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Background: Entrustable Professional Activities (EPAs) are the latest addition to a list of professional competencies that pharmacy educational organizations support, and accreditation organizations require, for assessment by colleges and schools of pharmacy. Objective: The study’s objective is to assess the use of Core EPAs in the patient care domain (by practice setting, position, and preceptor status) in contemporary pharmacy practice. Methods: This survey assessed the EPA activities of pharmacists practicing in North Dakota. The pharmacists were asked “how many times in the past 30 days have you delivered the following services in your practice setting?” Response options were: 0, 1, 2, 3, 4, and 5 or more times. Results: Of 990 potential respondents, 457 pharmacists (46.1%) returned a survey, and 107 (10.8%) answered every survey item in the patient care domain. Respondents reported that the highest rated activity items “Collect information to identify a patient's medication-related problems and health-related needs,” and “Analyze information to determine the effects of medication therapy, identify medication-related problems, and prioritize health-related needs” were performed an average of 3.9 times per week (SD=1.8), and 3.8 times per week (SD=2.0), respectively. Both of these items, were reported for 70% of the respondents at 5 or more times per week. For these items, the highest reported practice setting was ‘other’ practice settings (e.g., long-term care, community health centers) followed by chains, hospitals, and independent pharmacies. By position, clinical pharmacists and preceptors reported the highest activity levels for most EPAs and supportive example tasks. Conclusions: This study provides empirical evidence suggesting (but not proving) that EPAs have potential as a means to assess outcomes in pharmacy education and practice. Our study sets the stage for future work that further refines and assesses core EPA activities and supportive example tasks to measure the impact of how this process relates to outcomes of care.

Background: The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objective: To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. Methods: This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Results: Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (P

Regional anaesthesia and analgesia techniques are used to effectively manage acute pain after a variety of surgeries. With the rapid growth of ultrasound-guided procedures, anaesthetists are re-examining regional anaesthesia and analgesia and their roles in pain management. In this evolving field previous published data may not reflect current practice. Therefore, a narrative review of recent literature was undertaken to establish the current utility and efficacy of regional anaesthesia and analgesia for the management of acute pain following surgery. Only prospective randomised controlled trials published between March 2009 and March 2011 with outcome measures of analgesia efficacy were included. Sixty-five randomised controlled trials were identified involving 4841 patients. Regional techniques for the management of knee (26%), abdominal (26%) and shoulder (14%) surgery were most frequently studied. The review provides further evidence that regional anaesthesia and analgesia can offer excellent analgesia with acceptable side-effects for the management of postsurgical pain. In addition, the results of this review support the use of ultrasound guidance when performing regional techniques and continuous catheter techniques to prolong analgesia. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The sequence and progression of alcohol related life events were investigated in a sample of African Americans and compared with findings from a predominantly Caucasian sample. METHODS: Alcohol dependent participants were recruited from treatment facilities. Participants completed the Semi-Structured Assessment for the Genetics of Alcoholism to assess the physical, psychological and social manifestations of alcoholism and related disorders. RESULTS: The sequence and mean age of appearance of alcohol-related life events were similar for this sample of African-American men and women. While there were similarities in the progression of alcohol related life problems between the African American and the Caucasian samples, the frequency of symptom endorsement for most problems was significantly higher in the Caucasian sample. CONCLUSIONS: Identifying ethnic differences in the clinical course of alcohol dependence may be of importance in developing treatment plans and assist in the development of culturally sensitive intervention and prevention programs. [ABSTRACT FROM AUTHOR]

