Dynamic Measures of Team Adaptation.

Objective: Dynamic measures of team adaptation based in team cognition theory and the measurement of real-time team cognition are developed. The present study examines the validity and context-specificity of this measurement framework for simulation-based team training.

Background: Teams adapt by reorganizing their coordination behavior to overcome challenges in dynamic environments.

An automated content-based measure of closed loop communication among critical care air transport teams.

Successful teamwork is essential to ensure critical care air transport (CCAT) patients receive effective care. Despite the importance of team performance, current training methods rely on subjective performance assessments and do not evaluate performance at the team level. Researchers have developed the Team Dynamics Measurement System (TDMS) to provide real-time, objective measures of team coordination to assist trainers in providing CCAT aircrew with feedback to improve performance.

Comparison of intermolecular energy transfer from vibrationally excited benzene in mixed nitrogen-benzene baths at 140 K and 300 K.

Gas phase intermolecular energy transfer (IET) is a fundamental component of accurately explaining the behavior of gas phase systems in which the internal energy of particular modes of molecules is greatly out of equilibrium. In this work, chemical dynamics simulations of mixed benzene/N baths with one highly vibrationally excited benzene molecule (Bz) are compared to experimental results at 140 K. Two mixed bath models are considered.

Real-world use of the sufentanil sublingual tablet system for patient-controlled management of acute postoperative pain: a prospective noninterventional study.

To evaluate the real-life effectiveness, safety, tolerability and patient-reported outcomes (PRO) of the sufentanil sublingual tablet system (SSTS) for postoperative pain management (POPM). This prospective, multicenter, noninterventional, study included adults with acute moderate to severe postoperative pain who self-administered sufentanil using the SSTS. Main outcome measures were pain intensity at rest (numerical rating scale [NRS]: 0 [no pain] to 10 [most intense pain imaginable]); most intense pain intensity (0-10); 4-point patient assessment of the pain control method ("excellent", "good", "fair", "poor"); patient satisfaction with the pain control level and the method of administration of pain medication (6-point scale: "extremely satisfied", "very satisfied", "satisfied", "dissatisfied", "very dissatisfied", "extremely dissatisfied").

Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents.

Attention-deficit/hyperactivity disorder (ADHD) is 1 of the most common neurobehavioral disorders of childhood and can profoundly affect children's academic achievement, well-being, and social interactions. The American Academy of Pediatrics first published clinical recommendations for evaluation and diagnosis of pediatric ADHD in 2000; recommendations for treatment followed in 2001. The guidelines were revised in 2011 and published with an accompanying process of care algorithm (PoCA) providing discrete and manageable steps by which clinicians could fulfill the clinical guideline's recommendations.

Temperature perturbation related to the invisible ink vibrationally excited nitric oxide monitoring (VENOM) technique: a simulation study.

The limits of applicability of the invisible ink variant of the vibrationally excited nitric oxide monitoring (VENOM) technique for three distinct flow fields is reported in this work. This technique involves the generation of a grid of vibrationally excited NO (,2) by exciting the NO A-X electronic transition at 226 nm, which subsequently relaxes via fluorescence and collisional quenching to produce vibrationally excited NO (,2). This grid is then probed by two laser sheets tuned to distinct rotational states.

Non-statistical intermolecular energy transfer from vibrationally excited benzene in a mixed nitrogen-benzene bath.

A chemical dynamics simulation was performed to model experiments [N. A. West , J.

Analytical validation of a psychiatric pharmacogenomic test.

Aim: The aim of this study was to validate the analytical performance of a combinatorial pharmacogenomics test designed to aid in the appropriate medication selection for neuropsychiatric conditions.

Materials & Methods: Genomic DNA was isolated from buccal swabs. Twelve genes (65 variants/alleles) associated with psychotropic medication metabolism, side effects, and mechanisms of actions were evaluated by bead array, MALDI-TOF mass spectrometry, and/or capillary electrophoresis methods (GeneSight Psychotropic, Assurex Health, Inc.

Clinical Utility of Combinatorial Pharmacogenomics-Guided Antidepressant Therapy: Evidence from Three Clinical Studies.

DNA of 258 patients with treatment-resistant depression was collected in three 8-10 week, two-arm, prospective clinical trials. Forty-four allelic variations were measured in genes for the cytochrome P450 (CYP) enzymes CYP2D6, CYPC19, and CYP1A2, the serotonin transporter (SLC6A4), and the 5-HT2A receptor (HTR2A). The combinatorial pharmacogenomic (CPGx™) GeneSight test results were provided to clinicians to support medication changes from baseline (guided arm), or they were provided at the end of each study to clinicians of unguided patients who were treated as usual (TAU).

Use of combinatorial pharmacogenomic testing in two cases from community psychiatry.

This report describes two cases in which pharmacogenomic testing was utilized to guide medication selection for difficult to treat patients. The first patient is a 29-year old male with bipolar disorder who had severe akathisia due to his long acting injectable antipsychotic. The second patient is a 59-year old female with major depressive disorder who was not responding to her medication.

Resolving the energy and temperature dependence of C6H6 (∗) collisional relaxation via time-dependent bath temperature measurements.

