorsky Tanya L. , Eckrich Megan , McCracken Caitlin , Olstad Stacey
Published: April 2022

Introduction

In response to the coronavirus (COVID‐19) pandemic, Oregon State University College of Pharmacy designed and implemented a virtual six‐week case‐based learning elective rotation for advanced pharmacy practice experience (APPE).

Objectives

The goal was to develop and refine students' knowledge, critical thinking skills, evaluation and assimilation of scientific evidence, and behavior to provide patient‐focused disease management.

Methods

This APPE experience was delivered via asynchronous independent work and synchronous video conferencing. A diverse team of pharmacy experts including faculty, preceptors, and administrators developed and implemented the APPE rotation. Seventy students were divided into three groups, with each group rotating every two weeks in each of the following sections: acute care, ambulatory care, and drug information/journal club. Formative and summative assessment activities were mapped to eight student learning outcomes (SLOs). Graded activities were used to assess the achievement of SLOs, with a target minimum average of 80% as an acceptable level for achieving outcomes. At the end of the rotation, students completed a retrospective pre‐ and post‐survey to reflect their ability level for each course outcome and provide qualitative feedback regarding this APPE rotation.

Results

Sixty‐eight students completed the virtual APPE rotation. Two SLOs, one focused on the ability to evaluate and apply evidence‐based medicine and the other on the ability to establish patient‐specific goals, met the target at 80.42% and 81.14%, respectively. The average change in survey responses across all outcomes was positive with 12.35% increase. The largest increase from baseline was 15.22% in the students' ability to retrieve evidence‐based medicine and a 17.72% increase in developing drug‐related educational materials. Generally, qualitative feedback from students was positive.

Conclusion

The combination of Zoom and a university‐supported learning management system was a feasible and successful option to design and deliver experiential education in the context of COVID‐19 limitations. Students identified the strengths of this rotation as its structured nature and learning from content experts.
Maximizing the visual translation of medical information: A narrative review of the role of infographics in clinical pharmacy practice, education, and research
Authors: Barlow Brooke , Webb Andrew , Barlow Ashley
Published: April 2022

Introduction

Infographics, an abbreviated term for informational graphics, are visual representations of complex ideas or concepts. They have long played a role in the dissemination of ideas from various fields, such as business and arts. However, infographics have had an increasing role in the health care field and medical education, both for professionals and patients. To date, there is limited evidence on the use of infographics in the pharmacy profession. Conversely, the evidence is emerging for their use in other health care fields as an innovative strategy for education, dissemination of research, and public information.

Objectives

In this narrative review, we aim to summarize the basic principles of infographic design, the role of infographics in education and research dissemination, and the role of amplifying audience reach through sharing infographics on social media.

Methods

Medline and Google Scholar databases were searched for articles between 1969 and 2020 relating to infographics, healthcare, research and education then screened by all authors for their relevance to pharmacy practice.

Results

This narrative review discussed the supportive literature for the role of infographics in patient education, higher‐level education, and research dissemination with a closing discussion on the intersection between social media, infographis and education.

Conclusion

There is evolving evidence to support the use of infographics in patient education, research dissemination and higher‐level education. More research is needed to identify the role and impact of infographics in pharmacy education and clinical practice settings.
Transplant clinical pharmacy services improve cardiovascular risk factor management and control in Veteran organ transplant recipients
Authors: Elmaasarani Zana , Schumann Eric , Taber David J.
Published: April 2022

Introduction

Many factors influence long‐term graft survival for solid organ transplant recipients, with cardiovascular disease (CVD) associated death being a major issue. CVD management and risk control are essential to optimize outcomes in transplant recipients. Studies have shown interventions to reduce CVD risk, such as with the use of evidence‐based CVD medications, thus enhancing the probability of graft survival. However, further analysis is needed to assess the impact of CVD risk factor control in prolonging graft survival and outcomes.

Methods

This 10‐year retrospective, longitudinal cohort study included solid organ transplant recipients receiving care within the Veteran Affairs (VA) system between January 1, 2009 and August 31, 2019. The primary objective was to assess the impact of transplant pharmacy services (intervention incorporated at Ralph H. Johnson VA Medical Center [RHJ VAMC] after May 31, 2014) on CVD risk factor control and prescribing of medications with compelling indications for CVD prevention in Veteran post‐organ transplant recipients, using propensity score matching (PSM).

