Categories
Nevin Manimala Statistics

Mapping Pharmacy Student Learning During Cocurricular Activities to National Standards and Institutional Outcomes

Am J Pharm Educ. 2020 Nov;84(11):7825. doi: 10.5688/ajpe7825. Epub 2020 Jul 31.

ABSTRACT

Objective. To assess pharmacy student learning from co-curricular activities and map this to Accreditation Council of Pharmacy Education (ACPE) standards and the institution’s curricular outcomes.Methods. Student representatives of professional organizations at one college of pharmacy were asked to complete a 16-item questionnaire on behalf of their members about each cocurricular activity their organization completed. Descriptive statistics were used to characterize the results. Content analysis was conducted on open-ended questions, and resulting codes were mapped to ACPE Standards 2016 and curricular outcomes.Results. The majority (74%) of the 152 unique cocurricular activities reported were designated as community outreach events and an average of 15 (SD=43) student members participated in each activity. The most frequently selected domain by student representatives was “promoted professionalism” for 86% of activities. Upon distilling student representatives’ open-ended responses regarding their members’ learning, each response was assigned to one or more of 34 codes. The most frequently assigned codes to learning descriptions (36%) were for patient education and counseling.Conclusion. Representatives of student organizations characterized their members’ participation in cocurricular activities as opportunities for learning. The results from the content analysis aligned with the quantitative data collected. Cocurricular activities provide opportunities for Doctor of Pharmacy students to enhance their skills, knowledge, and attitudes in both pharmacy practice and personal areas that map to ACPE Standards 2016 and the college’s own curricular outcomes.

PMID:34283747 | DOI:10.5688/ajpe7825

Categories
Nevin Manimala Statistics

Polysubstance use in a Brazilian national sample: Correlates of co-use of alcohol and prescription drugs

Subst Abus. 2021 Jul 20:1-7. doi: 10.1080/08897077.2021.1949666. Online ahead of print.

ABSTRACT

Background: Responses to problem substance use have largely focused on illicit drugs, but reports on rising prescription drug misuse worldwide raise questions about their combined use with alcohol and potential consequences. The current study assessed prevalence of alcohol in conjunction with nonmedical opioid and benzodiazepine use across a nationally representative sample of adults in Brazil. Methods: Cross-sectional data on prevalence were estimated from the 2015 Brazilian Household Survey on Substance Use. We estimated past month nonmedical use of benzodiazepines and alcohol and past month nonmedical use of opioids and alcohol among adults who reported any past-year alcohol use. Zero-inflated Poisson models assessed independent correlates of alcohol and nonmedical opioid use, and alcohol and nonmedical benzodiazepine use. Results: Among adults who reported past year alcohol use, 0.4% (N = 257,051) reported past month alcohol and non-medical benzodiazepine use, and 0.5% (N = 337,333) reported past month alcohol and non-medical opioid use. Factors independently associated with co-use of alcohol and benzodiazepines included having depression (adjusted prevalence ratio (aPR):4.61 (95%CI 1.76-12.08)), anxiety (aPR:4.21 (95%CI 1.59-11.16)) and tobacco use (aPR: 5.48 (95%CI 2.26-13.27)). Factors associated with past-month alcohol and opioid use included having experienced physical or a threat of violence (aPR: 4.59 (95%CI 1.89-11.14)), and tobacco use (aPR:2.81(95%CI:1.29-6.12)). Conclusions: Co-use of prescription drugs with alcohol remains relatively rare among Brazilians, but findings point to a unique profile of persons at risk. Results of this study are important in light of changing dynamics and international markets of prescription drugs and the need for more research on use of these substances on a global scale.

PMID:34283709 | DOI:10.1080/08897077.2021.1949666

Categories
Nevin Manimala Statistics

PhenoGeneRanker: Gene and Phenotype Prioritization Using Multiplex Heterogeneous Networks

IEEE/ACM Trans Comput Biol Bioinform. 2021 Jul 20;PP. doi: 10.1109/TCBB.2021.3098278. Online ahead of print.

