Recent Research Articles from UNTHSC

Recent research articles indexed in PubMed from authors affiliated with the UNT Health Science Center.

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NCBI: db=pubmed; Term="University of North Texas Health Science Center"[All Fields] OR "Univ. of North Texas Health Science Center"[All Fields] OR "UNT Health Science Center"[All Fields] OR "Osteopathic Research Center"[All Fields] OR "University of North Texas System College of Pharmacy"[All Fields] OR "UNT System College of Pharmacy"[All Fields] OR "College of Pharmacy, University of North Texas System"[All Fields]
Updated: 1 hour 29 min ago

The effect of intermittent hypoxia training on migraine: a randomized controlled trial.

1 hour 29 min ago

The effect of intermittent hypoxia training on migraine: a randomized controlled trial.

Am J Transl Res. 2020;12(7):4059-4065

Authors: Bao X, Liu H, Liu HY, Long Y, Tan JW, Zhu ZM

Abstract
OBJECTIVE: To study the effect of intermittent hypoxia training (IHT) for migraine.
DESIGN: A single-blind, randomized controlled trial. All participants were recruited from a rehabilitation department in an acute university-affiliated hospital.
METHODS: Participants with migraines were randomly assigned to two groups (IHT group and control group). The Migraine Disability Assessment (MIDAS), Visual Analog Scale (VAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Vascular endothelial growth factor (VEGF), calcitonin gene related peptide (CGRP) and cerebrovascular hemodynamic parameters were collected at baseline and end of the 8th week. The attack frequencies of migraines were evaluated at 3 months.
RESULTS: Among the 48 subjects, five males and forty-three females, the ages ranged from 19 to 53 years old (mean ± SD = 31.3±7.78). MIDAS, SF-36, VAS, BAI, BDI, VEGF, CGRP and cerebrovascular hemodynamic parameters were improved after IHT intervention. There were significant differences between IHT group and the control group in MIDAS, SF-36, VAS, BAI, BDI, VEGF, CGRP and cerebrovascular hemodynamic parameters at the end of the 8th weeks (P<0.05). Attack frequencies were improved within 3 months after IH training intervention (P<0.01), but not in the control group (P>0.05). No adverse events occurred during the study.
CONCLUSION: IHT could improve migraines after intervention up to three months. IHT could be an effective method for relieving a migraine.

PMID: 32774759 [PubMed - as supplied by publisher]

Comment on: Curative-intent radiotherapy for pediatric osteosarcoma: The St. Jude experience.

1 hour 29 min ago
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Comment on: Curative-intent radiotherapy for pediatric osteosarcoma: The St. Jude experience.

Pediatr Blood Cancer. 2020 06;67(6):e28287

Authors: Vicenzi P, Johnnidis M, Hamby T, Ray A

PMID: 32293779 [PubMed - indexed for MEDLINE]

New Measures for the Coronavirus Disease 2019 Response: A Lesson From the Wenzhou Experience.

1 hour 29 min ago
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New Measures for the Coronavirus Disease 2019 Response: A Lesson From the Wenzhou Experience.

Clin Infect Dis. 2020 07 28;71(15):866-869

Authors: Ruan L, Wen M, Zeng Q, Chen C, Huang S, Yang S, Yang J, Wang J, Hu Y, Ding S, Zhang Y, Zhang H, Feng Y, Jin K, Zhuge Q

Abstract
As the outbreak of coronavirus disease 2019 (COVID-19) has spread globally, determining how to prevent the spread is of paramount importance. We reported the effectiveness of different responses of 4 affected cities in preventing the COVID-19 spread. We expect the Wenzhou anti-COVID-19 measures may provide information for cities around the world that are experiencing this epidemic.

PMID: 32246149 [PubMed - indexed for MEDLINE]

The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned?

1 hour 29 min ago
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The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned?

