Screening and referral programs for diabetes and cardiovascular disease: Can community pharmacists bridge the care gap?

Background And Objectives: Heart disease and diabetes are leading causes of death in the U.S., with timely screening, referrals, and education being critical for effective treatment.

Frequency dependence and harmonic distortion of stapes displacement and intracochlear pressure in response to very high level sounds.

Previous reports have suggested that intracochlear pressures (P) measured at the base of the cochlea increase directly proportionally with stapes displacement (D) in response to moderately high (<130 dB SPL) level sounds. Consistent with this assumption, we have reported that for low frequency sounds (<1 kHz), stapes displacement and intracochlear pressures increase linearly with sound pressure level (SPL) for moderately high levels (<130 dB SPL), but saturate at higher exposure levels (>130 dB SPL). However, the magnitudes of each response were found to be frequency dependent, thus the relationship between D and P may vary at higher frequencies or higher levels.

Range verification in heavy-ion therapy using a hadron tumour marker.

A new method to estimate the range of an ion beam in a patient during heavy-ion therapy was investigated, which was previously verified for application in proton therapy.The method consists of placing a hadron tumour marker (HTM) close to the tumour. As the treatment beam impinges on the HTM, the marker undergoes nuclear reactions.

Community Pharmacy Recruitment for Practice-Based Research: Challenges and Lessons Learned.

To support the successful integration of community pharmacies into value-based care models, research on the feasibility and effectiveness of novel pharmacist-provided patient care services is needed. The UNC Eshelman School of Pharmacy, supported by the National Association of Chain Drug Stores (NACDS) Foundation, designed the Community-based Valued-driven Care Initiative (CVCI) to (1) identify effective value-based patient care interventions that could be provided by community pharmacists, (2) implement and evaluate the feasibility of the selected patient care interventions, and (3) develop resources and create collaborative sustainability opportunities. The purpose of this manuscript is to describe recruitment strategies for CVCI and share lessons learned.

Pediatric Cardiac Arrest and Resuscitation.

Pediatric cardiac arrest in the emergency department is rare. We emphasize the importance of preparedness for pediatric cardiac arrest and offer strategies for the optimal recognition and care of patients in cardiac arrest and peri-arrest. This article focuses on both prevention of arrest and the key elements of pediatric resuscitation that have been shown to improve outcomes for children in cardiac arrest.

Telehealth medication management and health care spending in a Medicare Accountable Care Organization.

Value-based care is an opportunity for medication optimization services to improve medication management and reduce health care spending. The reach of these services may be extended through telehealth. However, as health care systems and payers grapple with the long-term financing of telehealth, real-world assessments are needed to evaluate the potential economic impact of pharmacy-driven telehealth services.

Updates in pediatric emergency medicine for 2022.

As a relatively new field, there has been a recent explosion in evidence around the management of children in the emergency department (ED). This review highlights 10 articles published in the last year providing evidence that is germane to the care of children by emergency medicine (EM) physicians. There is a focus on high prevalence conditions, such as fever and trauma, as well as interventions that can improve mortality, such as cardiopulmonary resuscitation and massive transfusion.

Impact of a Commercially Available Low Carbon Renewable Diesel Fuel on the Light-Off and Light-Down Characteristics of a Diesel Oxidation Catalyst.

Meeting future greenhouse gas emissions targets in transportation may require transition in part to renewable low carbon fuels to power the medium- and heavy-duty sectors. At this moment, market renewable low carbon diesel fuels are available and integrated with the fueling infrastructure in select areas. Though this is encouraging, little is known about the impact these renewable diesel fuels may have on modern aftertreatment systems and their ability to convert toxic emissions.

Updates in pediatric emergency medicine for 2021.

Physicians routinely treat sick children in the emergency department (ED). Many relevant articles on pediatric medicine are published in journals that are not typically read by many general emergency medicine physicians. We reviewed salient pediatric emergency medicine literature from the past year and identified ten impactful articles for general emergency physicians.