ABSTRACT

Uncovering genotype-phenotype relationships is a fundamental challenge in genomics. Gene prioritization is an important step for this endeavor to make a short manageable list from a list of thousands of genes coming from high-throughput studies. Network propagation methods are promising and state of the art methods for gene prioritization based on the premise that functionally related genes tend to be close to each other in the biological networks. Recently, we introduced PhenoGeneRanker, a network-propagation algorithm for multiplex heterogeneous networks. PhenoGeneRanker allows multi-layer gene and phenotype networks. It also calculates empirical p values of gene and phenotype ranks using random stratified sampling of seeds of genes and phenotypes based on their connectivity degree in the network. In this study, we introduce the PhenoGeneRanker Bioconductor package and its application to multi-omics rat genome datasets to rank hypertension disease-related genes and strains. We showed that PhenoGeneRanker performed better to rank hypertension disease-related genes using multiplex gene networks than aggregated gene networks. We also showed that PhenoGeneRanker performed better to rank hypertension disease-related strains using multiplex phenotype network than single or aggregated phenotype networks. We performed a rigorous hyperparameter analysis and, finally showed that Gene Ontology (GO) enrichment of statistically significant top-ranked genes resulted in hypertension disease-related GO terms.

PMID:34283720 | DOI:10.1109/TCBB.2021.3098278

Categories
Nevin Manimala Statistics

Treatment adherence with diclofenac 3% gel among patients with multiple actinic keratoses: an integrated low-intensity intervention program versus standard-of-care

Ital J Dermatol Venerol. 2021 Jul 20. doi: 10.23736/S2784-8671.21.07111-5. Online ahead of print.

ABSTRACT

BACKGROUND: Diclofenac 3% gel is a widely used topical treatment with proven efficacy in reducing the burden of Actinic Keratosis (AK), however clinical benefit might not fully translate in clinical practice as non-adherence is substantial for prolonged treatment regimens. We evaluated the efficacy of an integrated low-intensity intervention program versus standard-of-care on treatment adherence among patients with multiple AK receiving diclofenac in hyaluronic acid gel 3%.

METHODS: We designed an open label, randomized, parallel group, interventional, multicenter, longitudinal cohort study including patients with multiple, grade I/II AKs. Visits were scheduled for end of treatment (T4), follow-up 1 (T5) and follow-up 2 (T6) at 90, 180 and 365 days from baseline, respectively. Patients in the intervention group received additional visits at 30 and 60 days from baseline, a brief health education intervention, an enhanced patient-physician communication, a weekly SMS reminder to medication prescriptions.

RESULTS: Patients were equally allocated between intervention (intervention group [IG], N=86) and control group (CG, N=86); at baseline, both groups had similar socio-demographic and clinical characteristics. Change scores from baseline showed a slight increment in quality of life related to AK in both groups (CG: ΔT4 – T1=-0.079; IG: ΔT4 – T1=-0.006; p=0.39) and in quality of physicianpatient interaction reported by IG (ΔT3 – T2=0.18; p<.0001). Adherence rate was not statistically different between IG and CG (28.4% vs 40.7%; p=0.11). Patients reported similar satisfaction for effectiveness, convenience and side effects of treatment. Clinical conditions improved over time and results did not differ between groups; complete clearance rate at 1 year was 18% and 29% for CG and IG, respectively.

CONCLUSIONS: Our findings showed no difference in adherence rate between the two groups, suggesting that enhanced follow-up interventions and health care education may not be sufficient drivers to promote adherence among this clinical population. Further studies are needed to explore barriers to adherence with treatments for AKs.

PMID:34282872 | DOI:10.23736/S2784-8671.21.07111-5

Categories
Nevin Manimala Statistics

Time trends in general practitioners’ home visits for older patients: a retrospective cross-sectional study from Switzerland

Swiss Med Wkly. 2021 Jul 14;151:w20539. doi: 10.4414/smw.2021.20539. eCollection 2021 Jul 5.

ABSTRACT

WHAT IS KNOWN ON THE SUBJECT, AND WHAT THE STUDY ADDS: The number of home visits by general practitioners (GPs) has decreased in recent years, in contrast to the increasing number of frail and older patients in western countries. Current data on GP home visit numbers and rates are lacking for Switzerland. Our study provides new data on GP home visit numbers and rates, and their associations with patient characteristics.

AIM: Our study aimed at investigating the time trend of GP home visits to older patients from 2014 to 2018 in Switzerland, and associations between GP home visits and patient characteristics including healthcare utilisation and living situation.

METHODS: Retrospective cross-sectional study of insurance claims data from 2014 to 2018 among patients aged &ge;65 years (Nextrapolated = 2,095,102; Nraw = 339,301). We compared patient characteristics between patients with and without GP home visits using descriptive statistics. We performed logistic regression analyses to detect associations between patient characteristics and GP home visits, including subgroups of patients aged &ge;80 and patients living in a nursing home. Regression models were adjusted for age and sex.