Int J Epidemiol. 2020 06 01;49(3):717-726

Authors: Peeri NC, Shrestha N, Rahman MS, Zaki R, Tan Z, Bibi S, Baghbanzadeh M, Aghamohammadi N, Zhang W, Haque U

Abstract
OBJECTIVES: To provide an overview of the three major deadly coronaviruses and identify areas for improvement of future preparedness plans, as well as provide a critical assessment of the risk factors and actionable items for stopping their spread, utilizing lessons learned from the first two deadly coronavirus outbreaks, as well as initial reports from the current novel coronavirus (COVID-19) epidemic in Wuhan, China.
METHODS: Utilizing the Centers for Disease Control and Prevention (CDC, USA) website, and a comprehensive review of PubMed literature, we obtained information regarding clinical signs and symptoms, treatment and diagnosis, transmission methods, protection methods and risk factors for Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS) and COVID-19. Comparisons between the viruses were made.
RESULTS: Inadequate risk assessment regarding the urgency of the situation, and limited reporting on the virus within China has, in part, led to the rapid spread of COVID-19 throughout mainland China and into proximal and distant countries. Compared with SARS and MERS, COVID-19 has spread more rapidly, due in part to increased globalization and the focus of the epidemic. Wuhan, China is a large hub connecting the North, South, East and West of China via railways and a major international airport. The availability of connecting flights, the timing of the outbreak during the Chinese (Lunar) New Year, and the massive rail transit hub located in Wuhan has enabled the virus to perforate throughout China, and eventually, globally.
CONCLUSIONS: We conclude that we did not learn from the two prior epidemics of coronavirus and were ill-prepared to deal with the challenges the COVID-19 epidemic has posed. Future research should attempt to address the uses and implications of internet of things (IoT) technologies for mapping the spread of infection.

PMID: 32086938 [PubMed - indexed for MEDLINE]

A standalone humanitarian DNA identification database system to increase identification of human remains of foreign nationals.

Sun, 08/09/2020 - 05:00
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A standalone humanitarian DNA identification database system to increase identification of human remains of foreign nationals.

Int J Legal Med. 2020 Aug 06;:

Authors: Budowle B, Bus MM, Josserand MA, Peters DL

Abstract
The identification of missing persons and human remains is a worldwide problem which has been exacerbated with increased migrations and rampant human trafficking and smuggling cases. DNA typing and DNA databases are primary tools and resources used to help identify human remains and missing persons. The foundation of most, if not all, national DNA database systems, e.g., CODIS, is law enforcement identification. With such database systems, compliance with statutory and operational requirements is necessary to ensure the integrity of the databases. However, because of conditions in their homelands, relatives of missing persons at times may not trust the government and may be reluctant to contact a law enforcement agency, making it difficult to satisfy the law enforcement nexus necessary for entry into a national DNA database. A potential solution to increase the identification of unidentified human remains found within the USA, such as those that may be of foreign nationals, the University of North Texas Center for Human Identification (UNTCHI) has created a Humanitarian DNA Identification DNA Database (HDID) that enables family reference sample DNA profiles from non-US citizens to be compared with the DNA profiles from unidentified human remains within its local database system. This short communication describes the needs, basis, policies, and practices to inform the scientific, investigative, and legal communities and the public so that various entities may become aware and consider submitting family reference sample (FRS) profiles from foreign nationals for the purpose of searching against UNTCHI's HDID. It is our hope that by creating this HDID, another vehicle is available to support identification of human remains within the USA and to bring much needed answers to the family members of missing persons. The HDID will merge high forensic quality and best practices with the broader accessibility for non-US families to voluntarily donate DNA profiles for searching for missing loved ones.

PMID: 32767019 [PubMed - as supplied by publisher]

Automation, Monitoring, and Standardization of Cell Product Manufacturing.

Sun, 08/09/2020 - 05:00
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Automation, Monitoring, and Standardization of Cell Product Manufacturing.

