Impact of pharmacist-provided Medicare annual wellness visits and chronic care management on reimbursement and quality measures in a privately owned family medicine clinic.

Purpose: Improvement in patient outcomes from collaboration between pharmacists and physicians in ambulatory clinics has been well documented. Barriers to payment have made widespread growth of these collaborations slow. Medicare annual wellness visits (AWVs) and chronic care management (CCM) provide an opportunity for pharmacist-physician collaborations that are directly revenue generating.

Effect of pharmacogenomic testing on pharmacotherapy decision making in patients with symptoms of depression in an interprofessional primary care clinic.

Background: Variability in individual drug response may delay time to relief of symptoms for various disease states. As pharmacogenomic (PGx) testing becomes more widespread, providers are tasked with determining when and in who PGx testing is most appropriate. The use of PGx testing in patients with depressive symptoms has shown some utility, but how this translates to a general population within a primary care setting has yet to be determined.

Genetic Diversity of CD14 Promoter Gene Polymorphism () is Associated With Regulation of Malaria Parasitemia and Susceptibility to Infection.

CD14 is a multifunctional receptor expressed on many cell types and has been shown to mediate immune response resulting in the activation of an inflammatory cascade, with polymorphism of its promoter (rs2569190) found to be associated with susceptibility to several diseases. In malaria infection, the CD14 gene demonstrated a pathogenic profile in regulating experimental cerebral malaria, with reports of elevated levels of soluble CD14 in serum of patients but no definitive conclusion. We present a detailed analysis of genetic diversity of CD14 promoter gene (snp -159 C/T; rs2519190) polymorphism between a malaria-infected group and uninfected controls and its association with clinical parameters of disease.

Genetic variants of tumor necrosis factor-α -308G/A (rs1800629) but not Toll-interacting proteins or vitamin D receptor genes enhances susceptibility and severity of malaria infection.

Susceptibility to malaria infection has been associated with host genetic polymorphisms that differs between groups. We hypothesize that Toll-interacting proteins (TOLLIP), vitamin D receptor (VDR) and tumor necrosis factor-α (TNF) genes are significant contributors to susceptibility and disease severity in Plasmodium falciparum (Pf) infection. Our aim is to explore the genomic diversity and haplotype frequency of these genes, as well as extrapolate possible association with markers of severity, between malaria-infected and healthy controls.

A Novel Diterpene Glycoside with Nine Glucose Units from Stevia rebaudiana Bertoni.

Following our interest in new diterpene glycosides with better taste profiles than that of Rebaudioside M, we have recently isolated and characterized Rebaudioside IX-a novel steviol glycoside-from a commercially-supplied extract of Stevia rebaudiana Bertoni. This molecule contains a hexasaccharide group attached at C-13 of the central diterpene core, and contains three additional glucose units when compared with Rebaudioside M. Here we report the complete structure elucidation-based on extensive Nuclear Magnetic Resonance (NMR) analysis (1H, 13C, Correlation Spectroscopy (COSY), Heteronuclear Single Quantum Coherence-Distortionless Enhancement Polarization Transfer (HSQC-DEPT), Heteronuclear Multiple Bond Correlation (HMBC), 1D Total Correlation Spectroscopy (TOCSY), Nuclear Overhauser Effect Spectroscopy (NOESY)) and mass spectral data-of this novel diterpene glycoside with nine sugar moieties and containing a relatively rare 16 α-linked glycoside.

A New Diterpene Glycoside: 15α-Hydroxy-Rebaudioside M Isolated from Stevia rebaudiana.

In a continued search for novel diterpenoid glycosides, we recently isolated and characterized a Rebaudioside M derivative with a hydroxyl group at position 15 in the central diterpene core from an extract of Stevia rebaudiana Bertoni. Here we report the complete structure elucidation of 15α-hydroxy-Rebaudioside M (2) on the basis of NMR (1H, 13C, COSY, HSQC-DEPT, HMBC, 1D TOCSY, NOESY) and mass spectral data. Steviol glycoside with a hydroxyl group at C-15 in the central diterpene core has not been previously reported.

Degradation products of rubusoside under acidic conditions.

A natural sweetener, Rubusoside (1), subjected to extreme pH and temperature conditions, resulted in the isolation and structural elucidation of one novel rubusoside degradant (7), together with seven known degradants (2-6 and 8-9). ID and 2D NMR spectroscopy (1H, 13C, COSY, HSQC-DEPT, HMBC, and NOESY) and mass spectral data were used to fully characterize the degradant 7.

Complementary medical health services: a cross sectional descriptive analysis of a Canadian naturopathic teaching clinic.

Background: Historically, alongside regulatory and jurisdictional differences in scope of practices, practice patterns of naturopathic doctors (NDs) have varied widely to promote holistic or whole-person treatment using a variety of therapies including: controlled substances, minor surgery, a variety of complementary therapies, as well as both novel and conventional assessments. However, little is known about the observed practice patterns of NDs, the services provided to their patients, or the type of conditions for which patients of NDs are seeking treatment. In order to address this gap, a cross-sectional descriptive analysis of the largest Canadian teaching clinic for NDs was undertaken to better understand the services provided to the community and increase the knowledge regarding the use of naturopathic medicine.

Bioconversion of rebaudioside I from rebaudioside A.

To supply the increasing demand of natural high potency sweeteners to reduce the calories in food and beverages, we have looked to steviol glycosides. In this work we report the bioconversion of rebaudioside A to rebaudioside I using a glucosyltransferase enzyme. This bioconversion reaction adds one sugar unit with a 1→3 linkage.

Single enantiomer of YK-4-279 demonstrates specificity in targeting the oncogene EWS-FLI1.

Oncogenic fusion proteins, such as EWS-FLI1, are excellent therapeutic targets as they are only located within the tumor. However, there are currently no agents targeted toward transcription factors, which are often considered to be 'undruggable.' A considerable body of evidence is accruing that refutes this claim based upon the intrinsic disorder of transcription factors.

A concise synthesis of enantiopure circumdatins E, H and J.

A concise total synthesis of enantiopure circumdatins E, H and J has been developed using a reductive cyclization of chiral N-prolinoyl-2-nitrobenzamides to construct the core quinazolinone ring.

Multiplex single strand conformation polymorphism analysis by capillary electrophoresis with on-the-fly fluorescence lifetime detection.

This paper describes the use of on-the-fly fluorescence lifetime detection (OFLD) for multiplex single strand conformation polymorphism (SSCP) analysis by capillary electrophoresis (CE). The dye labels studied for multiplex SSCP-OFLD-CE analyses included RG, NBD, and BODIPY-FL. The dyes were first investigated for a model system of "Wild Type" and "Mutant" 43-base fragments designed to vary by a single A/T substitution.