Attitudes and behaviors toward alcohol and other drug (AOD) use were assessed among a subgroup of allied health (AH) and physician assistant (PA) students within two university-based health professions educational institutions in a midwestern state in 1999. AH/PA student response was 423 (77.5%); this included occupational therapy (n = 81; 60.4%), physical therapy [PT] (n = 222; 98.7%), PA (n = 68; 85.0%), and other AH programs (n = 52; 48.1%). In this AH/PA group, a family history of alcohol-related problems was reported by 40.1% and drug-related problems by 11.3%, with 42.5% of respondents reporting one or both. Such histories of family alcohol and drug problems were reported by 47.8% or 18.5% of PA students, respectively. Past-year alcohol, tobacco, and marijuana use were reported, respectively, by 88.1%, 26.1%, and 6.7%. The highest percentage use of marijuana was reported by PT students (9.0%). Past-year blackouts were reported by 21.9%, driving after three or more drinks or any drug use by 49.3%, attendance at class or work under the influence of AOD by 7.8%, patient care under the influence of AOD by 3.3%, lowered grades or job evaluations from AOD use by 5.0%, and AOD-related legal charges by 4.5%. 'Heavy drinking' (defined as consumption of five or more drinks per occasion during the past 2 weeks) was reported by 33.2%. Inadequate AOD education was reported by 55.1%, with 63.6% of PT respondents so reporting. AH and PA educational systems should proactively address student AOD prevention, education, and assistance needs. [ABSTRACT FROM AUTHOR]

Alcohol metabolism involves two key enzymes-alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). There are several types of ADH and ALDH, each of which may exist in several variants (i.e., isoforms) that differ in their ability to break down alcohol and its toxic metabolite acetaldehyde. The isoforms are encoded by different gene variants (i.e., alleles) whose distribution among ethnic groups differs. One variant of ADH is ADH1B, which is encoded by several alleles. An allele called ADH1 B*3 is unique to people of African descent and certain Native American tribes. This allele is associated with more rapid breakdown of alcohol, leading to a transient accumulation of acetaldehyde. African Americans carrying this allele are less likely to have a family history of alcoholism and experience a less rewarding subjective response to alcohol. Moreover, children of mothers with this allele are less vulnerable to alcohol-related birth defects. The enzyme ALDH1 also is encoded by several alleles. Two of these alleles that are found in African Americans-ALDH1 Al *2 and ALDH1 Al *3-may be associated with a reduced risk of alcoholism. [ABSTRACT FROM AUTHOR]

PurposeThe specific aim of this project was to form a partnership between a community health center (CHC) to improve access to exercise for low-income patients with type 2 diabetes.MethodsEligible participants were members of the Siouxland Community Health Center (SCHC), 19 years of age or older, with a diagnosis of type 2 diabetes. Patients were medically waived and received an invitation to exercise at the Siouxland YMCA. An exercise coach (pharmacist, registered nurse, or medical assistant) met with each patient and scheduled and conducted exercise visits for participating patients 2 times each week. Patients' baseline clinical variables were taken and assessed quarterly over a 12-month period.ResultsThis collaboration established an ongoing exercise program with a total of 1297 exercise encounters in a 12-month period. Forty-eight of 130 eligible patients (36.9%) visited the YMCA on at least 1 occasion. Patients were categorized as experimental (56.3%), involved (25%), and regular (18.8%) exercisers. Nine (18.8%) of the 48 patients attended supplementary YMCA exercise encounters. Five (11%) of the 48 patients renewed and purchased a membership at the YMCA and adopted a self-management approach to regular exercise.ConclusionThe creation of a partnership between a community health center and an exercise organization permitted disadvantaged patients with diabetes an affordable exercise program and contributed to improved clinical measurements. The exercise program can be used as a model for other community health centers and health professionals who desire to improve the implementation of an exercise program for patients with diabetes. [ABSTRACT FROM AUTHOR]

