Quantitative copper measurement in oxidized p-type silicon wafers using microwave photoconductivity decay

We propose a method to measure trace copper contamination in p-type silicon using the microwave photoconductivity decay (μ-PCD) technique. The method is based on the precipitation of interstitial copper, activated by high-intensity light, which results in enhanced minority carrier recombination activity. We show that there is a quantitative correlation between the enhanced recombination rate and the Cu concentration by comparing μ-PCD measurements with transient ion drift and total reflection x-ray fluorescence measurements. The results indicate that the method is capable of measuring Cu concentrations down to 10exp10cm−3. There are no limitations to wafer storage time if corona charge is used on the oxidized wafer surfaces as the charge prevents copper outdiffusion. We briefly discuss the role of oxide precipitates both in the copperprecipitation and in the charge carrier recombination processes.Peer reviewe

“Don’t Label Them as Addicts!” Student Pharmacists’ Views on the Stigma Associated with Opioid use Disorder

Background: Student pharmacists represent an important potential population for targeted educational interventions focused on skill and confidence development in order to improve interactions with opioid users and to decrease stigma. The objective of this study was to understand student pharmacists’ perceptions of opioid users. Methods: Focus groups were conducted with student pharmacists across Tennessee over two months in 2020. Concepts from the Transtheoretical Mode, Social Cognitive Theory, stigma, and results from a survey sent to student pharmacists were used to develop the open-ended questions. Thematic analysis was conducted to inductively identify main themes. The recruitment of student pharmacists continued until thematic saturation was obtained. Results: Three focus groups were conducted with a total of 16 student pharmacists in second, third, and fourth professional years. Thematic analysis revealed two themes: Don’t label them as addicts, Student Insight into OUD-Associated Stigma and five sub-themes: developing a judgment-free environment; unconscious bias; a possible connection between physical appearance and addiction; socio-cultural factors, addiction, and isolation; and motivators to decrease stigma. This study not only presents the pharmacy students experiences and their significance, but also reports their recommendations for addressing the stigma associated with OUD in the pharmacy curriculum. Conclusions: These findings highlight the need to normalize appropriate language when describing patients with OUD and avoid negative labels such as “addict.” The findings also indicate where the roots of stigma lie and provide some of the tools to fight stigma on different fronts. Future research should explore and address potential implicit biases throughout pharmacy curriculum

Unsafe "crossover-use" of chloramphenicol in Uganda: importance of a One Health approach in antimicrobial resistance policy and regulatory action.

Since the introduction of antibiotics into mainstream health care, resistance to these drugs has become a widespread issue that continues to increase worldwide. Policy decisions to mitigate the development of antimicrobial resistance are hampered by the current lack of surveillance data on antibiotic product availability and use in low-income countries. This study collected data on the antibiotics stocked in human (42) and veterinary (21) drug shops in five sub-counties in Luwero district of Uganda. Focus group discussions with drug shop vendors were also employed to explore antibiotic use practices in the community. Focus group participants reported that farmers used human-intended antibiotics for their livestock, and community members obtain animal-intended antibiotics for their own personal human use. Specifically, chloramphenicol products licensed for human use were being administered to Ugandan poultry. Human consumption of chloramphenicol residues through local animal products represents a serious public health concern. By limiting the health sector scope of antimicrobial resistance research to either human or animal antibiotic use, results can falsely inform policy and intervention strategies. Therefore, a One Health approach is required to understand the wider impact of community antibiotic use and improve overall effectiveness of intervention policy and regulatory action

Real-world, Multicenter Experience With Meropenem-Vaborbactam for Gram-Negative Bacterial Infections Including Carbapenem-Resistant Enterobacterales and Pseudomonas Aeruginosa

Background: We aimed to describe the clinical characteristics and outcomes of patients treated with meropenem-vaborbactam (MEV) for a variety of gram-negative infections (GNIs), primarily including carbapenem-resistant Enterobacterales (CRE). Methods: This is a real-world, multicenter, retrospective cohort within the United States between 2017 and 2020. Adult patients who received MEV for ≥72 hours were eligible for inclusion. The primary outcome was 30-day mortality. Classification and regression tree analysis (CART) was used to identify the time breakpoint (BP) that delineated the risk of negative clinical outcomes (NCOs) and was examined by multivariable logistic regression analysis (MLR). Results: Overall, 126 patients were evaluated from 13 medical centers in 10 states. The most common infection sources were respiratory tract (38.1%) and intra-abdominal (19.0%) origin, while the most common isolated pathogens were CRE (78.6%). Thirty-day mortality and recurrence occurred in 18.3% and 11.9%, respectively. Adverse events occurred in 4 patients: nephrotoxicity (n = 2), hepatoxicity (n = 1), and rash (n = 1). CART-BP between early and delayed treatment was 48 hours (P = .04). MEV initiation within 48 hours was independently associated with reduced NCO following analysis by MLR (adusted odds ratio, 0.277; 95% CI, 0.081-0.941). Conclusions: Our results support current evidence establishing positive clinical and safety outcomes of MEV in GNIs, including CRE. We suggest that delaying appropriate therapy for CRE significantly increases the risk of NCOs

