Evaluation of a flipped examination model implemented in a final-year undergraduate pharmacotherapeutics course

© 2019, American Association of Colleges of Pharmacy. All rights reserved. Objective. To assess final-year pharmacy students’ performance on and evaluate their experience with a “flipped examination” vs a traditional examination for an advanced clinical pharmacy course. Methods. Students devised multiple-choice questions for the flipped examination. The Biggs revised 2-factor Study Process Questionnaire was administered before and after the examination to assess any possible changes in the students’ perceptions of their level of engagement in the learning process. Focus group discussions also were conducted to further gauge the students’ feedback and insights into the flipped examination experience. Results. Changes in mean total study process scores at the deep and surface levels of learning were significant. The flipped examination experience was enjoyable, facilitated a less-stressful learning environment, and improved the students’ learning satisfaction, knowledge, and assessment grades. Conclusion. The flipped examination model is an innovative instructional approach that can bring about significant educational gains if designed well pedagogically

ANESTHESIA AND ANALGESIA IN ANTARCTIC FISH: AN EXPERIMENTAL APPROACH

Foi levado a efeito em peixes antárticos um estudo sobre as ações anestésicas e/ou analgésicas de depressores centrais ketamine, fentanyl e thiopental bem como do anestésico local benzocaina. As drogas foram adicionadas à água marinha aerada nas temperaturas de 1 a 1,5oC. Ketamine (15 mg/L) e fentanyl (50 g/L) não induziram anestesia mas causaram demorada analgesia e sedação. Doses de 100 mg/L de Thiopental foram necessárias para anestesiar peixes, ou seja, em concentração 30 vezes maior do que a dose anestésica usual utilizada para mamíferos. A anestesia ocasionada nos peixes foi longa - de 3 a 4 horas - e difícil de ser controlada. Um dos peixes utilizados na experimentação permaneceu em estado de comatose por quatro dias com sobrevida. Benzocaina em doses de 100 mg/L foi eficiente para anestesiar peixes dentro de 6 a 8 minutos após a sua administração. A anestesia, neste caso, teve duração de 15 a 20 minutos acompanhada de pequena depressão respiratória. Abstract It was studied in Antarctic fishes the anesthetic and/or analgesic actions of central depressors ketamine, fentanyl and thiopental as well as the local anesthetic benzocaine. The drugs were added to aerated marine water at temperatures of 1-1.5 C. Ketamine (15 mg/L) and fentanyl (50 g/L) failed in inducing anesthesia but caused a long lasting analgesia and sedation. Thiopental was required in doses of 100 mg/L to anesthetize the fishes, that is, about 30 times higher than the usual anesthetic dose for mammals. The anesthesia was long lasting, that is, 3-4 h, and difficult to control. One fish remained in a comatose state for four days with survival. Benzocaine in doses of 100 mg/L was successful in anesthetizing the fishes within 6-8 min, anesthesia lasting for 15-20 min, with a minor respiratory depression

Modelling of hypothetical SARS-CoV-2 point of care tests for routine testing in residential care homes: rapid cost-effectiveness analysis