STUDY PURPOSE: School principals were surveyed in rural and urban Nebraska schools to compare policies and procedures on school attendance, and to contrast the use of disciplinary procedures for attendance, violence and substance abuse. METHODS: A survey was sent to a 50 percent random sample of Nebraska schools. Respondent school addresses in metropolitan statistical areas (MSA) areas were categorized as urban, and non-MSA respondents were classified as rural area schools. RESULTS: Of the 680 surveys mailed, 464 (68.2 percent) completed surveys were returned. Overall, 86.2 percent of respondents were from rural schools and 13.8 percent from urban schools. A list of disciplinary problems and procedures was reported for a first-time offense by rural and urban schools. Both an 'occasional attendance problem' and a 'chronic attendance problem' were most frequently addressed through parent contact in both urban and rural areas. For 'fighting with another student,' rural schools most commonly reported discipline by teacher, followed by discipline by principal and parent contact. In urban schools, discipline by principal was most common. For 'using drugs other than alcohol or tobacco at school' in both areas, disciplinary procedures included parent contact and short-term suspension. A list of disciplinary problems and procedures was also reported for a second-time offense and third-time offense. For 'fighting with another student,' the most commonly reported procedure was discipline by principal and parent contact for a second-time offense, followed by short-term suspension and long-term suspension for a third-time offense. For 'using drugs other than alcohol or tobacco at school,' for a second time offense was long-term suspension and semester expulsion for a third-time offense. Principals were also asked in an open-response format, what program or procedures were currently in place to prevent violence in their school. Common responses were 'conflict resolution training,' followed by 'the Boys Town social skills and behaviors model' and 'a zero tolerance policy.' CONCLUSIONS: School principals generally reported similar disciplinary actions for most disciplinary problems. For recurrent offenses and for serious problems, principals generally used tougher disciplinary procedures. Some of the discrepancies in disciplinary actions, however, suggest the need for consistent enforcement and communication of policies for both urban and rural schools. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study investigated whether Nebraska schools with Student Assistance Programs (SAP) are associated with reduced adolescent alcohol use and a higher level of academic achievement than students from schools without a SAP. METHODS: In 1992, the Toward a Drug Free Nebraska (TDFN) survey was administered to 3,454 students in grades seven to twelve at eighty-three Nebraska schools. A second survey, the TDFN 'team activity report' collected from each school's team, the presence of a SAP (n = 34 schools) or absence of a SAP (n = 49 schools). Student responses for alcohol use and academic achievements were linked with the presence of a SAP through use of a school identification number on both surveys. RESULTS: Students from schools with a SAP reported a lower use of alcohol in the last thirty days, compared with students from schools without a SAP program (p < 0.05), and they also reported a significant difference in academic achievement (p < 0.05). CONCLUSIONS: While this study used post hoc analysis of data, the results suggest lower alcohol use and higher academic achievement among students from SAP schools. Given SAPs' popularity, these trends suggest that further research should be conducted to demonstrate the effectiveness of student assistance programs. [ABSTRACT FROM AUTHOR]

Xenia2 is a DV cluster actinobacteriophage that infects Gordonia rubripertincta NRRL B-16540. The genome is 68,135bp, has a GC content of 57.9% and 98 predicted protein-coding genes, 33 of which have a predicted function. Xenia2 has a lysis cassette with an endolysin (lysin A) and four different holin-like transmembrane proteins., Competing Interests: The authors declare no conflict of interest.

Background: Limited research exists on impacts of air pollution on non-human mammals, particularly animal athletes such as Thoroughbred racehorses. Athletes have a greater risk of exposure as heightened exertion and increased airflow carry more pollutants deeper into the respiratory tract., Objectives: To provide insights into the impact of ambient air pollution, particularly fine particulate matter (PM 2.5 ), on race speed., Study Design: Retrospective observational study., Methods: Data were obtained from The Jockey Club Information Systems, covering 31 407 winning races by Thoroughbred horses in California spanning 10 years (2011-2020) and evaluated the association between air pollution and winning race speeds. For race days, we collected PM 2.5 data from the nearest U.S. Environmental Protection Agency (EPA) monitoring site within 100 km of each racetrack (n = 12). We assessed the associations between daily average PM 2.5 concentrations and speed of winning horses with linear mixed effects regression. We adjusted for horse characteristics, race-related covariates, temporal indicators (e.g., year), other air pollutants and temperature. We conducted sensitivity analyses by adjusting extreme air pollution days by reassigning values to the 95th percentile value and conducting linear mixed effects regression on series of datasets with incremental cutpoints of PM 2.5 ., Results: In the cutpoint analysis, we found that for PM 2.5 between 4 and 23.6 μg/m 3 , speed decreased 0.0008 m/s (95% CI: -0.0014562 to -0.00018) for every 1 μg/m 3 increase of PM 2.5 ., Main Limitations: Limitations include the use of offsite monitors leading to imprecise exposure measurements, not using training practice data, and generalisability as the study focuses on California racetracks., Conclusion: This study highlights the need to create advisories to safeguard the performance of horses during periods of poor air quality. Further research is recommended to explore additional factors influencing the relationship between air pollution and equine welfare., (© 2024 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.)