RESULTS: The yearly GP home visit rate declined from 10.7% to 9.3% from 2014 to 2018 (p &lt;0.0001). Among patients aged &ge;80, the rate declined from 26.1% to 23.1% (p &lt;0.0001), and among patients living in a nursing home from 68.7% to 65.8% (p &lt;0.0001). Regression analyses revealed increased health care utilisation and a higher burden of morbidity and mortality in patients receiving GP home visits.

CONCLUSION: There is an ongoing decline of GP home visits over the past years, with a potentially negative impact on the quality of care for older and frail patients.

PMID:34282849 | DOI:10.4414/smw.2021.20539

Categories
Nevin Manimala Statistics

Primary undifferentiated pleomorphic sarcoma in oral-maxillary area: retrospective study and molecular analysis

Histol Histopathol. 2021 Jul 20:18359. doi: 10.14670/HH-18-359. Online ahead of print.

ABSTRACT

Undifferentiated pleomorphic sarcoma (UPS) in oral-maxillary area is rarely reported. Herein, we aimed to investigate the clinical characteristics, treatment strategies, prognosis, and molecular features of the oral-maxillary UPS. In total, 10 cases with primary oral-maxillary UPS were included. The rapidly progressive UPS can easily develop to an advanced and life-threatening stage, especially concerning the complex anatomical structures and spaces in the oral-maxillary area. The final diagnosis for UPS greatly depended on histological findings and immunohistochemistry staining after the exclusion of all possible differential diagnoses. Retrospectively, the treatment strategies for the included cases still referred to those of oral squamous cell carcinoma (OSCC). Statistically, the median overall survival (OS) for all the included cases was 7.75 months (range: 5-17 months). Comparatively, 3 cases had improved OS (median survival: 17 months, range: 17-18 months) and experienced PR/SD with neoadjuvant chemotherapy (anlotinib). The molecular features were demonstrated by using whole exonic sequencing for 1 included case. Cancer driver gene detection revealed GBP4 as a candidate driver gene for the primary oral-maxillary UPS. Additionally, a missense mutation in gene PIK3CA (p.E545K) was also identified. Our findings could greatly expand the knowledge about primary oral-maxillary UPS, and provide molecular evidences to improve the therapeutic options for primary oral-maxillary UPS.

PMID:34282850 | DOI:10.14670/HH-18-359

Categories
Nevin Manimala Statistics

CD27 mRNA expression in mycosis fungoides

Ital J Dermatol Venerol. 2021 Jul 20. doi: 10.23736/S2784-8671.21.06953-X. Online ahead of print.

ABSTRACT

BACKGROUND: The etiopathogenesis of MF remains obscure. CD27 is a member of the tumor necrosis factor receptor superfamily (TNFRS) that regulates lymphocyte function4. Expression of CD27 protein and mRNA has been reported in B-cell lymphomas5 and adult T-cell leukemia/lymphoma6. In this study, we examined the expression of CD27 in the skin of MF patients by real time PCR. The amount of CD27 was measured in MF patients and healthy controls.

METHODS: A total of 98 skin biopsies were analyzed: 12 obtained from healthy donors and 86 obtained Cryostatic sections OCT-embedded affected by MF. Relative quantification of mRNA CD27 expression was achieved by means of TaqMan amplification and normalization to glyceraldehyde-3-phosphate dehydrogenase (GAPDH).

RESULTS: Housekeeping gene was detectable in all Skin samples and there isn’t difference between healthy control and MF p value 0.1564. CD27 mRNA sequences were found in 3 of 12 (25%) of skin obtained from healthy donors and in 59 of 86 (68%) of skin obtained from Cryostatic sections OCT-embedded affected by MF. The chi-square statistic with Yates correction is 6.8413 and the p-value is 0.0089. When we compared the CD27 expression in MF and controls the RQ analysis show a value of 9.12±14.13. A RQ of 9.12 means that this gene is 9.12 times more expressed in MF skin samples then in the healthy skin samples. No difference were observed in the MF clustered by stages.

CONCLUSIONS: Our findings indicates that CD27 can be used as diagnostic/prognostic markers, and whether anti-CD27 antibodies can be used in therapy.

PMID:34282858 | DOI:10.23736/S2784-8671.21.06953-X

Categories
Nevin Manimala Statistics

Adherence of obstructive sleep apnoea syndrome patients to positive airway pressure therapy – 10-year follow-up

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2021 Jul 2. doi: 10.5507/bp.2021.041. Online ahead of print.

ABSTRACT

PURPOSE: Continuous positive airway pressure (CPAP) is the most effective therapy for obstructive sleep apnoea syndrome (OSAS). Long-term adherence is necessary; however, it may be widely variable based on current literature, where the predicting factors are also not well defined. The aim of this study was to assess ten-year adherence to CPAP and to define factors influencing it.