Results

A total of 2710 total Veterans were included (248 patients at the RHJ VAMC and 2462 patients at all comparator VAMCs) after PSM. There were significant improvements in yearly low‐density lipoprotein and glycated hemoglobin (A1C) monitoring in the pre‐ vs post‐intervention cohorts as compared with national trends (15.1% vs 27.1%; P < .001). There was a significant increase in the percentage of patients on high‐intensity statins as compared with national trends in difference in difference estimates (5.7%; 95% confidence interval [CI]: 1.0% to 10.4%, P = .0167). There were promising signals, such as improvements in A1C <7% goal obtainment (9.6%; 95% CI: −4.5% to 23.6%, P = .1823) and increased angiotensin‐converting enzyme inhibitor/angiotensin II receptor blockers therapy use compared with national trends (4.8%; 95% CI: −2.5% to 10.7%, P = .2243), not reaching statistical significance.

Conclusion

Transplant pharmacy services incorporated in a Veteran population improves CVD risk factor control by improving pertinent laboratory monitoring and increasing the usage of compelling CVD medications.
A multipronged approach to teaching end‐of‐life care to student pharmacists
Authors: Howard Meredith L. , Atanda Adenike , Gaviola Marian L.
Published: April 2022

Introduction

Student pharmacists are typically taught topics regarding end‐of‐life care through required didactic courses or professional electives. Important topics such as death and dying and empathetic communication skills surrounding difficult end‐of‐life care discussions are often unaddressed. To best equip students with the skills needed for practice, it is important to expose them to multiple aspects of end‐of‐life care.

Objective

To evaluate the impact of a coordinated multipronged teaching approach including a workshop‐based activity on student pharmacists' initial perceptions, knowledge, and confidence related to end‐of‐life care.

Methods

Within our curriculum, topics surrounding end‐of‐life care have historically focused on pharmacotherapy with minimal time spent on conversation practice and empathy development. In spring 2019, we conducted an all‐day session incorporating various teaching approaches (ie, didactic lecture, ethical debate, Death over Dinner workshop) to prepare students to engage in these difficult discussions. A 21‐item survey, administered at three time points (pre‐, mid‐, post‐), assessed student pharmacists across three domains: Perceptions, Confidence, and Knowledge surrounding end‐of‐life.

Results

Ninety‐six students participated in the session with 91% completing the pre‐survey, 69% completing the midpoint, and 59% completing the post‐survey. Forty‐nine (51%) completed matched survey responses across all time points. There was significant improvement in 13 (62%) of the survey items across three domains: 43% of items related to perception, 43% knowledge, and 100% confidence.

Conclusions

A multipronged, workshop‐based approach to teaching end‐of‐life care to facilitate difficult discussions surrounding death improved perceptions, confidence, and perceived knowledge among student pharmacists. This approach provided numerous avenues for students to learn and develop empathetic communication skills surrounding end‐of‐life care and represents an innovative approach to prepare students for conversations surrounding death and dying within their professional and personal lives.
Association between admission medication reconciliation by pharmacists on the accuracy of hospital discharge medication lists
Authors: Francis Martina , Wai Angela , Patanwala Asad E.
Published: April 2022

Introduction

Medication errors upon hospital discharge can lead to patient harm. Medication reconciliation during the admission process can potentially impact discharge medication lists. This study aimed to determine the extent to which a pharmacist medication reconciliation on hospital admission affects the accuracy of discharge medication lists.

Methods

A prospective observational study was conducted in a major metropolitan tertiary hospital in Sydney, Australia. Patients in the hospital discharge lounge were recruited to evaluate the accuracy of their medication list in the discharge letter. Patients were categorized into two groups: (a) those who received a pharmacist admission medication history (PHARM) and (b) those who did not (non‐PHARM). The primary outcomes were the proportion of patients with medication errors in their discharge letter.

Results

There were 102 patients included in the study (51 in each group). Patients in the PHARM group were less likely to have one or more medication errors in the discharge letter compared to the no‐PHARM group (70.6% [n = 36/51] versus 92.2% [n = 47/51] [P = .010]). When restricted to prescription only errors (i.e. excluding over the counter [OTC] or herbal medications) the proportion with errors was 51.0% (n = 26/51) in the PHARM group versus 84.3% (n = 43/51) in the no‐PHARM group (P = .001). Patients in the PHARM group were less likely to have errors that were of moderate or greater risk (31.4% [n = 16/51] versus 68.6% [n = 35/51] [P < .001]). After adjusting for confounders in the Poisson regression analysis, patients in the PHARM group had a lower error rate compared to the non‐PHARM group (incidence rate ratio 0.51, 95% confidence interval 0.38–0.69, P < .001).

Conclusion

A pharmacist‐completed medication history and reconciliation on hospital admission improves the accuracy of discharge medication lists. This study highlights that medication errors during the admission process may be propagated to hospital discharge.