The Covid-19 pandemic has highlighted the precarity of urban society, illustrating both opportunities and challenges. Teleworking rates increased dramatically during the pandemic and may be sustained over the long term. For transportation planners, these changes belie the broader questions of how the geography of work and commuting will change based on pandemic-induced shifts in teleworking and what this will mean for society and policymaking. This study focuses on these questions by using survey data ( n  = 2580) gathered in the autumn of 2021 to explore the geography of current and prospective telework. The study focuses on the Greater Golden Horseshoe, the mega-region in Southern Ontario, representing a fifth of Canadians. Survey data document telework practices before and during the pandemic, including prospective future telework practices. Inferential models are used to develop working-from-home scenarios which are allocated spatially based on respondents' locations of work and residence. Findings indicate that telework appears to be poised to increase most relative to pre-pandemic levels around downtown Toronto based on locations of work, but increases in teleworking are more dispersed based on employees' locations of residence. Contrary to expectations by many, teleworking is not significantly linked to home-work disconnect - suggesting that telework is poised to weaken the commute-housing trade-off embedded in bid rent theory. Together, these results portend a poor outlook for downtown urban agglomeration economies but also more nuanced impacts than simply inducing sprawl., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© Urban Studies Journal Limited 2023.)

Purpose of Review: Diabetes mellitus is a chronic medical condition affecting many individuals worldwide and leads to billions of dollars spent within the healthcare system for its treatment and complications. Complications from diabetes include diabetic foot conditions that can have a devasting impact on quality of life. Diabetic foot ulcers and amputations occur in minority individuals at an increased rate compared to Caucasian individuals. This review provides an update examining the racial and ethnic disparities in the management of diabetic foot conditions and the differences in rates of amputation., Recent Findings: Current research continues to show a disparity as it relates to diabetic foot management. There are novel treatment options for diabetic foot ulcers that are currently being explored. However, there continues to be a lack in racial diversity in new treatment studies conducted in the USA. Individuals from racial and ethnic minority groups have diabetes at higher rates compared to Caucasian individuals, and are also more likely to develop diabetic foot ulcers and receive amputations. Over the last few years, more efforts have been made to improve health disparities. However, there needs to be an improvement in increasing racial diversity when investigating new therapies for diabetic foot ulcers., (© 2023. The Author(s).)

In addition to the repulsive and attractive interaction forces described by Derjaguin-Landau-Verwey-Overbeek (DLVO) theory, many charged colloid systems are stabilized by non-DLVO contributions stemming from specific material attributes. Here, we investigate non-DLVO contributions to the stability of polymer colloids stemming from the intra-particle glass transition temperature ( T g ). Flash nanoprecipitation is used to fabricate nanoparticles (NPs) from a library of polymers and dispersion stability is studied in the presence of both hydrophilic and hydrophobic salts. When adding KCl, stability undergoes a discontinuous decrease as T g increases above room temperature, indicating greater stability of rubbery NPs over glassy NPs. Glassy NPs are also found to interact strongly with hydrophobic phosphonium cations (PR 4 + ), yielding charge inversion and intermediate aggregation while rubbery NPs resist ion adsorption. Differences in the lifetime of ionic structuration within mobile surface layers is presented as a potential mechanism underlying the observed phenomenon.