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes coronavirus disease 2019 (COVID-19), which at the time of writing (January 2021) was responsible for more than 2.25 million deaths worldwide and over 100,000 deaths in the UK. SARS-CoV-2 appears to be highly transmissible and could rapidly spread in residential care homes. Objective The work undertaken aimed to estimate the clinical effectiveness and cost-effectiveness of viral detection point-of-care tests for detecting SARS-CoV-2 compared with laboratory-based tests in the setting of a hypothetical care home facility for elderly residents. Perspective/setting The perspective was that of the NHS in 2020. The setting was a hypothetical care home facility for elderly residents. Care homes with en suite rooms and with shared facilities were modelled separately. Methods A discrete event simulation model was constructed to model individual residents and simulate the spread of SARS-CoV-2 once it had entered the residential care facility. The numbers of COVID-19-related deaths and critical cases were recorded in addition to the number of days spent in isolation. Thirteen strategies involving different hypothetical SARS-CoV-2 tests were modelled. Recently published desirable and acceptable target product profiles for SARS-CoV-2 point-of-care tests and for hospital-based SARS-CoV-2 tests were modelled. Scenario analyses modelled early release from isolation based on receipt of a negative SARS-CoV-2 test result and the impact of vaccination. Incremental analyses were undertaken using both incremental cost-effectiveness ratios and net monetary benefits. Results Cost-effectiveness results depended on the proportion of residential care facilities penetrated by SARS-CoV-2. SARS-CoV-2 point-of-care tests with desirable target product profiles appear to have high net monetary benefit values. In contrast, SARS-CoV-2 point-of-care tests with acceptable target product profiles had low net monetary benefit values because of unnecessary isolations. The benefit of allowing early release from isolation depended on whether or not the facility had en suite rooms. The greater the assumed efficacy of vaccination, the lower the net monetary benefit values associated with SARS-CoV-2 point-of-care tests, when assuming that a vaccine lowers the risk of contracting SARS-CoV-2. Limitations There is considerable uncertainty in the values for key parameters within the model, although calibration was undertaken in an attempt to mitigate this. Some degree of Monte Carlo sampling error persists because of the timelines of the project. The example care home simulated will also not match those of decision-makers deciding on the clinical effectiveness and cost-effectiveness of introducing SARS-CoV-2 point-of-care tests. Given these limitations, the results should be taken as indicative rather than definitive, particularly the cost-effectiveness results when the relative cost per SARS-CoV-2 point-of-care test is uncertain. Conclusions SARS-CoV-2 point-of-care tests have considerable potential for benefit for use in residential care facilities, but whether or not this materialises depends on the diagnostic accuracy and costs of forthcoming SARS-CoV-2 point-of-care tests. Future work More accurate results would be obtained when there is more certainty on the diagnostic accuracy of and the reduction in time to test result associated with SARS-CoV-2 point-of-care tests when used in the context of residential care facilities, the proportion of care home penetrated by SARS-CoV-2 and the levels of immunity once vaccination is administered. These parameters are currently uncertain. Funding This report was commissioned by the National Institute for Health Research (NIHR) Evidence Synthesis programme as project number 132154. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 39. See the NIHR Journals Library website for further project information

Effect of genistein and oestradiol on the adrenal cortex of the ovariectomised adult female albino rats

Background: Genistein, a naturally occurring soy isoflavone, attracts interest as an effective and safe alternative to hormone replacement therapy for menopausal problems. The aim of the current study was to compare between the effect of genistein and oestradiol on the adrenal cortex of the ovariectomised adult female albino rats. Materials and methods: Twenty rats were used in the current study and divided into four groups, 5 rats in each group; group 1 (control non-ovariectomised), group 2 (ovariectomised), group 3 (ovariectomised + genistein) and group 4 (ovariectomised + oestradiol). The rats were sacrificed after 4 weeks. Both adrenal glands were removed for light microscope using haematoxylin and eosin stain, ultrastructural study and immunohistochemical examination using proliferating cell nuclear antigen, caspase-3, and oestrogen receptor-b. Results: Ovariectomised rats showed signs of degeneration in all zones of adrenal cortex. On the other hand, treatment with genistein showed restoration of the adrenal cortex with less proliferative effect than oestradiol. Conclusions: So, genistein can be used as effective therapy to decrease the symptoms of menopause without fear of cancer development

Modelling of hypothetical SARS-CoV-2 point-of-care tests on admission to hospital from A&E : rapid cost-effectiveness analysis

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes coronavirus disease 2019. At the time of writing (October 2020), the number of cases of COVID-19 had been approaching 38 million and more than 1 million deaths were attributable to it. SARS-CoV-2 appears to be highly transmissible and could rapidly spread in hospital wards. Objective The work undertaken aimed to estimate the clinical effectiveness and cost-effectiveness of viral detection point-of-care tests for detecting SARS-CoV-2 compared with laboratory-based tests. A further objective was to assess occupancy levels in hospital areas, such as waiting bays, before allocation to an appropriate bay. Perspective/setting The perspective was that of the UK NHS in 2020. The setting was a hypothetical hospital with an accident and emergency department. Methods An individual patient model was constructed that simulated the spread of disease and mortality within the hospital and recorded occupancy levels. Thirty-two strategies involving different hypothetical SARS-CoV-2 tests were modelled. Recently published desirable and acceptable target product profiles for SARS-CoV-2 point-of-care tests were modelled. Incremental analyses were undertaken using both incremental cost-effectiveness ratios and net monetary benefits, and key patient outcomes, such as death and intensive care unit care, caused directly by COVID-19 were recorded. Results A SARS-CoV-2 point-of-care test with a desirable target product profile appears to have a relatively small number of infections, a low occupancy level within the waiting bays, and a high net monetary benefit. However, if hospital laboratory testing can produce results in 6 hours, then the benefits of point-of-care tests may be reduced. The acceptable target product profiles performed less well and had lower net monetary benefits than both a laboratory-based test with a 24-hour turnaround time and strategies using data from currently available SARS-CoV-2 point-of-care tests. The desirable and acceptable point-of-care test target product profiles had lower requirement for patients to be in waiting bays before being allocated to an appropriate bay than laboratory-based tests, which may be of high importance in some hospitals. Tests that appeared more cost-effective also had better patient outcomes. Limitations There is considerable uncertainty in the values for key parameters within the model, although calibration was undertaken in an attempt to mitigate this. The example hospital simulated will also not match those of decision-makers deciding on the clinical effectiveness and cost-effectiveness of introducing SARS-CoV-2 point-of-care tests. Given these limitations, the results should be taken as indicative rather than definitive, particularly cost-effectiveness results when the relative cost per SARS-CoV-2 point-of-care test is uncertain. Conclusions Should a SARS-CoV-2 point-of-care test with a desirable target product profile become available, this appears promising, particularly when the reduction on the requirements for waiting bays before allocation to a SARS-CoV-2-infected bay, or a non-SARS-CoV-2-infected bay, is considered. The results produced should be informative to decision-makers who can identify the results most pertinent to their specific circumstances. Future work More accurate results could be obtained when there is more certainty on the diagnostic accuracy of, and the reduction in time to test result associated with, SARS-CoV-2 point-of-care tests, and on the impact of these tests on occupancy of waiting bays and isolation bays. These parameters are currently uncertain