Front Bioeng Biotechnol. 2020;8:811

Authors: Doulgkeroglou MN, Di Nubila A, Niessing B, König N, Schmitt RH, Damen J, Szilvassy SJ, Chang W, Csontos L, Louis S, Kugelmeier P, Ronfard V, Bayon Y, Zeugolis DI

Abstract
Although regenerative medicine products are at the forefront of scientific research, technological innovation, and clinical translation, their reproducibility and large-scale production are compromised by automation, monitoring, and standardization issues. To overcome these limitations, new technologies at software (e.g., algorithms and artificial intelligence models, combined with imaging software and machine learning techniques) and hardware (e.g., automated liquid handling, automated cell expansion bioreactor systems, automated colony-forming unit counting and characterization units, and scalable cell culture plates) level are under intense investigation. Automation, monitoring and standardization should be considered at the early stages of the developmental cycle of cell products to deliver more robust and effective therapies and treatment plans to the bedside, reducing healthcare expenditure and improving services and patient care.

PMID: 32766229 [PubMed - as supplied by publisher]

Potential Biochemical Mechanisms of Brain Injury in Diabetes Mellitus.

Sun, 08/09/2020 - 05:00
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Potential Biochemical Mechanisms of Brain Injury in Diabetes Mellitus.

Aging Dis. 2020 Jul;11(4):978-987

Authors: Ma WX, Tang J, Lei ZW, Li CY, Zhao LQ, Lin C, Sun T, Li ZY, Jiang YH, Jia JT, Liang CZ, Liu JH, Yan LJ

Abstract
The goal of this review was to summarize current biochemical mechanisms of and risk factors for diabetic brain injury. We mainly summarized mechanisms published in the past three years and focused on diabetes induced cognitive impairment, diabetes-linked Alzheimer's disease, and diabetic stroke. We think there is a need to conduct further studies with increased sample sizes and prolonged period of follow-ups to clarify the effect of DM on brain dysfunction. Additionally, we also think that enhancing experimental reproducibility using animal models in conjunction with application of advanced devices should be considered when new experiments are designed. It is expected that further investigation of the underlying mechanisms of diabetic cognitive impairment will provide novel insights into therapeutic approaches for ameliorating diabetes-associated injury in the brain.

PMID: 32765958 [PubMed - as supplied by publisher]

Editorial: Diabetes and Obesity Effects on Lung Function.

Sun, 08/09/2020 - 05:00
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Editorial: Diabetes and Obesity Effects on Lung Function.

Front Endocrinol (Lausanne). 2020;11:462

Authors: Chen XF, Yan LJ, Lecube A, Tang X

PMID: 32765427 [PubMed - as supplied by publisher]

Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives.

Sun, 08/09/2020 - 05:00
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Osteopathic Manipulation in the Management of Chronic Pain: Current Perspectives.

J Pain Res. 2020;13:1839-1847

Authors: Licciardone JC, Schultz MJ, Amen B

Abstract
Chronic pain is a common condition that often interferes with work or other activities. Guidelines support the use of non-pharmacological treatments, such as spinal manipulation, in patients with chronic pain. Osteopathic physicians in the United States are uniquely positioned to manage chronic pain because their professional philosophy embraces the biopsychosocial model and they are trained in the use of osteopathic manipulative treatment (OMT) to complement conventional medical care. This narrative review provides current perspectives on the osteopathic approach to chronic pain management, including evidence for the efficacy of OMT based on systematic searches of the biomedical literature and the ClinicalTrials.gov database. Men, persons with low levels of education, and non-White and Hispanic patients are significantly less likely to have received OMT during their lifetime. Patients with low back and neck pain are most likely to be treated with OMT, and osteopathic manipulative medicine specialty physicians and family medicine physicians most often use OMT. However, many osteopathic physicians report using OMT infrequently. Although OMT is considered safe, based on millions of patient encounters over more than a century, there is limited evidence on its efficacy in treating chronic pain. The lone exception involves chronic low back pain, wherein there is evidence from systematic reviews, a large clinical trial, and observational studies. There is lesser evidence to support cost effectiveness and patient satisfaction associated with OMT for chronic pain. The only clinical practice guideline established by the American Osteopathic Association recommends that OMT should be used to treat chronic low back pain in patients with somatic dysfunction. Given the philosophy of osteopathic medicine, universal training of osteopathic physicians to use OMT, and national guidelines supporting non-pharmacological treatments for chronic pain, it is unclear why OMT use is reported to be remarkably low in physician surveys.