Hedgehogs occur within an urban mammal guild in the United Kingdom. This guild commonly utilizes anthropogenic food provision, which is potentially beneficial to wild animal populations, but may also bring competitors and predators into proximity, raising the question of how these species interact in urban gardens. In this study, we determined interactions between hedgehogs, foxes, badgers, and domestic cats using videos submitted via citizen science. We analyzed interactions within and between species to determine interaction type, hierarchical relationships, and effect of supplementary food presence/amount. We found that overall agonistic interactions between individuals occurred more frequently (55.4%) than neutral interactions (44.6%) and that interspecific interactions showed greater agonism (55.4%) than intraspecific ones (36%). Within intraspecific interactions, those between hedgehogs were the most agonistic (54.9%) and between badgers the least (6.7%). Species composition of the interaction affected agonism, with interactions between cats and foxes showing the highest level (76.7%). In terms of overall "wins", where access to garden resources was gained, badgers dominated cats, which were dominant or equal to foxes, which dominated hedgehogs. However, hedgehogs exhibited a greater overall proportion of wins (39.3%) relative to cats. Our findings are important in the context of the documented impact of patchy resources on urban wildlife behavior, and we show that provision of anthropogenic food can potentially result in unintended consequences. We recommend actions to reduce proximity of guild competitors in space and time to limit negative effects.

Polymeric colloids have shown potential as "building blocks" in applications ranging from formulations of Pickering emulsions and drug delivery systems to advanced materials, including colloidal crystals and composites. However, for applications requiring tunable properties of charged colloids, obstacles in fabrication can arise through limitations in process scalability and chemical versatility. In this work, the capabilities of flash nanoprecipitation (FNP), a scalable nanoparticle (NP) fabrication technology, are expanded to produce charged polystyrene colloids using sulfonated polystyrene ionomers as a new class of NP stabilizers. Through experimental exploration of formulation parameters, increases in the ionomer content are shown to reduce the particle size, mitigating a significant trade-off between the final particle size and inlet concentration; thus, expanding the processable material throughput of FNP. Further, the degree of sulfonation is found to impact stabilization with optimal performance achieved by selecting ionomers with intermediate (2.45-5.2 mol %) sulfonation. Simulations of single ionomer chains and their arrangement in multicomponent NPs provide molecular insights into the assembly and structure of NPs wherein the partitioning of ionomers to the particle surface depends on the polymer molecular weight and degree of sulfonation. By combining the insights from simulations with diffusion-limited growth kinetics and parametric fits to experimental data, a simple design formulation relation is proposed and validated. This work highlights the potential of ionomer-based stabilizers for controllably producing charged NP dispersions in a scalable manner.

Breast cancer screening decreases stage at diagnosis, treatment morbidity, and disease mortality. A comprehensive risk assessment is critical to determine an individual's most appropriate screening regimen. Multiple guidelines exist for screening mammography in average-risk individuals, which differ on age and frequency of screening. Annual mammography starting at age 40 is associated with the greatest reduction in breast cancer mortality and greatest number of life-years saved. A formal risk calculator is helpful to assess one's lifetime risk of breast cancer and assess eligibility for high-risk screening. Screening guidelines exist for genetic mutations that increase breast cancer risk., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Inflammatory disorders of the breast are common benign breast conditions. Lactational mastitis occurs in breastfeeding women and may be associated with breast abscess in severe cases. Non-lactational inflammatory disorders are less common and include idiopathic granulomatous mastitis, periductal mastitis, and tuberculous mastitis. While these disorders have some similarities in their presentation, each disorder requires a specific treatment regimen for resolution, and correct diagnosis is crucial for appropriate treatment. In this chapter, we will review the presentation, diagnosis, and management of each of these distinct clinical entities., Competing Interests: Declaration of competing interest The author has no conflicts of interest., (Copyright © 2021. Published by Elsevier Ltd.)

