Improving Collaboration between Pharmacists and Physicians

Physicians and pharmacists have differing but complementary roles that can optimize patient care when structured effectively. Unfortunately, these two professionals are not collaborating well enough, as patient outcomes, especially in relation to medication adherence, continue to decline. Coordinated care of patients can improve by expanding bidirectional communication and sharing additional patient information with each other. It will be necessary to continue to promote collaborative care in the educational and training stages of these professionals’ careers to build trust and understanding of professional scope. Ultimately, the healthcare infrastructure will have to continue to progress to make collaboration more available and valuable to physicians and pharmacists

Medical marijuana: a public health perspective

Over the few years medical marijuana is growing in the United States. Because of the medical marijuana legislators able to legalized recreational marijuana in the two states in the US. Marijuana has several potential benefits that help in certain disease. The delivery of marijuana is also important because smoking marijuana has severe side effects. Physicians also play important role in medical marijuana, physicians also divided on the use of medical marijuana. Their attitude towards medical marijuana important for the treatment of disease is important for the community. Marijuana is the most commonly used illegal drug in the US and all over world, several risks associated with it. Major concern is medical marijuana increased the use of marijuana and will create the public health problem in the society. There are several medical benefits from the marijuana but require more research to establish the marijuana as a medicine. Control of medical marijuana is also major issue for the law enforcement agencies and challenge for policymakers also in the United States

Carbon Fiber Microelectrode Arrays for Neuroprosthetic and Neuroscience Applications.

The aim of this work is to develop, validate, and characterize the insertion mechanism, tissue response, and recording longevity of a new high-density carbon fiber microelectrode array. This technology was designed to significantly improve the field of penetrating microelectrodes while simultaneously accommodating the variable needs of both neuroscientists and neural engineers. The first study presents the fabrication and insertion dynamics of a high-density carbon fiber electrode array using a dual sided printed circuit board platform. The use of this platform has pushed electrode density to limits not seen in other works. This necessitated the use of an encapsulation method that served to temporarily stiffen the fibers during insertion, but did not enter the brain as many other shuttles do for other probe designs. The initial findings in this work informed the development of an even higher density array using a silicon support structure as a backbone. The second study reports on the tissue reaction of chronically implanted carbon fiber electrode arrays as compared to silicon electrodes. Due to their smaller footprint, the reactive response to carbon fibers should be greatly attenuated, if not non-existent. Results show a scarring response to the implanted silicon electrode with elevated astrocyte and microglia activity coupled to a local decrease in neuronal density. The area implanted with the carbon fiber electrodes showed a varied response, from no detectable increase in astrocytic or microglial activity to an elevated activation of both cell types, but with no detectable scars. Neuronal density in the carbon fiber implant region was unaffected. The data demonstrates that the small carbon fiber profile, even in an array configuration, shows an attenuated reactive response with no visible scaring. The final study reports on the viability of chronically implanted high-density carbon fiber arrays as compared to more traditional silicon planar arrays with comparable site sizes. While most new probe technologies or designs are able to demonstrate proof of concept functionality in acute preparations, very few show the ability to record chronic unit activity. This study aims to provide a comprehensive analysis of electrophysiology data collected over implant durations ranging from 3 – 5 months.PhDBiomedical EngineeringUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/111557/1/parasp_1.pd

Volumetric, acoustical and computational study on molecular interactions in binary mixtures of Ricinoleic acid with some halobenzenes

1194-1205Densities (ρ) and speed of sound (u) of binary liquid mixtures of Ricinoleic acid with some halobenzenes at 303.15, 308.15 and 313.15 K and atmospheric pressure have been reported over the entire composition range. From the experimentally measured density (ρ), excess molar volumes (V), have been calculated. Deviation of the speeds of sound (u), isentropic compressibility (ks), deviation in isentropic compressibility (ks), deviation in acoustic impedance (z) and intermolecular free length (Lf) have been calculated using experimentally measured speed of sound,(u). Various theoretical speeds of sound and average deviations have been calculated using well established equations like Nomoto (Unmt) Ideal Mixing Rule (Uimr), Junji (Ujunji) and Jacobson’s Free Length Theory, (Uflt). To derive fitting coefficients, (Ai) with standard deviation, (σ), excess properties have been fitted with the Redlich-Kister type polynomial equation. The variation of these properties with composition and temperature has been discussed in terms of molecular interaction on mixing and their interacting abilities. Observations reveal that there have been strong interactions between components. Strength of interactions between components has been described with theoretical computational calculations