METHODS: In total, 107 patients (91 males) were enrolled in this study, with an average age of 53.5 years (SD 10.1), with CPAP therapy being indicated (Apnoea-Hypopnoea Index – AHI > 15). Anthropometric and social status data have been obtained as well as the average use of CPAP through device memory.

RESULTS: Sufficient adherence (> 4 hours per night) was found in 57% of patients in the first year with no subsequent significant change during the next 9 years. Adherence correlated significantly with the severity of OSAS – AHI (r = 0.321 over 5 years) and Epworth Sleepiness Scale (r = 0.317 over ten years) but did not correlate with the pressure used or the age of the patient. No statistically significant differences have been found between the sexes, the different mask groups, or the social status groups.

CONCLUSION: Good adherence to CPAP therapy in OSAS patients is essential. According to our results, patients with more severe OSAS or more severe sleepiness seem to have better adherence.

PMID:34282803 | DOI:10.5507/bp.2021.041

Categories
Nevin Manimala Statistics

Prevention of COVID-19 by mRNA-based vaccines within the general population of California

Clin Infect Dis. 2021 Jul 20:ciab640. doi: 10.1093/cid/ciab640. Online ahead of print.

ABSTRACT

BACKGROUND: Estimates of COVID-19 vaccine effectiveness under real-world conditions, and understanding of barriers to uptake, are necessary to inform vaccine rollout.

METHODS: We enrolled cases (testing positive) and controls (testing negative) from among the population whose SARS-CoV-2 molecular diagnostic test results from 24 February-29 April 2021 were reported to the California Department of Public Health. Participants were matched on age, sex, and geographic region. We assessed participants’ self-reported history of mRNA-based COVID-19 vaccine receipt (BNT162b2 and mRNA-1273). Participants were considered fully vaccinated two weeks after second dose receipt. Among unvaccinated participants, we assessed willingness to receive vaccination. We measured vaccine effectiveness (VE) via the matched odds ratio of prior vaccination, comparing cases with controls.

RESULTS: We enrolled 1023 eligible participants aged ≥18 years. Among 525 cases, 71 (13.5%) received BNT162b2 or mRNA-1273; 20 (3.8%) were fully vaccinated with either product. Among 498 controls, 185 (37.1%) received BNT162b2 or mRNA-1273; 86 (16.3%) were fully vaccinated with either product. Two weeks after second dose receipt, VE was 87.0% (95% confidence interval: 68.6-94.6%) and 86.2% (68.4-93.9%) for BNT162b2 and mRNA-1273, respectively. Fully vaccinated participants receiving either product experienced 91.3% (79.3-96.3%) and 68.3% (27.9-85.7%) VE against symptomatic and asymptomatic infection, respectively. Among unvaccinated participants, 42.4% (159/375) residing in rural regions and 23.8% (67/281) residing in urban regions reported hesitancy to receive COVID-19 vaccination.

CONCLUSIONS: Authorized mRNA-based vaccines are effective at reducing documented SARS-CoV-2 infections within the general population of California. Vaccine hesitancy presents a barrier to reaching coverage levels needed for herd immunity.

PMID:34282839 | DOI:10.1093/cid/ciab640

Categories
Nevin Manimala Statistics

Meta-Analysis of Microdissected Breast Tumors Reveals Genes Regulated in the Stroma but Hidden in Bulk Analysis

Cancers (Basel). 2021 Jul 5;13(13):3371. doi: 10.3390/cancers13133371.

ABSTRACT

Transcriptome data provide a valuable resource for the study of cancer molecular mechanisms, but technical biases, sample heterogeneity, and small sample sizes result in poorly reproducible lists of regulated genes. Additionally, the presence of multiple cellular components contributing to cancer development complicates the interpretation of bulk transcriptomic profiles. To address these issues, we collected 48 microarray datasets derived from laser capture microdissected stroma or epithelium in breast tumors and performed a meta-analysis identifying robust lists of differentially expressed genes. This was used to create a database with carefully harmonized metadata that we make freely available to the research community. As predicted, combining the results of multiple datasets improved statistical power. Moreover, the separate analysis of stroma and epithelium allowed the identification of genes with different contributions in each compartment, which would not be detected by bulk analysis due to their distinct regulation in the two compartments. Our method can be profitably used to help in the discovery of biomarkers and the identification of functionally relevant genes in both the stroma and the epithelium. This database was made to be readily accessible through a user-friendly web interface.

PMID:34282769 | DOI:10.3390/cancers13133371