A groundwater monitoring network surrounding a pumping well (such as a public water supply) allows for early contaminant detection and mitigation where possible contaminant source locations are often unknown. This numerical study investigates how the contaminant detection probability of a hypothetical sentinel-well monitoring network consisting of one to four monitoring wells is affected by aquifer spatial heterogeneity and dispersion characteristics, where the contaminant source location is randomized. This is achieved through a stochastic framework using a Monte Carlo approach. A single production well is considered that results in converging non-uniform flow close to the well. Optimal network arrangements are obtained by maximizing a weighted risk function that considers true and false positive detection rates, sampling frequency, early detection, and contaminant travel time uncertainty. Aquifer dispersivity is found to be the dominant parameter for the quantification of network performance. For the range of parameters considered, a single monitoring well screening the full aquifer thickness is expected to correctly and timely identify at least 12% of all incidents resulting in contaminants reaching the production well. This proportion increases to a global maximum of 96% for a network consisting of four wells and very dispersive transport conditions. Irrespective of network size and sampling frequency, more dispersive transport conditions result in higher detection rates. Increasing aquifer heterogeneity and decreasing aquifer spatial continuity also lead to higher detection rates, though these effects are diminished for networks of 3 or more wells. Statistical anisotropy has no effect on the network performance. Earlier detection, which is critical for remedial action and supply safety, comes with a significant cost in terms of detection rate, and should be carefully considered when a monitoring network is being designed., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The Centers for Disease Control and Prevention recognized the need for educational materials for clinicians on the prevention and early diagnosis of gynecologic cancers. The American College of Obstetricians and Gynecologists convened a panel of experts in evidence review from the Society for Academic Specialists in General Obstetrics and Gynecology and content experts from the Society of Gynecologic Oncology to review relevant literature, best practices, and existing practice guidelines for the development of evidence-based educational materials for women's health care clinicians about uterine cancer. This article is the evidence summary of the literature review of health disparities and inequities related to uterine cancer. Substantive knowledge gaps are noted and summarized to provide guidance for future research., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

The Centers for Disease Control and Prevention recognized the need for educational materials for clinicians on the prevention and early diagnosis of gynecologic cancers. The American College of Obstetricians and Gynecologists convened a panel of experts in evidence review from the Society for Academic Specialists in General Obstetrics and Gynecology and content experts from the Society of Gynecologic Oncology to review relevant literature, best practices, and existing practice guidelines as a first step toward developing evidence-based educational materials for women's health care clinicians about uterine cancer. Panel members conducted structured literature reviews, which were then reviewed by other panel members and discussed at a virtual meeting of stakeholder professional and patient advocacy organizations in January 2021. This article is the evidence summary of the relevant literature and existing recommendations to guide clinicians in the prevention, early diagnosis, and special considerations of uterine cancer. Substantive knowledge gaps are noted and summarized to provide guidance for future research., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: Improve appropriate and timely administration of rapid acting antihypertensive medication for the management of hypertensive emergency in pregnancy with utilization of an automated electronic health record (EHR) alert in an academic birthplace., Study Design: An automated alert was incorporated into an existing EHR that notified providers of a documented severe range blood pressure, defined as systolic blood pressure (SBP) ≥ 160 mmHg or diastolic blood pressure (DBP) ≥ 110 mmHg. Retrospective chart review was utilized to evaluate appropriate intervention before and after implementation of the alert (referred to as pre-implementation and post-implementation cohorts)., Main Outcome Measures: The primary outcome was appropriate administration of rapid-acting antihypertensive medication for the management of hypertensive emergency. Secondary outcomes included: appropriate administration of intravenous (IV) magnesium sulfate for seizure prophylaxis, initiation of oral antihypertensive medication postpartum, and appropriate timing of follow up for blood pressure evaluation following discharge., Results: Of 98 patients identified as having hypertensive emergency in the pre-implementation cohort, 34 (35%) received treatment with a rapid acting antihypertensive medication within one hour compared with 54 of 104 (55%) of patients in the post-implementation cohort (35% vs 55%, RR 1.40 95% CI 1.07-1.82). Significantly more patients followed up for a blood pressure check within one week of discharge (41% vs 31%; p = 0.02). There was not a significant effect on the administration of IV magnesium sulfate or initiation of oral medications postpartum., Conclusion: An automated EHR alert improved timely administration of rapid-acting antihypertensive medications for hypertensive emergency and has the potential to improve compliance with national preeclampsia guidelines., (Copyright © 2021 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Polymer colloids arise in a variety of contexts ranging from synthetic to natural systems. The structure of polymeric colloids is crucial to their function and application. Hence, understanding the mechanism of structure formation in polymer colloids is important to enabling advances in their production and subsequent use as enabling materials in new technologies. Here, we demonstrate how the specific pathway from precipitation to vitrification dictates the resulting morphology of colloids fabricated from polymer blends. Through continuum simulations, free energy calculations, and experiments, we reveal how colloid structure changes with the trajectory taken through the phase diagram. We demonstrate that during solvent exchange, polymer-solvent phase separation of a homogeneous condensate can precede polymer-polymer phase separation for blends of polymers that possess some degree of miscibility. For less-miscible, higher-molecular-weight blends, phase separation and kinetic arrest compete to determine the final morphology. Such an understanding of the pathways from precipitation to vitrification is critical to designing functional structured polymer colloids., Competing Interests: The authors declare no competing financial interest., (© 2021 The Authors. Published by American Chemical Society.)

