Natural Drugs: Trends, Properties, and Decline in FDA Approvals.

The purpose of this review is to better characterize the contribution and properties of FDA-approved drugs that can be found unmodified in nature. Defined inclusion criteria were applied to drugs identified in previous studies and in annual FDA approval reports to compile a comprehensive list of approved drugs found in nature. Databases and scientific literature were searched to identify chemical and drug properties of these entities, including chemical classes, approval years, drug indications, and approved delivery methods.

Impacts of the Certified Community Behavioral Health Clinic Demonstration on Emergency Department Visits and Hospitalizations.

Objective: The Certified Community Behavioral Health Clinic (CCBHC) demonstration is designed to increase access to comprehensive ambulatory care and crisis services, which may reduce emergency department (ED) visits and hospitalizations. This study examined whether the demonstration had an impact on ED visits and hospitalizations in Missouri, Oklahoma, and Pennsylvania.

Methods: This difference-in-differences analysis used Medicaid claims data from 2015 to 2019 to examine service use during a 12-month baseline period and the first 24 months of the demonstration for beneficiaries who received care from CCBHCs and beneficiaries who received care from other behavioral health clinics in the same state, representing care as usual.

Medicare beneficiaries with more comprehensive primary care physicians report better primary care.

Objective: To examine whether primary care physician (PCP) comprehensiveness is associated with Medicare beneficiaries' overall rating of care from their PCP and staff.

Data Sources: We linked Medicare claims with survey data from Medicare beneficiaries attributed to Comprehensive Primary Care Plus (CPC+) physicians and practices.

Study Design: We performed regression analyses of the associations between two claims-based measures of PCP comprehensiveness in 2017 and beneficiaries' rating of care from their PCP and practice staff in 2018.

Evaluating the effects of a mindfulness mobile application on student pharmacists' stress, burnout, and mindfulness.

Purpose: Pharmacists report high levels of burnout. Mindfulness approaches have been demonstrated to have positive results in the general population and in other healthcare professions. However, limited studies have been performed evaluating mindfulness approaches in student pharmacists.

Subjective Voice Outcomes in Surgeon Versus Technician-Monitored Recurrent Laryngeal Nerves in Thyroidectomy.

Objectives: To compare subjective voice outcomes and postoperative laryngoscopic examination findings of patients with subjective voice complaints between surgeon-monitored and certified technician-monitored thyroidectomies.

Methods: Patients who underwent hemithyroidectomy, total thyroidectomy, and completion thyroidectomy using a nerve monitoring system between November 2015 and June 2018 were included in the study. Retrospective chart review was carried out to assess how often patients reported voice changes and to record postoperative flexible laryngoscopic findings of patients when that examination was performed.

Practice-site-level measures of primary care comprehensiveness and their associations with patient outcomes.

Objectives: To develop two practice-site-level measures of comprehensiveness and examine their associations with patient outcomes, and how their performance differs from physician-level measures.

Data Sources: Medicare fee-for-service claims.

Study Design: We calculated practice-site-level comprehensiveness measures (new problem management and involvement in patient conditions) across 5286 primary care physicians (PCPs) at 1339 practices in the Comprehensive Primary Care initiative evaluation in 2013.

Top consumer uses of bestselling, single-ingredient vitamin and mineral supplements.

Objective: Vitamin and mineral supplements are widely used for self-care of a variety of medical conditions, but little is known about the specific conditions for which they are used. This study mined consumer product reviews to determine specific ways vitamin and mineral supplements are being used therapeutically.

Design/setting: A cross-sectional analysis of user reviews for top-selling, single-ingredient vitamin and mineral products from a popular online retailer was performed to identify the most frequently appearing words associated with medical conditions.

Getting Rigor Right.

A colleague of mine once shared a story he heard of an organic chemistry teacher who would tell people he had one of the most important, lifesaving jobs in the world. Why? Because he made sure academically unprepared premed students never made it to medical school. Teachers can have many possible motivations for maintaining high academic standards in their courses.

A Pilot Evaluation of I'M HAPPY: An Interactive Module to Halt Abuse of Prescriptions in Preteens and Youth.

The purpose of this project was to create a web-accessible drug education program that would positively impact student knowledge and perceptions. An interactive computer module (Interactive Module to Halt Abuse of Prescriptions in Preteens and Youth [I'M HAPPY]) was created using a combination of e-learning and animation software. The module used narrated illustrations, animations, and games to explain what over-the-counter (OTC) and prescription drugs are, how they are used correctly, and what risks they carry.

Metformin Promotes Anti-tumor Biomarkers in Human Endometrial Cancer Cells.

Metformin (MET) is increasingly implicated in reducing the incidence of multiple cancer types in patients with diabetes. However, similar effects of MET in non-diabetic women with endometrial cancer (EC) remain unknown. In a pilot study, obese non-diabetic women diagnosed with type 1, grade 1/2 EC, and consenting to participate were randomly assigned to receive MET or no MET (control (CON)) during the pre-surgical window between diagnosis and hysterectomy.

A usability assessment of riding lawn-mowing equipment with varying levels of design standards compliance.

The use of riding lawn equipment (RLE) is related to a significant number of accidents every year. To provide basis for product design and enhance user performance and safety, a usability and performance assessment of modern riding lawn-mowing tractor designs and features was conducted in a real-world test environment. Five current commercially available RLEs were tested with response measures including task performance time and accuracy, physiological workload, system usability scores (SUS), and subjective rankings of RLE models.

New approaches to measuring the comprehensiveness of primary care physicians.

Objective: To develop claims-based measures of comprehensiveness of primary care physicians (PCPs) and summarize their associations with health care utilization and cost.

