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Research plays a vital role in advancing the pharmacy profession and improving patient care. It is a fundamental skill for learners to develop during their training under guided mentorship. Incorporating learners into research and quality improvement (QI) projects can yield numerous benefits for the learner, mentor, and institution. Despite this, there are barriers to integrating learners into research and QI projects which may stem from institutions and individuals. To ensure success when engaging in the research process, strategies centered around clear communication and illustrating the value should be implemented. Successful research programs require planning strategically, setting clear expectations, providing mentorship, and remaining adaptable to overcome barriers encountered during the process. The purpose of this paper is to discuss barriers to incorporating learners into research and QI projects and provide both mentors and learners strategies, tips and examples for success with perspectives and opinions from the American College of Clinical Pharmacy Adult Medicine and Education and Training Practice Research Networks. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ydbio.2004.03.031 Byline: Meredith L. Howard, Eric H. Davidson Keywords: cis-Regulatory module; Gene regulatory network; Repression; Feedback loop Abstract: During development, an organism undergoes many rounds of pattern formation, generating ever-greater complexity with each ensuing round of cell division and specification. The instructions for executing this process are encoded in the cis-regulatory modules that direct the expression of developmental transcription factors and signaling molecules. Each transcription factor binding site within a cis-regulatory module contributes information about when, where, or how much a gene is turned on, and by dissecting the modules driving a given gene, all the inputs governing expression of the gene can be accurately identified. Furthermore, by mapping the output of each gene to the inputs of other genes, it is possible to reverse engineer developmental circuits and even whole networks. At this higher level of organization, common bilaterian strategies for specifying progenitor fields, locking down regulatory states, and driving development forward emerge. Article History: Received 20 January 2004; Revised 20 March 2004; Accepted 20 March 2004

An essential node in the gene regulatory network (GRN) for endomesoderm specification in the sea urchin embryo lies within the regulatory system of the otx gene. According to the predictions of the GRN, based on perturbation analysis and expression data, the [beta]1/2 transcription unit of this gene is engaged during specification in interactions with two other regulatory genes, krox and gatae. It is predicted to be driven into activity by the krox gene, to form a positively reinforcing functional loop with the gatae gene, and to respond to its own output as well. Here we isolate the relevant otx cis-regulatory element, and examine the specific input predictions of the GRN at the level of its genomic DNA sequence. This [beta]1/2-otx regulatory module performs the necessary functions, as shown by use of expression constructs. It requires gatae, otx, and krox inputs, as predicted, and it operates as an 'AND' logic processor in that removal of any one of these inputs essentially destroys activity. The necessary target sites were identified in the module sequence, and mutation of these sites was demonstrated to produce the same respective effects on construct expression as does blocking its regulatory inputs by treatment with morpholino anti-sense oligonucleotides. For spatial expression in the endoderm, one particular pair of Gata sites is essential and these function synergistically with an adjacent Otx site. We thus demonstrate directly the structure/function relationships of the genomic regulatory code, at this key node of the endomesoderm GRN. Keywords: Gene regulatory network; otx; krox; gatae; Endomesoderm specification; Sea urchin embryo

This commentary addresses key differences between remote and on‐site experiential education, including necessary resources and rotation structure. Health care education during the COVID‐19 pandemic was primarily delivered electronically. Student‐based resources such as computers/laptops, stable internet connections, and privacy (physical space and electronic security) became essential for student learning, testing, and provision of patient care. When student resources were limited, educational programs had to adapt to help students in need. Preceptors were required to restructure experiential rotations to provide learning experiences while keeping up with increased clinical‐related workloads. Students had increased projects and papers and decreased face‐to‐face time with patients and professionals. Many community pharmacies were able to educate students on‐site, whereas ambulatory care–based sites generally pivoted to telehealth‐based interactions. Although telehealth appeared useful, rollout was difficult because of differences in technology, accessibility, and capability. Inpatient‐based training proved most difficult and often had to be halted for patient and student safety. Many schools also used unique non–patient care electives to fill experiential gaps and keep students on target for graduation. Delivery of experiential education had a different set of challenges from didactic education. Creative examples to address these challenges included roving tablets with Zoom sessions during rounds, artificial or de‐identified cases, and hybrid clinical/dispensing rotations, though most experiences were canceled or restricted by exclusion of patients with COVID‐19 patients. Overall, pharmacy education continued. However, many of the methods for training with partly or entirely remote approaches were novel and may become integrated into the "new normal." The face of the world has changed, and pharmacy education must change with it. [ABSTRACT FROM AUTHOR]

Purpose: To review the effects of statin use in patients at risk for or diagnosed with Clostridium difficile infection (CDI) on CDI incidence, treatment success, and mortality. Methods: A literature search was performed through January 2019 using the following terms: statins, HMG-CoA inhibitors, Clostridium difficile, Clostridium difficile associated diarrhea, and Clostridium difficile infection. Additional references were identified from a review of literature citations. Studies evaluating statin effects on C difficile -related outcomes were included. Results: A total of 8 studies were identified for inclusion in this review. All studies were retrospective. Five studies reported the association between statin use and the development of CDI, suggesting that statins may decrease risk of CDI development in patients already on statin. In one study, there was an improved treatment response against CDI with the use of statin. Three retrospective studies evaluated statin use and mortality from CDI and only one study found significant mortality benefit in statin users. Conclusions: Statin use may have a protective effect against the development of CDI and improve CDI treatment success; however, it is unclear if use confers a mortality benefit. Current data remain sparse and larger, prospective studies are needed to confirm current results and identify the specific population that may benefit the most from this intervention. [ABSTRACT FROM AUTHOR]

Background: Continuous infusion ketorolac is sometimes utilized for analgesia in postoperative coronary artery bypass graft (CABG) patients despite contraindications for use. Limited literature surrounds this topic; therefore, this study was conducted to evaluate the safety of this practice., Methods: This retrospective cohort study evaluated the primary outcome of mortality and secondary outcomes of incidence of bleeding and myocardial infarction (MI). All patients who underwent isolated CABG surgeries and received continuous infusion ketorolac during the study period were included. An equal number of randomly selected isolated CABG patients served as control patients. Electronic medical records and the Society of Thoracic Surgeons (STS) database were utilized to determine baseline characteristics and outcomes; Results: One hundred and seventy-eight patients met inclusion; 89 in each group. More patients in the control group underwent on-pump surgeries (78.6% vs. 29.2%, p = 0.01) and had higher STS risk scores (1.1% vs. 0.6%, p = 0.003). There was no difference in mortality between the ketorolac group and control group (2.2% vs. 3.3%, p = 0.605). Additionally, no patients experienced a MI and there was no difference in bleeding incidence (5.5% vs. 6.7%, p = 0.58); Conclusions: No association was found between continuous infusion ketorolac and increased risk of mortality, MI, or bleeding events in postoperative CABG patients. Considerations to differences in baseline characteristics must be made when interpreting results.