Evaluation of HER-2/neu gene amplification and protein expression in non-small cell lung carcinomas

HER-2/neu gene amplification and cell surface overexpression are important factors in breast cancer for prognosis and prediction of sensitivity to anti-HER-2/neu monoclonal antibody therapy. In lung cancer, the clinical significance of HER-2/neu expression is currently under evaluation. We investigated 238 non-small lung carcinomas for HER-2/neu protein overexpression by immunohistochemistry using the HercepTest. We found 2+ or 3+ overexpression in 39 patients (16%), including 35% in adenocarcinomas and 20% in large cell carcinomas, but only 1% of squamous cell carcinomas. Marked (3+) overexpression was uncommon (4%). The association between protein expression and gene copy number per cell, as determined by fluorescence in situ hybridisation assay, was investigated in 51 of these NSCLC tumours. Twenty-seven tumours (53%) were negative by both tests. Marked (3+) protein expression and gene amplification were present in only 4% of samples. In 11 tumours (21%), gene gain was accompanied by chromosomal aneusomy and did not result in high protein levels while in 7 (14%) the score 2+ was associated with maximum number of signals per cell <9. The prognostic implication of HER-2/neu protein expression was studied in 187 surgically resected tumours. No statistical difference in survival was observed comparing patients with positive (2+/3+) and negative tumours (0/1+), although 3+ patients showed a tendency to shorter survival. The therapeutic implications of protein expression and gene amplification in lung cancer need to be examined in prospective clinical trials

Pharmacy Students’ Perceptions and Stigma Surrounding Naloxone Use in Patients with Opioid Use Disorder: A Mixed Methods Evaluation

Pharmacists represent a key group of healthcare professionals that can increase awareness and destigmatize naloxone use. The objective of this study was to investigate pharmacy student perceptions of the use, dispensing, and stigma surrounding naloxone. An electronic survey was administered to pharmacy students that included questions about demographics, work history, naloxone use, and naloxone stigma. Separate qualitative interviews were performed to identify themes surrounding naloxone use. Two-hundred sixty-two participants completed the survey. The majority of participants were &ldquo;highly willing&rdquo; (74%) to fill a naloxone prescription for a patient and &ldquo;somewhat comfortable&rdquo; (38%) in counseling on naloxone; most were &ldquo;somewhat comfortable&rdquo; (38%) administering naloxone. Naloxone is &ldquo;very rarely&rdquo; (87%) recommended in community workplace settings, and the majority (64%) reported that patients never request information about naloxone availability. Seventy-six percent of respondents reported that naloxone-associated interactions have an influence on the way they communicate with patients in community pharmacy settings. Thematic analyses found that pharmacy students identify the importance of naloxone as a life-saving medication and the need for naloxone training, but patient-perceived stigma and limited access to naloxone remain prevalent. Pharmacy students are generally well-versed and inclined toward distributing, counseling on, and administering naloxone. Naloxone is rarely dispensed and patient conversations involving naloxone are infrequent in community settings. Future efforts focused on approaches toward difficult patient conversations and normalization of naloxone are needed to destigmatize and facilitate use

Importance of pharmacist-patient relationship in people living with HIV and concomitant opioid use disorder

Background: PLWHA commonly suffer from chronic pain that is often treated with opioids, leading to subsequent opiate use disorders. As the majority of Americans live in close proximity to a pharmacy, community pharmacists are well equipped to interact with PLWHA. Few data quantify the needs of PLWHA with OUD, or how they utilize community pharmacists. Objectives: To characterize the perceptions of Persons Living with HIV/AIDS (PLWHA) and using opioid medications on the interaction with pharmacists. Methods: For this study, a qualitative approach was used. A key purpose of interviews is to encourage and inspire the subject to share a significant event of his/her life with the interviewer. Recruitment for face-to-face interviews with PLWHA continued until saturation was achieved. The Theory of Planned Behavior was used to assess the findings from this study. Sixteen interviews were transcribed verbatim and content analysis was performed by two researchers using Dedoose®, a qualitative software. Codes were grouped based on similarities into categories that facilitated the emergence of themes. Results: Content analysis revealed two major themes. The first theme presents the subjects\u27 beliefs and opinions about pharmacists\u27 interactions when picking up their opioid prescriptions. Several subjects described encounters with the pharmacists that facilitated a trustful relationship. In the second theme, the analysis showed that the relationship with community pharmacists could be improved by having a more in-depth counseling about opioid medication and abuse. Conclusions: These data highlight how PLWHA would like to interact with pharmacists when picking up opioid prescriptions. These results depicted how some subjects are using the pharmacists as a vital resource for medication information. These findings also demonstrated how for some subjects a more detailed counseling session when they receive opioid medications could be crucial in changing their behavior. Thus, community pharmacists are well positioned to reduce the usage of opioid medications and change PLWHA behavior and attitudes toward opioid prescriptions