Data Sources And Study Setting: A total of 5359 PCPs caring for over 1 million Medicare fee-for-service beneficiaries from 1404 practices.

Study Design: We developed Medicare claims-based measures of physician comprehensiveness (involvement in patient conditions and new problem management) and used a previously developed range of services measure.

Lessons Learned Using a Demonstration in a Large Classroom of Pharmacy Students.

To create a demonstration that would enhance student understanding of the following acid/base concepts: the opposing effects of a weak acid and its conjugate base, the acidifying effects of carbon dioxide on blood pH, and the resistance of a buffered solution to changes in pH. The demonstrations were delivered to four different years of first-year pharmacy (P1) students in three different ways: as live in-class demonstrations, as a series of three short videos posted online, and as a series of three short videos used both in class and posted online. Quizzes were administered to each set of students and qualitative feedback solicited.

Using drawings to probe the affective experience of pharmacy students on rotation: A pilot study.

Introduction: The objective of this study was to use drawings to assess the global affective experience of pharmacy students on rotation.

Methods: Students nearing graduation were asked to submit a drawing that captured the essence of their Advanced Pharmacy Practice Experience (APPE). Drawings were analyzed qualitatively using inductive content analysis and the affects portrayed in the drawings were coded, themed and categorized.

Immersion of virtual reality for rehabilitation - Review.

Virtual reality (VR) shows promise in the application of healthcare and because it presents patients an immersive, often entertaining, approach to accomplish the goal of improvement in performance. Eighteen studies were reviewed to understand human performance and health outcomes after utilizing VR rehabilitation systems. We aimed to understand: (1) the influence of immersion in VR performance and health outcomes; (2) the relationship between enjoyment and potential patient adherence to VR rehabilitation routine; and (3) the influence of haptic feedback on performance in VR.

Increasing N deposition impacts neither diversity nor functions of deadwood-inhabiting fungal communities, but adaptation and functional redundancy ensure ecosystem function.

Nitrogen deposition can strongly affect biodiversity, but its specific effects on terrestrial microbial communities and their roles for ecosystem functions and processes are still unclear. Here, we investigated the impacts of N deposition on wood-inhabiting fungi (WIF) and their related ecological functions and processes in a highly N-limited deadwood habitat. Based on high-throughput sequencing, enzymatic activity assay and measurements of wood decomposition rates, we show that N addition has no significant effect on the overall WIF community composition or on related ecosystem functions and processes in this habitat.

Inhibition of FAAH, TRPV1, and COX2 by NSAID-serotonin conjugates.

Serotonin was linked by amidation to the carboxylic acid groups of a series of structurally diverse NSAIDs. The resulting NSAID-serotonin conjugates were tested in vitro for their ability to inhibit FAAH, TRPV1, and COX2. Ibuprofen-5-HT and Flurbiprofen-5-HT inhibited all three targets with approximately the same potency as N-arachidonoyl serotonin (AA-5-HT), while Fenoprofen-5-HT and Naproxen-5-HT showed activity as dual inhibitors of TRPV1 and COX2.

A board game to assist pharmacy students in learning metabolic pathways.

Objectives: To develop and evaluate a board game designed to increase students' enjoyment of learning metabolic pathways; their familiarity with pathway reactions, intermediates, and regulation; and, their understanding of how pathways relate to one another and to selected biological conditions.

Design: The board game, entitled Race to Glucose, was created as a team activity for first-year pharmacy students in the biochemistry curriculum.

Assessment: A majority of respondents agreed that the game was helpful for learning regulation, intermediates, and interpathway relationships but not for learning reactions, formation of energetic molecules, or relationships, to biological conditions.

Fluorogenic phospholipids as head group-selective reporters of phospholipase A activity.

PLA (phospholipases A) are important mediators of cell signaling, generating bioactive fatty acids and LPLs (lysophospholipids). PLA products having different head groups can initiate vastly different types of signaling. Fluorogenic analogues of the PLs (phospholipids) PA (phosphatidic acid), PC (phosphatidylcholine), PE (phosphatidylethanolamine), and PG (phosphatidylglycerol) were synthesized as PLA substrates for rapidly determining in real time the influence of head group modifications on cell signaling both in vitro and in cells.

Caspase-3-dependent activation of calcium-independent phospholipase A2 enhances cell migration in non-apoptotic ovarian cancer cells.

Calcium-independent phospholipase A(2) (iPLA(2)) plays a pivotal role in phospholipid remodeling and many other biological processes, including inflammation and cancer development. iPLA(2) can be activated by caspase-3 via a proteolytic process in apoptotic cells. In this study we identify novel signaling and functional loops of iPLA(2) activation leading to migration of non-apoptotic human ovarian cancer cells.

Synthesis and evaluation of fluorogenic substrates for phospholipase D and phospholipase C.

Fluorogenic analogues of phosphatidylcholine and lysophosphatidylcholine, DDPB and lysoDDPB, were synthesized by an enzyme-assisted strategy. The analogues were evaluated as substrates for phospholipases C and D and lysophospholipase D. DDPB was cleaved by bacterial and plant phospholipase D (PLD) enzymes and represents the first direct fluorogenic substrate for real-time measurement of PLD activity.

Lysophosphatidic acid is constitutively produced by human peritoneal mesothelial cells and enhances adhesion, migration, and invasion of ovarian cancer cells.

Lysophosphatidic acid (LPA) is both a potential marker and a therapeutic target for ovarian cancer. It is critical to identify the sources of elevated LPA levels in ascites and blood of patients with ovarian cancer. We show here that human peritoneal mesothelial cells constitutively produce LPA, which accounts for a significant portion of the chemotactic activity of the conditioned medium from peritoneal mesothelial cells to ovarian cancer cells.