The Efficacy of Antidepressants in Alleviating Anhedonia in Depressed Patients

Background: Anhedonia, or the inability to feel pleasure, is an important symptom of depression because it may be involved in preventing complete recovery and facilitating depression relapse. The relationship between depression severity and anhedonia in patients being treated with antidepressants has not been widely studied. The objective of this study was to characterize the alleviation of anhedonia in patients taking antidepressants for depression. Methods: This was a prospective survey distributed at three outpatient psychiatric settings. Subjects above the age of twenty who indicated a depression diagnosis were included. Subjects with schizophrenia, bipolar disorder, or substance abuse disorder were excluded. A 37-question survey was distributed from January 27, 2016 to March 8, 2016. The survey included demographic questions, the Snaith-Hamilton Pleasure Scale (SHAPS) to determine presence of anhedonia, and the Clinically Useful Depression Outcomes Scale (CUDOS) to quantify depression severity. Results: Seventy one surveys were included in the study with 83% of them being female. There was a moderate positive correlation between depression severity and the prevalence of anhedonia (p\u3c0.001). Ninety percent of patients had been on antidepressants for over two months; 70% had depression and 43% had anhedonia. Significant proportions of patients were involved in psychotherapy and had comorbid anxiety disorders. No significant conclusions were found about the relationship between drug class and anhedonia. Conclusion: Anhedonia in depressed patients may not be as persistent to antidepressants as hypothesized, and it is more prevalent in patients with more severe depression. No specific treatment approaches were identified to target anhedonia

Thermophysical, acoustical, spectral and DFT study of intermolecular interactions of terpinolene with cresols

797-815Densities and speed of sound have been measured experimentally for binary mixtures of terpinolene with cresols (o-cresol, m-cresol, p-cresol) at three different temperatures 303.15, 308.15 and 313.15 K at atmospheric pressure. From primary physical properties, some secondary properties like molar volume (Vm), excess molar volume V, partial molar volume (,i) excess partial molar volume (,), apparent molar volume (Vm,φ,i), deviation in speed of sound (u), isentropic compressibility (s), deviation in isentropic compressibility (s), acoustical impedance (z), deviation in acoustical impedances (z), intermolecular free length (Lf), partial molar isentropic compression (,m,i), excess partial molar isentropic compression (,i) and apparent molar isentropic compression (Ks,m,φ,i) have been calculated. Infinite dilution apparent molar volume (V,φ,1), infinite dilution apparent molar isentropic compression(Ks,m,φ,1), empirical parameters Sv, Bv and Sk, Bk of the Redlich-Rosenberg-Mayer equation with the limiting apparent molar expansibility (E) have been also calculated along with some theoretical speed of sound calculating relations such as Nomoto relation (unmt), Ideal mixture relation (uimr, Junji relation (ujunji) and Free length theory relation (uflt) with their standard deviation (σ). All the calculated values of excess/deviation properties have been fitted with the fourth order Redlich-Kister polynomial equation and their standard deviation (σ) values are also calculated. FTIR spectral analysis of binary mixtures at 4:1, 1:1 and 1:4 composition ratios have been carried out at 298.15 K. Computational calculations such as optimization of pure and binary mixtures in gas phase, bond length, Mulliken charges, theoretical vibrational frequencies and NBO calculations on basis of the DFT (Density Functional Theory) have been also carried out. The results are discussed in term of presence of intermolecular interactions, types, strength and behavior with change of temperatures and cresol components in binary mixtures

Case series of mucormycosis occurring in patients of COVID-19

Mucormycosis is an umbrella term used for diseases caused by many non-septate filamentous fungal species which is caused by sub-phylum Mucormycotina. It is an acute opportunistic and aggressive fulminant invasive infection that can occur in immunocompromised patients, such as uncontrolled diabetes, renal failure, organ transplant, long-term corticosteroid and immunosuppressive therapy, AIDS, malignancy and corona virus disease 2019 (COVID 19) infections. Mucormycosis is now third most common invasive mycoses after candidiasis and aspergillosis. The COVID-19 infection is characterised by wide range of disease patterns, ranging from mild to life-threatening pneumonia. Many bacterial and fungal co-infections may exist and may be associated with preexisting morbidity or may develop as a hospital-acquired infection such as ventilator-associated pneumonia. Extensive use of corticosteroids and broad-spectrum antibiotics lead to exacerbation of preexisting disease. The aim of this study is to identify the risk factors along with high index of suspicion, early diagnosis and aggressive management of mucormycosis

Thermophysical, Acoustical, Spectral and DFT Study of Intermolecular Interactions of Terpinolene with Cresols.