Introduction : The use of orthobiologics as supplemental treatment for foot and ankle pathologies have increased in the past decades. They have been used to improve the healing of bone and soft tissue injuries. There have been several studies that examined the use of biologics for knee and hip pathologies but the foot and ankle construct has unique features that must be considered. Areas covered : The biologics for foot and ankle injuries that are covered in this review are platelet-rich plasma (PRP), stem cells, growth factors, hyaluronic acid, bone grafts, bone substitutes, and scaffolds. These modalities are used in the treatment of pathologies related to tendon and soft tissue as well as cartilage. Expert opinion : The utilization of biological adjuncts for improved repair and regeneration of ankle injuries represents a promising future in our efforts to address difficult clinical problems. The application of concentrated bone marrow and PRP each represents the most widely studied and commonly used injection therapies with early clinical studies demonstrating promising results, research is also being done using other potential therapies such as stem cells and growth factors; further investigation and outcome data are still needed.

African Americans (AA) have lower prevalence of alcohol dependence and higher subjective response to alcohol than European Americans. Genome-wide association studies (GWAS) have identified genes/variants associated with alcohol dependence specifically in AA; however, the sample sizes are still not large enough to detect variants with small effects. Admixture mapping is an alternative way to identify alcohol dependence genes/variants that may be unique to AA. In this study, we performed the first admixture mapping of DSM-IV alcohol dependence diagnosis, DSM-IV alcohol dependence criterion count, and two scores from the self-rating of effects of ethanol (SRE) as measures of response to alcohol: the first five times of using alcohol (SRE-5) and average of SRE across three times (SRE-T). Findings revealed a region on chromosome 4 that was genome-wide significant for SRE-5 (p value = 4.18E-05). Fine mapping did not identify a single causal variant to be associated with SRE-5; instead, conditional analysis concluded that multiple variants collectively explained the admixture mapping signal. PPARGC1A, a gene that has been linked to alcohol consumption in previous studies, is located in this region. Our finding suggests that admixture mapping is a useful tool to identify genes/variants that may have been missed by current GWAS approaches in admixed populations., (© 2020 Wiley Periodicals, LLC.)

Objective: To assess how pet owners perceive the role of veterinary medicine in addressing climate change and animal health and determine if there is a client-driven economic incentive to establish sustainable veterinary business practices. Sample: 1,044 dog and/or cat owners residing in the United States who had used veterinary services within the last 3 years. Procedures: An online Amazon mTurk survey about climate change and the perceived effects on client-owned dogs and cats was distributed to pet owners. Results: Most respondents believe climate change is occurring, and two-thirds of pet owners would value knowing their veterinarian received training on the animal health impacts of climate change. Over half of the respondents would pay more for veterinary services at a clinic with a reduced environmental impact. Additionally, clients would value some form of sustainability certification to aid in identification of such practices. Demographic influences found to be statistically significant included age, political ideology and where one resides (i.e., urban, suburban, or rural) whereas gender and income level, were not found to be significant. Conclusions and Clinical Relevance: Our data suggest there is an economic incentive for veterinary professionals to be knowledgeable about the health impacts of climate change and to implement and market sustainable practice initiatives. Prioritizing sustainable practice initiatives and climate change education in veterinary practices has the potential to mutually benefit both practitioner and client through shared patient health and financial incentives., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Deluty, Scott, Waugh, Martin, McCaw, Rupert, Webb, Baumgarn, Carpenter and Duncan.)