PMID: 32765058 [PubMed - as supplied by publisher]

Hypoxia post-conditioning promoted glycolysis in mice cerebral ischemic model.

Sun, 08/09/2020 - 05:00
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Hypoxia post-conditioning promoted glycolysis in mice cerebral ischemic model.

Brain Res. 2020 Aug 04;:147044

Authors: Ren C, Han R, Hu J, Li H, Li S, Liu Y, Cheng Z, Ji X, Ding Y

Abstract
Ischemic stroke initiated by transient or permanent cerebral blood flow decline remains the leading cause of permanent disability in industrialized nations. Therapeutic strategies to improve patient recovery are remain limited. Hypoxia post-conditioning (HPostC) has been known to be neuroprotective against ischemic injuries in vivo and in vitro. Understanding its mechanism of action may promote its clinical translation. In this study, we devised a method of HPostC treatment to provide protection from a focal cerebral ischemic induced injury and to explore the underling mechanism. We found that our HPostC method improved energy supply by elevating the level of glucose, pyruvate and ATP/ADP ratio within the cerebral hemisphere in mice. In the distal middle cerebral artery occlusion (dMCAO) mice, this HPostC treatment reduced infarct size, and was associated with increased levels of pyruvate, pyruvate/lactate ratio and ATP/ADP ratio. Western blot analysis indicated that the HPostC treatment up-regulated AMPK signaling activities in the cerebral hemisphere. Our results suggest that this HPostC treatment exerts its neuroprotective effect by promoting glycolysis to elevate the ATP/ADP level, and the AMPK/PFKFB3 signaling pathway. These findings may provide biomarkers for clinical use of HPostC methods.

PMID: 32763237 [PubMed - as supplied by publisher]

Smoking cessation and survival among people diagnosed with non-metastatic cancer.

Sat, 08/08/2020 - 07:26
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Smoking cessation and survival among people diagnosed with non-metastatic cancer.

BMC Cancer. 2020 Aug 05;20(1):726

Authors: Barnett TE, Lu Y, Gehr AW, Ghabach B, Ojha RP

Abstract
BACKGROUND: We aimed to estimate the effects of smoking cessation on survival among people diagnosed with cancer.
METHODS: We used data from a Comprehensive Community Cancer Program that is part of a large urban safety-net hospital system. Eligible patients were diagnosed with primary invasive solid tumors between 2013 and 2015, and were current smokers at time of diagnosis. Our exposure of interest was initiation of smoking cessation within 6 months of cancer diagnosis. We estimated inverse probability weighted restricted mean survival time (RMST) differences and risk ratio (RR) for all cause 3-year mortality.
RESULTS: Our study population comprised 369 patients, of whom 42% were aged < 55 years, 59% were male, 44% were racial/ethnic minorities, and 59% were uninsured. The 3-year RMST was 1.8 (95% CL: - 1.5, 5.1) months longer for individuals who initiated smoking cessation within 6 months of cancer diagnosis. The point estimate for risk of 3-year mortality was lower for initiation of smoking cessation within 6 months of diagnosis compared with no initiation within 6 months (RR = 0.72, 95% CL: 0.37, 1.4).
CONCLUSIONS: Our point estimates suggest longer 3-year survival, but the results are compatible with 1.5 month shorter or 5.1 longer 3-year overall survival after smoking cessation within 6 months of cancer diagnosis. Future studies with larger sample sizes that test the comparative effectiveness of different smoking cessation strategies are needed for more detailed evidence to inform decision-making about the effect of smoking cessation on survival among cancer patients.
IMPLICATIONS FOR CANCER SURVIVORS: The benefits of smoking cessation after cancer diagnosis may include longer survival, but the magnitude of benefit is unclear.

PMID: 32758159 [PubMed - in process]

Transitioning from acute to chronic pain: a simulation study of trajectories of low back pain.