The relaxation of highly vibrationally excited benzene, generated by 193 nm laser excitation, was studied using the transient rotational-translational temperature rise of the N2 bath, which was measured by proxy using two-line laser induced fluorescence of seeded NO. The resulting experimentally measured time-dependent N2 temperature rises were modeled with MultiWell based simulations of Collisional Energy Transfer (CET) from benzene vibration to N2 rotation-translation. We find that the average energy transferred in benzene deactivating collisions depends linearly on the internal energy of the excited benzene molecules and depends approximately linearly on the N2 bath temperature between 300 K and 600 K.

The clinical validity and utility of combinatorial pharmacogenomics: Enhancing patient outcomes.

Prescribing safe and effective medications is a challenge in psychiatry. While clinical use of pharmacogenomic testing for individual genes has provided some clinical benefit, it has largely failed to show clinical utility. However, pharmacogenomic testing that integrates relevant genetic variation from multiple loci for each medication has shown clinical validity, utility and cost savings in multiple clinical trials.

Combinatorial Versus Individual Gene Pharmacogenomic Testing in Mental Health: A Perspective on Context and Implications on Clinical Utility.

Pharmacogenomic testing in mental health has not yet reached its full potential. An important reason for this involves differentiating individual gene testing (IGT) from a combinatorial pharmacogenomic (CPGx) approach. With IGT, any given gene reveals specific information that may, in turn, pertain to a smaller number of medications.

Prolonged oral antibiotic suppression in osteomyelitis and associated outcomes in a Veterans population.

Objective: Prolonged oral antimicrobial suppression has been suggested as an alternative treatment for patients with prosthetic joint infections who are unable or unwilling to undergo surgical intervention; however, little data exists for utilizing this approach in patients with chronic osteomyelitis and no artificial hardware.

Methods: We retrospectively reviewed the medical records of all patients over a 5-year time frame who were treated with chronic oral antibiotic suppression for osteomyelitis and who had no artificial hardware. Clinical outcomes, risk factors for treatment failure, and adverse drug reactions were evaluated.

Combinatorial pharmacogenomic guidance for psychiatric medications reduces overall pharmacy costs in a 1 year prospective evaluation.

Objectives: The objective of this project was to determine pharmacy cost savings and improvement in adherence based on a combinatorial pharmacogenomic test (CPGx ) in patients who had switched or added a new psychiatric medication after having failed monotherapy for their psychiatric disorder.

Research Design And Methods: The prospective project compared 1 year pharmacy claims between a GeneSight CPGx guided cohort and a propensity-matched control group. Patients were project eligible if they augmented or switched to a different antidepressant or antipsychotic medication within the previous 90 days.

Clinical validity: Combinatorial pharmacogenomics predicts antidepressant responses and healthcare utilizations better than single gene phenotypes.

In four previous studies, a combinatorial multigene pharmacogenomic test (GeneSight) predicted those patients whose antidepressant treatment for major depressive disorder resulted in poorer efficacy and increased health-care resource utilizations. Here, we extended the analysis of clinical validity to the combined data from these studies. We also compared the outcome predictions of the combinatorial use of allelic variations in genes for four cytochrome P450 (CYP) enzymes (CYP2D6, CYP2C19, CYP2C9 and CYP1A2), the serotonin transporter (SLC6A4) and serotonin 2A receptor (HTR2A) with the outcome predictions for the very same subjects using traditional, single-gene analysis.

A prospective, randomized, double-blind study assessing the clinical impact of integrated pharmacogenomic testing for major depressive disorder.

Objective: A prospective double-blind randomized control trial (RCT) to evaluate the benefit of a combinatorial, five gene pharmacogenomic test and interpretive report (GeneSight) for the management of psychotropic medications used in the treatment of major depression in an outpatient psychiatric practice.

Methods: Depressed adult outpatients were randomized to a treatment as usual (TAU, n=25) arm or a pharmacogenomic-informed GeneSight (n=26) arm. Subjects were blinded to their treatment group and depression severity was assessed by blinded study raters.

Utility of integrated pharmacogenomic testing to support the treatment of major depressive disorder in a psychiatric outpatient setting.

Objective: The objective was to evaluate the potential benefit of an integrated, five-gene pharmacogenomic test and interpretive report (GeneSight) for the management of psychotropic medications used to treat major depression in an outpatient psychiatric practice.

Methods: The open-label study was divided into two groups. In the first (unguided) group (n = 113), pharmacogenomic information was not shared until all participants completed the study.

Psychiatric pharmacogenomics predicts health resource utilization of outpatients with anxiety and depression.

Antidepressants are among the most widely prescribed medications, yet only 35-45% of patients achieve remission following an initial antidepressant trial. The financial burden of treatment failures in direct treatment costs, disability claims, decreased productivity, and missed work may, in part, derive from a mismatch between optimal and actual prescribed medications. The present 1 year blinded and retrospective study evaluated eight direct or indirect health care utilization measures for 96 patients with a DSM-IV-TR diagnosis of depressive or anxiety disorder.

Using a pharmacogenomic algorithm to guide the treatment of depression.

The objective of this study was to evaluate the potential benefit of utilizing a pharmacogenomic testing report to guide the selection and dosing of psychotropic medications in an outpatient psychiatric practice. The non-randomized, open label, prospective cohort study was conducted from September 2009 to July 2010. In the first cohort, depressed patients were treated without the benefit of pharmacogenomic testing (the unguided group).