BIOLOGICAL CONTROL OF SOIL -BORNE FUNGAL PATHOGENS

Seventeen bacterial isolates have been successfully isolated and purified from soil rhizosphere samples collected from different agricultural areas Buhayra, Sharqia and Alqilyubia of Egypt, and screened for production of chitinase enzymes had the highest chitinolytic activities amongst those investigated. Isolate S3-C and S1-C were Identified by biochemical, physiological tests and 16s rRNA gene primer as Bacillus cereus S3C, Gene Bank NCBI accession MK185696 and Bacillus cereus S1C accession MK185697. The production of chitinase by B.cereus S3C and Bacillus cereus S1C was optimized using colloidal chitin medium amended with 1% colloidal chitin at 30°C after five days of incubation. B.cereus S3C had potential for cell wall lysis of many phytopathogenic fungi tested such as Fusarium oxysporum and Rhizoctonia solani Potato phytopathogenic fungi by in vitro antagonistic test. The addition of B. cereus S3C chitinase was more effective than that of B.cereus S1C in increasing the resistance of Potato plants infected with various Soil- borne phytopathogenic fungi

Antimicrobial effect of Chitosan and Nano-Chitosan against some Pathogens and Spoilage Microorganisms

An experiment was conducted to investigate the antimicrobial effect of chitosan and nano-chitosan. Two Gram-negative, three Gram-positive bacteria and three fungal strains were used as test microorganisms. The obtained results indicated that 88% of nano-chitosan particle size was in the range of 93.76nm and 12% in 405nm. Nano-chitosan showed maximum antibacterial activity against S. aureus and L. monocytogenes with inhibition zone of 30mm (23µg/ml concentration) and the lowest 23mm with E. coli at the same concentration. Other tested bacteria were affected in different degrees. The MIC and MLC ranged between 64 to 256 and 128 to 512µg/ml, respectively. The highest effect was against S. aureus at 23.04µg/ml. Chitosan solution was found to have less antifungal activity against C. albicans when compared to nano-chitosan. MIC and MLC for chitosan and nano-chitosan were recorded at 64 and 128µg/ml with chitosan and 23.04 and 46.08µg/ml with nano-chitosan. The highest nano-chitosan activity was recorded against S. cerevisiae, 7 and 16µg/ml for MIC and MLC, respectively. Nano-chitosan at concentrations 3.0 and 4.5µg/ml were the most effective to retard fungal activity

Neurodevelopmental abnormalities in children with PHACE syndrome.

Prior case reports have identified neurodevelopmental abnormalities in children with PHACE syndrome, a neurocutaneous disorder first characterized in 1996. In this multicenter, retrospective study of a previously identified cohort of 93 children diagnosed with PHACE syndrome from 1999 to 2010, 29 children had neurologic evaluations at ≥ 1 year of age (median age: 4 years, 2 months). In all, 44% had language delay, 36% gross motor delay, and 8% fine motor delay; 52% had an abnormal neurological exam, with speech abnormalities as the most common finding. Overall, 20 of 29 (69%) had neurodevelopmental abnormalities. Cerebral, but not posterior fossa, structural abnormalities were identified more often in children with abnormal versus normal neurodevelopmental outcomes (35% vs. 0%, P = .04). Neurodevelopmental abnormalities in young children with PHACE syndrome referred to neurologists include language and gross motor delay, while fine motor delay is less frequent. Prospective studies are needed to understand long-term neurodevelopmental outcomes