The pharmacist as a public health resource: Expanding telepharmacy services to address social determinants of health during the COVID-19 pandemic.

Background: The advent of COVID-19 exacerbated the impact of social determinants of health (SDOH) on patients' ability to manage their health, especially those with chronic conditions. Clinical pharmacists are well positioned to expand the patient care services they already provide to address patients' basic social needs, which may otherwise impede medication access and adherence.

Objectives: The purpose of this exploratory study was to evaluate the feasibility of expanding a comprehensive medication management (CMM) telepharmacy service to include SDOH support.

Synthesis of a dual carbon-14-labeled calcitonin gene-related peptide receptor antagonist for use in a human absorption-distribution-metabolism-elimination study.

Oral calcitonin gene-related peptide (CGRP) receptor antagonists have been shown to be effective in the acute and preventive treatment of migraine. CGRP receptor antagonists offer safety advantages over triptans because they are not active vasoconstrictors, which reduces cardiovascular risks. Bristol Myers Squibb discovered a high affinity CGRP receptor antagonist BMS-927711 for the treatment of migraine now FDA approved as Nurtec® ODT (rimegepant).

Intra- and inter-fraction relative range verification in heavy-ion therapy using filtered interaction vertex imaging.

Heavy-ion therapy, particularly using scanned (active) beam delivery, provides a precise and highly conformal dose distribution, with maximum dose deposition for each pencil beam at its endpoint (Bragg peak), and low entrance and exit dose. To take full advantage of this precision, robust range verification methods are required; these methods ensure that the Bragg peak is positioned correctly in the patient and the dose is delivered as prescribed. Relative range verification allows intra-fraction monitoring of Bragg peak spacing to ensure full coverage with each fraction, as well as inter-fraction monitoring to ensure all fractions are delivered consistently.

Synthesis of tritium labeled 30-KDa PEG and conjugation to form [ H]Pegbelfermin.

Non-alcoholic steatohepatitis (NASH) is the most chronic liver condition in the western population and is fueled by the obesity and type 2 diabetes epidemic. Pegbelfermin (1), a PEGylated human fibroblast growth factor 21 (FGF21) analogue, has previously been shown to improve markers of metabolism and liver fibrosis in obese patients with type 2 diabetes. Radiolabeled Pegbelfermin was needed to access the accumulation of intact drug and metabolized PEG.

Pediatric emergency medicine literature 2020.

Most children are treated at general Emergency Departments (EDs) and not specialized pediatric EDs. Therefore, it is crucial for emergency medicine physicians to be aware of recent developments in pediatric emergency medicine. Often impactful articles on pediatric emergency medicine are not published in the journals regularly studied by general emergency medicine physicians.

Influence of Ash-Soot Interactions on the Reactivity of Soot from a Gasoline Direct Injection Engine.

Gasoline particulate filters (GPF) are being utilized in certain markets on gasoline direct injection (GDI) vehicles to reduce tailpipe particulate emissions as required by particle number regulations. GPF filtration efficiency is dependent on soot build-up within the filter. Since soot oxidizes within the GPF during normal vehicle operation, an understanding of soot reactivity is important for optimizing aftertreatment architecture and engine calibration.

Making the economic value proposition for pharmacist comprehensive medication management (CMM) in primary care: A conceptual framework.

Introduction: Comprehensive medication management (CMM) is a patient care process provided by clinical pharmacists in primary care settings that ensures optimal use of medications with timely follow-up. Despite widespread evidence that shows CMM improves clinical and medication-related outcomes, pharmacist-delivered CMM services often fail to be adopted into U.S.

Unifying a profession and a health care system: Building the case for a "one pharmacy" global community.

The rational use of medicines to achieve better patient outcomes is a global concern. This need has pressured the practice of pharmacy to move away from focusing only on dispensing of the drug product towards the patient's appropriate utilization of the medicine. PharmAlliance, a unique partnership among three leading schools of pharmacy at the University of North Carolina at Chapel Hill (United States), Monash University (Australia), and University College London (United Kingdom), convened a Global Summit of Pharmacy Practice Innovation in November 2017 to bring together the leaders of the professional associations of the three countries to dialogue about how to lead the identified changes.