Fri, 08/07/2020 - 06:34
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Transitioning from acute to chronic pain: a simulation study of trajectories of low back pain.

J Transl Med. 2019 09 06;17(1):306

Authors: Su J, Du Y, Bevers K, Xiao P, Licciardone J, Brotto M, Gatchel RJ

Abstract
BACKGROUND: Identifying how pain transitions from acute to chronic is critical in designing effective prevention and management techniques for patients' well-being, physically, psychosocially, and financially. There is an increasingly pressing need for a quantitative and predictive method to evaluate how low back pain trajectories are classified and, subsequently, how we can more effectively intervene during these progression stages.
METHODS: In order to better understand pain mechanisms, we investigated, using computational modeling, how best to describe pain trajectories by developing a platform by which we studied the transition of acute chronic pain.
RESULTS: The present study uses a computational neuroscience-based method to conduct such trajectory research, motivated by the use of hypothalamic-pituitary-adrenal (HPA) axis activity-history over a time-period as a way to mimic pain trajectories. A numerical simulation study is presented as a "proof of concept" for this modeling approach.
CONCLUSIONS: This model and its simulation results have highlighted the feasibility and the potential of developing such a broader model for patient evaluations.

PMID: 31492167 [PubMed - indexed for MEDLINE]

Curcumin Nanoparticles and Their Cytotoxicity in Docetaxel-Resistant Castration-Resistant Prostate Cancer Cells.

Thu, 08/06/2020 - 14:30
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Curcumin Nanoparticles and Their Cytotoxicity in Docetaxel-Resistant Castration-Resistant Prostate Cancer Cells.

Biomedicines. 2020 Jul 30;8(8):

Authors: Tanaudommongkon I, Tanaudommongkon A, Prathipati P, Nguyen JT, Keller ET, Dong X

Abstract
Most prostate cancer patients develop resistance to anti-androgen therapy. This is referred to as castration-resistant prostate cancer (CRPC). Docetaxel (DTX) is the mainstay treatment against CRPC. However, over time patients eventually develop DTX resistance, which is the cause of the cancer-related mortality. Curcumin (CUR) as a natural compound has been shown to have very broad pharmacological activities, e.g., anti-inflammatory and antioxidant properties. However, CUR is very hydrophobic. The objective of this study was to develop CUR nanoparticles (NPs) and evaluate their cytotoxicity in DTX-resistant CRPC cells for the treatment of DTX-resistant CRPC. We tested solubility of CUR in different lipids and surfactants. Finally, Miglyol 812 and D-alpha-tocopheryl poly (ethylene glycol) succinate 1000 (TPGS) were chosen to prepare lipid-based NPs for CUR. We fully characterized CUR NPs that had particle size < 150 nm, high drug loading (7.5%), and entrapment efficiency (90%). Moreover, the CUR NPs were successfully lyophilized without using cryoprotectants. We tested the cytotoxicity of blank NPs, free CUR, and CUR NPs in sensitive DU145 and PC3 cells as well as their matching docetaxel-resistant cells. Cytotoxicity studies showed that blank NPs were very safe for all tested prostate cancer cell lines. Free CUR overcame the resistance in PC3 cells, but not in DU145 cells. In contrast, CUR NPs significantly increased CUR potency in all tested cell lines. Importantly, CUR NPs completely restored CUR potency in both resistant DU145 and PC3 cells. These results demonstrate that the CUR NPs have potential to overcome DTX resistance in CRPC.

PMID: 32751450 [PubMed]

The Podiatric Medical Profession: A Gender Comparison.

Wed, 08/05/2020 - 07:56
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The Podiatric Medical Profession: A Gender Comparison.

