Publications by authors named "Mary Smith"

International Classification of Diseases, Tenth Revision (ICD-10) billing data used in outpatient stewardship metrics is under-described for acute and chronic sinusitis. We found that different sinusitis ICD-10 definitions impacted antibiotic prescribing rates (APRs). Chronic sinusitis ICD-10s dilute overall sinusitis APR, particularly in primary care settings and should be examined separately.

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  • Over two decades, initiatives have aimed to enhance STEM undergraduate outcomes, with the inclusive Research Education Community (iREC) emerging as a scalable reform model that supports STEM faculty in implementing course-based research to improve student learning.
  • This study utilized pathway modeling to describe the HHMI Science Education Alliance (SEA) iREC, identifying how faculty engagement leads to sustainable adoption and improvement of new teaching strategies through feedback from over 100 participating faculty members.
  • The findings indicate that iREC fosters a collaborative environment where STEM faculty can share expertise and data, thereby enhancing their teaching practices and contributing to the overall evolution of undergraduate science education.
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Objective: Computerized clinical decision support (CDS) assists healthcare professionals in making decisions to improve patient care. In the realms of antimicrobial stewardship (ASP) and infection prevention (IP) programs, CDS interventions can play a crucial role in optimizing antibiotic prescribing practices, reducing healthcare-associated infections, and promoting diagnostic stewardship when optimally designed. This primer article aims to provide ASP and IP professionals with a practical framework for the development, design, and evaluation of CDS interventions.

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Purpose: Pharmacologic therapies for neurofibromatosis type 1-associated plexiform neurofibromas (NF1-PNs) are limited; currently, none are US Food and Drug Administration-approved for adults.

Methods: ReNeu is an open-label, multicenter, pivotal, phase IIb trial of mirdametinib in 58 adults (≥18 years of age) and 56 children (2 to 17 years of age) with NF1-PN causing significant morbidities. Patients received mirdametinib capsules or tablets for oral suspension (2 mg/m twice daily, maximum 4 mg twice daily), regardless of food intake, in 3 weeks on/1 week off 28-day cycles.

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  • - This review focuses on health-related quality of life (HRQOL) for children with severe epilepsy that doesn't respond to medication and looks at how epilepsy surgery affects HRQOL.
  • - Factors that negatively impact a child's HRQOL include cognitive and emotional issues, parental anxiety, family stress, and specific epilepsy-related challenges.
  • - Post-surgery studies show that many children experience HRQOL improvements, mainly related to achieving seizure freedom, but more long-term research is needed to better understand how and when these improvements happen.
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  • The study examined how knowledge of circulating tumor DNA (ctDNA) status influences treatment decisions in women with high-risk triple-negative breast cancer after chemotherapy.
  • A survey with 286 participants simulated scenarios involving ctDNA outcomes and patient willingness to accept adjuvant therapy based on perceived recurrence risks and treatment toxicities.
  • Results indicated that negative ctDNA status led to less acceptance of adjuvant therapy, while positive ctDNA status made the benefits of treatment more significant than concerns about side effects.
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  • - The International League Against Epilepsy's (ILAE) Task Force created recommendations for diagnosing and treating anxiety and depression in kids with epilepsy after reviewing studies on screening measures and treatment effectiveness.
  • - Key recommendations for diagnosis include universal screening, closer monitoring for high-risk children, and using multiple sources to assess symptoms while emphasizing the importance of recognizing symptoms for better treatment outcomes.
  • - For treatment, individualized plans are advised, with monitoring for mild cases and referrals for more severe conditions, alongside the development of clinical care pathways and age-appropriate psychosocial interventions.
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  • The study aimed to assess how palbociclib treatment affects health-related quality of life (HRQoL) in patients with hormone receptor-positive, HER2-negative advanced or metastatic breast cancer through a systematic review of literature up to June 2023.
  • A total of 15 studies, including randomized controlled trials and real-world evidence studies, indicated that HRQoL is generally maintained or even improved in patients treated with palbociclib compared to monotherapy.
  • The findings showed consistent positive effects on individual patient outcomes like pain and fatigue, with comparable results across diverse patient groups, suggesting that HRQoL is largely preserved when palbociclib is added to endocrine therapy.
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Rogers' principle of integrality was examined using quantitative methodology by the author in 1986. Since then, Rogers made revisions changing from probability and multidimensionality to unpredictability and pandimensionality. Another look at integrality through a lens congruent with the revisions was designed.