Optimizing medication use through a synergistic technology testing process integrating implementation science to drive effectiveness and facilitate scale.

Objectives: 1) To describe a synergistic technology testing process (STTP) that integrates traditional technology assessment with implementation science principles to drive uptake, enhance outcomes, and facilitate scaling of medication optimization health information technology solutions; and 2) to illustrate the application of the STTP using an example that involves designing and testing a medication therapy problem (MTP) platform for use by pharmacists in primary care.

Summary: Optimizing medication services requires supportive technologies that have been fully tested before release. Current testing approaches are not sufficient to produce the information needed to accelerate uptake and drive impact.

LC-MS/MS bioanalysis of plasma 1, 14-tetradecanedioic acid and 1, 16-hexadecanedioic acid as candidate biomarkers for organic anion-transporting polypeptide mediated drug-drug interactions.

Aim: A robust LC-MS/MS assay was developed to quantify endogenous 1, 14-tetradecanedioic acid (TDA) and 1, 16-hexadecanedioic acid (HDA) in human plasma as potential biomarkers for evaluating drug-drug interactions mediated by the hepatic drug transporters, organic anion-transporting polypeptides.

Results: This assay was validated using fit-for-purpose approach over standard curve range of 2.5-1000 nM for TDA and HDA using analyte-free charcoal-stripped human plasma as the surrogate matrix.

Air- and Bone-Conducted Sources of Feedback With an Active Middle Ear Implant.

Objectives: Active middle ear implants (AMEI) have been used to treat hearing loss in patients for whom conventional hearing aids are unsuccessful for varied biologic or personal reasons. Several studies have discussed feedback as a potential complication of AMEI usage, though the feedback pathway is not well understood. While reverse propagation of an acoustic signal through the ossicular chain and tympanic membrane constitutes an air-conducted source of feedback, the implanted nature of the device microphone near the mastoid cortex suggests that bone conduction pathways may potentially be another significant factor.

Design, Synthesis, and SAR of C-3 Benzoic Acid, C-17 Triterpenoid Derivatives. Identification of the HIV-1 Maturation Inhibitor 4-((1 R,3a S,5a R,5b R,7a R,11a S,11b R,13a R,13b R)-3a-((2-(1,1-Dioxidothiomorpholino)ethyl)amino)-5a,5b,8,8,11a-pentamethyl-1-(prop-1-en-2-yl)-2,3,3a,4,5,5a,5b,6,7,7a,8,11,11a,11b,12,13,13a,13b-octadecahydro-1 H-cyclopenta[ a]chrysen-9-yl)benzoic Acid (GSK3532795, BMS-955176).

GSK3532795, formerly known as BMS-955176 (1), is a potent, orally active, second-generation HIV-1 maturation inhibitor (MI) that advanced through phase IIb clinical trials. The careful design, selection, and evaluation of substituents appended to the C-3 and C-17 positions of the natural product betulinic acid (3) was critical in attaining a molecule with the desired virological and pharmacokinetic profile. Herein, we highlight the key insights made in the discovery program and detail the evolution of the structure-activity relationships (SARs) that led to the design of the specific C-17 amine moiety in 1.

Confirmation of Pharmaceutical Identifiers via DART-TOF-MS.

A direct analysis in real time ion source coupled with a time-of-flight mass spectrometer (DART-TOF-MS) is a suitable confirmatory technique for the analysis of pharmaceutical preparations, with accompanying reference sources for preparation markings. The DART-TOF-MS instrument allows for simple sample preparation and decreased analysis time, both crucial in a forensic laboratory setting. Differentiation can be made between active drug ingredients with the same molecular weight, such as hydrocodone and codeine, as well as pharmaceutical preparation mixtures, such as oxycodone and acetaminophen, using exact masses of the protonated molecules and fragment peaks compared to a standard.