J Foot Ankle Surg. 2020 Jul 31;:

Authors: Brower BA, Butterworth ML, Crawford ME, Jennings MM, Tan Z, Moore JD, Suzuki S, Carpenter BB

Abstract
The number of women in podiatric medicine and surgery has increased steadily over the past 4 decades; however, there appears to be a large and continued gender gap with respect to representation in academic medicine and other positions of power. National and state level organizational data were obtained from multiple podiatry professional societies to evaluate the rate at which women achieved leadership roles within the podiatric profession over time. A secondary questionnaire was also developed and electronically mailed to 8684 doctors of podiatric medicine to help capture additional leadership information and to provide further insight into the trends observed. The response rate was 26% (2276/8684). Female representation in academia, research/publications, most leadership positions, and board certifications has increased over time, but at a slower rate than the number of women entering the profession. We observed a decreasing trend of females completing fellowships, speaking at national meetings, becoming residency directors, and receiving American College of Foot and Ankle Surgeons- and American Podiatric Medical Association-sponsored grants/awards. Based on the survey results, female podiatric physicians were more likely to be single, have fewer children, spend more time in a clinical setting, be less satisfied with work, and experience higher work stress levels than their male colleagues. Of the female respondents, 73% described experiencing gender discrimination at some point in their career, and 42% reported experiencing sexual harassment, compared with only 6% and 5% of men, respectively. There continues to be a gender gap in leadership roles, which may be explained partially by work/life balance issues, gender discrimination, and other issues.

PMID: 32747184 [PubMed - as supplied by publisher]

Effect of General Anesthesia on Cardiac Magnetic Resonance-Derived Cardiac Function in Repaired Tetralogy of Fallot.

Mon, 08/03/2020 - 06:38

Effect of General Anesthesia on Cardiac Magnetic Resonance-Derived Cardiac Function in Repaired Tetralogy of Fallot.

Pediatr Cardiol. 2020 Aug 01;:

Authors: Muyskens S, Roshan T, Honan K, Umejiego J, Raynaud S, Ogunyankin F

Abstract
Cardiac magnetic resonance imaging (CMR)-derived ejection fraction (EF) predicts adverse outcomes in repaired tetralogy of Fallot (rTOF) and drives timing of pulmonary valve replacement. Certain patient populations require sedation for successful CMR image acquisition. General anesthesia (GA) has been shown to depress EF and heart rate (HR) in animal models, however, its effect on congenital heart disease is unknown. A retrospective review was conducted of all CMR patients referred with rTOF between January 2011 and May 2019. The cohort was separated into GA and non-GA groups. Propensity score matching (PSM) adjusted for selection bias. A kernel matching algorithm was used to match subjects and the differences in mean treatment effect on the treated were computed for left ventricular (LV) and right ventricular (RV) EF, HR, and cardiac index (CI). 143 patients met criteria, 37 patients under GA (mean age 15 years, range 2-45, 59% male), and 106 patients without GA (mean age 21 years, range 10-53, 50% male). Unmatched analysis showed significant depression of LV EF (50 vs. 57%, p < 0.001) and RV EF (42 vs. 48%, p < 0.001) in the GA group compared to the non-GA group. There was no significant difference in HR or CI. After matching and PSM adjustment, the GA group had a significant decrease in LV EF (49 vs. 56%, p < 0.001), RV EF (41 vs. 48%, p < 0.001), CI (2728 vs. 3701 ml/min/m2, p < 0.001), and HR (72 vs. 79 bpm, p = 0.04). General anesthesia with sevoflurane results in depressed CMR-derived EF.

PMID: 32740671 [PubMed - as supplied by publisher]

Reflective metacognition and objective structured clinical examination performance in introductory pharmacy practice experiences.

Mon, 08/03/2020 - 06:38

Reflective metacognition and objective structured clinical examination performance in introductory pharmacy practice experiences.