Objective: To quantify the use of the interprofessional team member (ITM) domain of entrustable professional activities (EPAs) by North Dakota pharmacists across practice sites, roles in practice, and by preceptor status., Methods: Survey methods were used to characterize the self-reported frequency with which pharmacists undertake core EPAs and supporting tasks in the ITM domain. The survey was administered to registered pharmacists practicing in North Dakota (n=990) during the fall of 2018, of which 457 (46.1%) responded. After eliminating responses with incomplete or missing information, 119 responses were available for analysis., Results: For the overall EPA ITM domain, "Collaborate as a member of an interprofessional team population" pharmacists reported performing these activities an average (mean) of 3.3 times per month (SD=2.3). Within this domain, the highest reported example activity was "Use setting appropriate communication skills when interacting with others" (mean=4.1, SD 1.8), followed by "Communicate a patient's medication-related problem(s) to another health professional" (mean=3.3, SD 2.0), and "Contribute medication-related expertise to the team's work" (mean=3.1, SD=2.2). ITM domain and supporting example activities were performed at a greater rate in hospitals, community health centers and long-term-care facilities. For most items, preceptors reported a greater use of activities, than did non-preceptors., Conclusions: North Dakota pharmacists currently complete tasks outlined in the ITM domain of the EPAs, although their contributions are varied by task, role, and preceptor status., Competing Interests: CONFLICT OF INTEREST The authors report no conflict of interest in the conduction of this study or the preparation of this manuscript., (Copyright: © Pharmacy Practice and the Authors.)

Monte Carlo uncertainty analysis, model calibration and optimization applications in hydrology, usually involve a very large number of forward transient model solutions, often resulting in computational bottlenecks. Parallel processing can significantly reduce overall simulation time, benefiting from the architecture of modern computers. This work investigates system performance using two realistic flow and transport modeling scenarios, applied to various modeling hardware, to provide information on the expected performance of parallel simulations and inform investment decisions. We investigate how performance, measured in terms of speedup and efficiency, changes with increasing number of parallel processes. We conclude that the maximum performance achieved by parallelization can range from 40% to 100% of the theoretical limit, with the lower increases associated with multi-CPU servers. The number of parallel processes required to maximize performance is application dependent, and in contrast to common practice, often needs to be significantly larger than the total number of system CPU cores. Further testing is required to better understand how the physical problem being simulated affects the optimal number of parallel processes needed. Finally, when laptops are considered for modeling applications, careful consideration should be given not only to the specifications but also to the intended use designated by the manufacturer., (© 2020, National Ground Water Association.)

The white rhinoceros ( Ceratotherium simum ) is experiencing unsustainable poaching losses fuelled by a demand for horn. Increasingly, private and state reserves are dehorning their rhinoceros populations in an attempt to reduce poaching pressure. Rhinoceroses use their horns in social interactions as well as during resource access and so its partial removal as part of reserve management practices may adversely influence these behaviours. Physiological stress can correlate with animal welfare, reproductive state and health and thus acts as a useful indicator of these parameters. To establish whether dehorning causes a physiological stress response, glucocorticoid and gonadal steroid profiles of free-ranging white rhinoceroses were determined through the collection and analysis of faecal steroid metabolites before and after dehorning. Faecal corticoid profiles were not influenced by the number of occasions a rhinoceros had been dehorned or by the number of days that had elapsed since dehorning. Furthermore, there was no apparent suppression in the concentrations of testosterone or progesterone metabolites in males and females, respectively, after exposure to multiple dehorning procedures. These findings should increase wildlife managers' confidence that dehorning does not negatively impact white rhinoceros physiology as measured hormonally., (© The Author(s) 2020. Published by Oxford University Press and the Society for Experimental Biology.)