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We provide a case example of the collaborative process required to plan and implement initiatives to enhance team-based primary care, drawing on experiences of six disciplines working together to create new curricula as part of Team Primary Care. Recommendations to strengthen collaboration from our team include building capacity requires an understanding of unique disciplinary roles and understanding of unique elements of primary care; competencies have to be specifically articulated and demonstrated within a primary care context; interprofessional education within and across disciplines is needed; establishing primary care competencies would provide a common set of skills, knowledge, values, and attitudes to form a foundation in which to build the capacity of the interprofessional primary care workforce; and interprofessional collaboration is needed in implementing team-based primary care in practice and in preparing an interprofessional workforce prepared to leverage the expertise of the entire team.

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Objective: To provide schools and colleges of pharmacy a snapshot of Introductory Pharmacy Practice Experience (IPPE) program characteristics to generate and share ideas for IPPE program modifications to improve student learning outcomes and comply with Standards 2025.

Methods: A 41-item electronic survey was distributed to 140 Accreditation Council for Pharmacy Education fully accredited schools and colleges of pharmacy in 2023. IPPE program characteristics such as structure, learning activities, assessments, and requirements were described.

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  • Insular epilepsy is increasingly recognized as a significant issue in patients with epilepsy, warranting more research into its cognitive and psychological impacts to enhance clinical care and identify surgery candidates.
  • A scoping review was conducted, analyzing 39 studies that assessed cognitive and behavioral outcomes in individuals with insular epilepsy, focusing on standardized psychological measures.
  • Findings show that both children and adults with insular epilepsy often experience lower cognitive functioning and behavioral challenges, but their outcomes tend to remain stable after surgical interventions involving the insula, helping neuropsychologists better understand patient needs before and after surgery.
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  • The Advocate-BREAST project aims to enhance the breast cancer patient experience through targeted education and patient-centered research.* -
  • A survey sent to nearly 7,000 breast cancer survivors revealed high satisfaction with care but identified significant concerns regarding symptoms and support, particularly around issues like sexual dysfunction and emotional health.* -
  • Patients expressed a need for better psychological support and clear educational resources, leading to proposed Quality Improvement projects focusing on holistic care and wellness programs.*
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  • - The study, Advocate-BREAST80+, assessed the needs of breast cancer patients aged 80 and older (P80+) compared to younger patients (P80-).
  • - A survey was conducted with 6,918 participants from the Mayo Clinic Breast Disease Registry, finding that P80+ were less likely to receive certain therapies and were significantly less satisfied with information about side effects and management.
  • - While P80+ reported lower anxiety levels, they were much less involved in clinical trials and showed little interest in participating in future studies, highlighting a need for improved education and support for this age group.
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  • Breast cancer treatment involves a team of specialists from surgical, radiation, and medical oncology fields.
  • The NCCN Guidelines provide recommendations for various types of breast cancer, including different stages and specific conditions like Paget's disease and treatment during pregnancy.
  • This issue highlights the management of systemic therapies for nonmetastatic breast cancer, both before and after surgery.
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  • - The study explores the beliefs of rural family members about opioid use disorder (OUD) treatment, particularly medication for opioid use disorder (MOUD), revealing concerns about MOUD being viewed as another addiction rather than a necessary treatment.
  • - Four main themes emerged from interviews: the view of MOUD as a short-term solution, the importance of residential and mental health services, the need for individuals to be ready for treatment, and the stigma that hinders access to care.
  • - The findings indicate a disconnect between the belief in OUD as a disease and the perception that MOUD should only be used temporarily, emphasizing the need for better education on MOUD's effectiveness and addressing stigma in healthcare and rural communities.
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  • Outcomes from vagus nerve stimulation (VNS) improve over time in children with drug-resistant epilepsy, but the benefits of deep brain stimulation (DBS) versus continued VNS optimization were unclear.
  • A study involving 18 children aged 8-17 showed that adding DBS after a year of ineffective VNS led to significantly greater seizure reduction (51.9% vs. 12.3%).
  • While DBS resulted in fewer bothersome seizures, it did not improve the overall quality of life, suggesting that earlier consideration of DBS could be beneficial for children not responding to VNS.
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Introduction: Teaching professionalism is a fundamental aspect of medical undergraduate education, delivering important domains of professional attitudes, ethics, and behaviors. The effects of educational interventions can be assessed by measuring the change in such domains, but validated assessment tools for these professionalism domains are lacking. In this study, we constructed and conducted expert validation of a modified theory of planned behavior (TPB) questionnaire to assess changes in professional behaviors (PBs) in medical students.