Curr Pharm Teach Learn. 2020 Oct;12(10):1208-1214

Authors: Tatachar A, Wettergreen S, Summers S

Abstract
BACKGROUND AND PURPOSE: Objective structured clinical examinations (OSCEs) allow for holistic evaluation of clinical competence, but integration of reflective practices on OSCE performance has not been well-studied.
EDUCATIONAL ACTIVITY AND SETTING: To develop metacognitive skills, second-year pharmacy students completed a self-reflection assignment on a mock medication therapy management OSCE in an introductory pharmacy practice experience course. Students who completed the course during the prior year (no self-reflection assignment) served as the control. The study assessed the correlation of students' reflections of their OCSE abilities to OSCE performance and evaluated if student demographics influenced the correlation.
FINDINGS: There were 107 students in the control group and 95 students in the intervention group. A higher proportion of students passed the overall OSCE in the control group (67.4%) compared to the intervention group (58.9%), but this was not statistically significant. Neither gender, age, nor Pharmacy College Admissions Test score had an effect on OSCE pass rates. Grade point average did have a significant effect on OSCE pass rates (P = .019). Overall, no statistically significant association was seen in summative OSCE performance between students who used structured, guided questions to reflect on their formative OSCE performance and those who did not (P > .05).
SUMMARY: Despite this study's results, faculty continue to embrace the concept of reflective practice. Further research is needed to assess the value and role of reflective practice in pharmacy education.

PMID: 32739058 [PubMed - as supplied by publisher]

Incorporating Pharmacometrics into Pharmacoeconomic Models: Applications from Drug Development.

Sat, 08/01/2020 - 05:05
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Incorporating Pharmacometrics into Pharmacoeconomic Models: Applications from Drug Development.

Pharmacoeconomics. 2020 Jul 31;:

Authors: Srinivasan M, White A, Chaturvedula A, Vozmediano V, Schmidt S, Plouffe L, Wingate LT

Abstract
Pharmacometrics is the science of quantifying the relationship between the pharmacokinetics and pharmacodynamics of drugs in combination with disease models and trial information to aid in drug development and dosing optimization for clinical practice. Considering the variability in the dose-concentration-effect relationship of drugs, an opportunity exists in linking pharmacokinetic and pharmacodynamic model-based estimates with pharmacoeconomic models. This link may provide early estimates of the cost effectiveness of drug therapies, thus informing late-stage drug development, pricing, and reimbursement decisions. Published case studies have demonstrated how integrated pharmacokinetic-pharmacodynamic-pharmacoeconomic models can complement traditional pharmacoeconomic analyses by identifying the impact of specific patient sub-groups, dose, dosing schedules, and adherence on the cost effectiveness of drugs, thus providing a mechanistic basis to predict the economic value of new drugs. Greater collaboration between the pharmacoeconomics and pharmacometrics community can enable methodological improvements in pharmacokinetic-pharmacodynamic-pharmacoeconomic models to support drug development.

PMID: 32734572 [PubMed - as supplied by publisher]

Costs and cost-effectiveness of the Patient-centered HIV Care Model: A collaboration between community-based pharmacists and primary medical providers.

Sat, 08/01/2020 - 05:05
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Costs and cost-effectiveness of the Patient-centered HIV Care Model: A collaboration between community-based pharmacists and primary medical providers.

J Acquir Immune Defic Syndr. 2020 Jul 23;:

Authors: Shrestha RK, Schommer JC, Taitel MS, Garza OW, Camp NM, Akinbosoye OE, Clay PG, Byrd KK, Patient-centered HIV Care Model Team

Abstract
BACKGROUND: The Patient-centered HIV Care Model (PCHCM) is an evidence-informed structural intervention that integrates community-based pharmacists with primary medical providers to improve rates of HIV viral suppression. This report assesses the costs and cost-effectiveness of the PCHCM.
SETTING: Patient-centered HIV Care Model METHODS:: Three project sites, each composed of a medical clinic and one or two community-based HIV-specialized pharmacies, were included in the analyses. PCHCM required patient data sharing between medical providers and pharmacists and collaborative therapy-related decision making. Intervention effectiveness was measured as the incremental number of patients virally suppressed (HIV RNA <200 copies/mL at the last test in a 12-month measurement period). Micro-costing direct measurement methods were used to estimate intervention. The cost per patient, cost per patient visit, and incremental cost per patient virally suppressed were calculated from the health care providers' perspective. Additionally, the number of HIV transmissions averted, lifetime HIV treatment cost saved, quality-adjusted life years (QALYs) saved, and cost per QALY saved were calculated from the societal perspective, using standard methods and reported values from the published literature.
RESULTS: Overall, the PCHCM annual intervention cost for the three project sites was $226,741. The average cost per patient, cost per patient visit, and incremental cost per patient virally suppressed were $813, $48, and $5,039, respectively. The intervention averted 2.75 HIV transmissions and saved 12.22 QALYs and nearly $1.28 million in lifetime HIV treatment costs. The intervention was cost saving overall and at each project site.
CONCLUSIONS: The PCHCM can be delivered at a relatively low cost and is a cost-saving intervention to assist patients in achieving viral suppression and preventing HIV transmission.