Abstract Densities and speed of sound were measured experimentally for binary mixtures of terpinolene with cresols (o-cresol, m-cresol, p-cresol) at three different temperatures 303.15, 308.15 and 313.15K at atmospheric pressure. From primary physical properties, some secondary properties like molar volume , excess molar volume , partial molar volume , excess partial molar volume , apparent molar volume , deviation in speed of sound , isentropic compressibility , deviation in isentropic compressibility , acoustical impedance , deviation in acoustical impedances , intermolecular free length , partial molar isentropic compression , excess partial molar isentropic compression  and apparent molar isentropic compression  were calculated. Infinite dilution apparent molar volume , infinite dilution apparent molar isentropic compression , empirical parameters ,  and ,  of the Redlich-Rosenberg-Mayer equation with the limiting apparent molar expansibility  were also calculated. Some theoretical speed of sound calculating relations such as Nomoto relation , Ideal mixture relation , Junji relation  and Free length theory relation  were also calculated with their standard deviation . All the calculated values of excess/deviation properties were fitted with the fourth order Redlich-Kister polynomial equation and their standard deviation  values were also calculated. FT-IR spectral analysis of binary mixtures at 4:1, 1:1 and 1:4 composition ratios were carried out at 298.15K. Computational calculations such as optimization of pure and binary mixtures in gas phase, bond length, Mulliken charges, theoretical vibrational frequencies and NBO calculations on basis of the DFT (Density Function Theory) were also carried out. The results were discussed in term of presence of intermolecular interactions, types, strength and behavior with change of temperatures and cresol components in binary mixtures

Whole Body Cryotherapy as a Novel Treatment for Long COVID Syndrome Associated Brain Fog

SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19), was first discovered in December 2019 in Wuhan, China when adults began presenting with severe pneumonia of an unknown cause. SARS-CoV-2 can cause a wide range of clinical manifestations. SARS-CoV-2 can penetrate the olfactory mucosa and may enter the brain through the cribriform plate along the olfactory tract, through vagal or trigeminal pathways, or pass through the blood-brain barrier. Once inside the brain, levels of inflammatory cytokines are increased and can lead to altered learning, memory, neuroplasticity, hallucinations, nightmares, cognitive and attention deficits, new-onset anxiety and depression, and psychosis. A theoretical treatment for long COVID syndrome, whole body cryotherapy, involves exposing the entire body, including the head, to ultra-low temperatures for a brief time using an enclosed space referred to as a whole-body cryochamber. This literature review evaluates the efficacy of whole body cryotherapy on long COVID syndrome and its current clinical uses

Signal distortion from microelectrodes in clinical EEG acquisition systems

Many centers are now using high-density microelectrodes during traditional intracranial electroencephalography (iEEG) both for research and clinical purposes. These microelectrodes are FDA-approved and integrate into clinical EEG acquisition systems. However, the electrical characteristics of these electrodes are poorly described and clinical systems were not designed to use them; thus, it is possible that this shift into clinical practice could have unintended consequences. In this study, we characterized the impedance of over 100 commercial macro- and microelectrodes using electrochemical impedance spectroscopy (EIS) to determine how electrode properties could affect signal acquisition and interpretation. The EIS data were combined with the published specifications of several commercial EEG systems to design digital filters that mimic the behavior of the electrodes and amplifiers. These filters were used to analyze simulated brain signals that contain a mixture of characteristic features commonly observed in iEEG. Each output was then processed with several common quantitative EEG measurements. Our results show that traditional macroelectrodes had low impedances and produced negligible distortion of the original signal. Brain tissue and electrical wiring also had negligible filtering effects. However, microelectrode impedances were much higher and more variable than the macroelectrodes. When connected to clinical amplifiers, higher impedance electrodes produced considerable distortion of the signal at low frequencies (<60 Hz), which caused significant changes in amplitude, phase, variance and spectral band power. In contrast, there were only minimal changes to the signal content for frequencies above 100 Hz. In order to minimize distortion with microelectrodes, we determined that an acquisition system should have an input impedance of at least 1 GΩ, which is much higher than most clinical systems. These results show that it is critical to account for variations in impedance when analyzing EEG from different-sized electrodes. Data from microelectrodes may yield misleading results unless recorded with high-impedance amplifiers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98632/1/1741-2552_9_5_056007.pd