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  • - The study investigates the link between a specific patient-reported outcome (the GP5 assessment from a cancer therapy scale) and early treatment discontinuation due to side effects in patients with newly diagnosed multiple myeloma.
  • - Conducted between February and April 2023, the research analyzed responses from participants in the ECOG-ACRIN E1A11 trial, focusing on treatment regimens involving bortezomib and carfilzomib, with assessments taken at various intervals during treatment.
  • - Results from logistic regression will highlight whether higher reported bother from adverse events correlates with a higher likelihood of discontinuing treatment early, adjusting for factors like treatment type, patient demographics, and disease stage.
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Asymptomatic bacteriuria and urinary tract infection in renal transplant are important antimicrobial stewardship targets but are difficult to identify within electronic medical records. We validated an "electronic phenotype" of antibacterials prescribed for these indications. This may be more useful than billing data in assessing antibiotic indication in this outpatient setting.

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  • The epilepsy monitoring unit (EMU) can experience unnoticed changes in cognitive and behavioral health due to medical and environmental factors.
  • The psychomotor vigilance task (PVT) was tested on seven children in the EMU, linking their performance to seizure counts, medication levels, and sleep quality.
  • Findings showed that performance on the PVT was negatively affected by increased antiseizure medications and epileptiform activity, suggesting this task could help monitor patient responses and guide clinical choices.
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  • The study aimed to assess the quality of life (HRQOL) of parents whose children underwent epilepsy surgery versus those treated with medical therapy over two years.
  • Researchers collected data from parents at multiple intervals and adjusted for various factors using a linear mixed model.
  • Results indicated similar HRQOL trajectories for both groups, but parents of surgical patients had slightly higher HRQOL, though overall improvement was limited, potentially due to persistent issues in the children.
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  • Regulatory agencies are promoting systematic collection of patient experience data, particularly patient-reported outcomes (PROs), in cancer trials to enhance regulatory decision-making.
  • There’s an increasing acknowledgment that understanding cancer treatment tolerability should involve the patients' perspectives, especially regarding side effects that may not be fully reported by clinicians.
  • Methodologies for evaluating patient-reported tolerability are being developed, but current methods remain largely descriptive, and inconsistencies in analyses and objectives of PROs present challenges for interpreting the results effectively.
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Animals and animal models have been invaluable for our current understanding of human and animal biology, including physiology, pharmacology, biochemistry, and disease pathology. However, there are increasing concerns with continued use of animals in basic biomedical, pharmacological, and regulatory research to provide safety assessments for drugs and chemicals. There are concerns that animals do not provide sufficient information on toxicity and/or efficacy to protect the target population, so scientists are utilizing the principles of replacement, reduction, and refinement (the 3Rs) and increasing the development and application of new approach methods (NAMs).

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