PMID: 32732767 [PubMed - as supplied by publisher]

Ramadan and Culturally Competent Care: Strengthening Tuberculosis Protections for Recently Resettled Muslim Refugees.

Sat, 08/01/2020 - 05:05
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Ramadan and Culturally Competent Care: Strengthening Tuberculosis Protections for Recently Resettled Muslim Refugees.

J Public Health Manag Pract. 2020 Sep/Oct;26(5):E13-E16

Authors: Stockbridge EL, Kabani FA, Gallups JS, Miller TL

Abstract
To improve latent tuberculosis infection treatment completion rates, Tarrant County Public Health began providing after-dusk home delivery of a 12-dose latent tuberculosis infection regimen of weekly rifapentine plus isoniazid administered via directly observed preventive therapy during Ramadan, a month of prayer and daytime fasting observed by Muslims. In unadjusted difference-in-difference logistic regression analyses (n = 148), Muslim patients had lower treatment completion rates than non-Muslim patients during Ramadan prior to program implementation (68.8% vs 95.4%), whereas rates were comparable postimplementation (95.7% vs 96.4%; difference-in-difference P = .011). Similar results were found after adjusting for age and gender (pre: 71.4% vs 94.8%; post: 95.5% vs 96.3%; P = .032). These findings provide evidence of the need for and effectiveness of programmatic innovations tailored to the varying cultural norms of the widely diverse populations served by public health authorities and suggest that culturally competent clinical care may advance population health goals.

PMID: 32732732 [PubMed - in process]

Next generation sequencing and functional pathway analysis to understand the mechanism of action of copper-tolfenamic acid against pancreatic cancer cells.

Wed, 07/29/2020 - 05:48
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Next generation sequencing and functional pathway analysis to understand the mechanism of action of copper-tolfenamic acid against pancreatic cancer cells.

Process Biochem. 2020 Feb;89:155-164

Authors: Hurtado M, Prokai L, Sankpal UT, Levesque B, Maram R, Chhabra J, Brown DT, Gurung RK, Holder AA, Vishwanatha JK, Basha R

Abstract
Anti-cancer activity of tolfenamic acid (TA) in preclinical models for pancreatic cancer (PaCa) is well established. Since the dosage for anti-cancer actions of TA is rather high, we recently demonstrated that IC50 values of Copper-TA are 30-80% less than TA in 12 cancer cell lines. This study elucidates the underlying mechanisms of Copper-TA in PaCa cells. Control and Copper-TA (IC50) treated PaCa cells were processed by next-generation sequencing (NGS) to determine differentially expressed genes using HTG EdgeSeq Oncology Biomarker panel. Ingenuity Pathway Analysis (IPA®) was used to identify functional significance of altered genes. The conformational studies for assessing the expression of key regulators and genes were conducted by Western blot and qPCR. IPA® identified several networks, regulators, as well as molecular and cellular functions associated with cancer. The top 5 molecular and cellular functions affected by Cu-TA treatment were cell death and survival, cellular development, cell growth and proliferation, cell cycle and cellular movement. The expression of top upstream regulators was confirmed by Western blot analysis while qPCR results of selected genes demonstrated that Copper-TA is efficacious at lower doses than TA. Results suggest that Copper-TA alters genes/key regulators associated with cancer and potentially serve as an effective anti-cancer agent.

PMID: 32719579 [PubMed]

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