ABSTRACT
The emergence of the "4th Industrial Revolution," i.e. the convergence of artificial intelligence, the Internet of Things, advanced materials, and bioengineering technologies, could accelerate socioeconomic insecurities and anxieties or provide beneficial alternatives to the status quo. In the post-Covid-19 era, the entities that are best positioned to capitalize on these innovations are large firms, which use digital platforms and big data to orchestrate vast ecosystems of users and extract market share across industry sectors. Nonetheless, these technologies also have the potential to democratize ownership, broaden political-economic participation, and reduce environmental harms. We articulate the potential sociotechnical pathways in this high-stakes crossroads by analyzing cellular agriculture, an exemplary 4th Industrial Revolution technology that synergizes computer science, biopharma, tissue engineering, and food science to grow cultured meat, dairy, and egg products from cultured cells and/or genetically modified yeast. Our exploration of this space involved multi-sited ethnographic research in both (a) the cellular agriculture community and (b) alternative economic organizations devoted to open source licensing, member-owned cooperatives, social financing, and platform business models. Upon discussing how these latter approaches could potentially facilitate alternative sociotechnical pathways in cellular agriculture, we reflect upon the broader implications of this work with respect to the 4th Industrial Revolution and the enduring need for public policy reform.
ABSTRACT
In an effort to identify novel antithrombotics, we have investigated protease-activated receptor 4 (PAR4) antagonism by developing and evaluating a tool compound, UDM-001651, in a monkey thrombosis model. Beginning with a high-throughput screening hit, we identified an imidazothiadiazole-based PAR4 antagonist chemotype. Detailed structure-activity relationship studies enabled optimization to a potent, selective, and orally bioavailable PAR4 antagonist, UDM-001651. UDM-001651 was evaluated in a monkey thrombosis model and shown to have robust antithrombotic efficacy and no prolongation of kidney bleeding time. This combination of excellent efficacy and safety margin strongly validates PAR4 antagonism as a promising antithrombotic mechanism.
Subject(s)
Benzofurans/pharmacology , Fibrinolytic Agents/pharmacology , Hemorrhage/prevention & control , Receptors, Thrombin/antagonists & inhibitors , Thrombosis/prevention & control , Animals , Benzofurans/chemistry , Benzofurans/pharmacokinetics , Biological Availability , Disease Models, Animal , Fibrinolytic Agents/chemistry , Fibrinolytic Agents/pharmacokinetics , HEK293 Cells , Hemorrhage/metabolism , Humans , Macaca fascicularis , Models, Chemical , Molecular Structure , Platelet Aggregation/drug effects , Receptors, Thrombin/genetics , Receptors, Thrombin/metabolism , Structure-Activity Relationship , Thrombosis/metabolismABSTRACT
PURPOSE: The impact of telepharmacy in a multihospital health system was evaluated. SUMMARY: Telepharmacy services were implemented at five hospitals within a Catholic, nonprofit, integrated delivery network health system. Telepharmacy services were provided by seven pharmacists employed by the health system. Using a virtual private network or terminal server, pharmacists directly accessed hospital servers and information systems to conduct their work. Telephone calls were automatically routed to the telepharmacist so that handling of nursing and other calls would be transparent to staff. Hours of telepharmacy service were 5 p.m. to 2 a.m. Monday through Friday evenings at four of the hospitals and 8 p.m. to 10 p.m. at the rural hospital. Order-processing time for routine orders was reduced from 26.8 to 14 minutes (p < 0.0001), while stat order processing was shortened from 11.6 to 8.8 minutes (p = 0.007). For routine orders, turnaround times greater than 60 minutes became almost nonexistent after telepharmacy services were implemented. The number of clinical interventions documented increased by 42%, from 619 to 881, equivalent to a net annualized saving of $1,132,144. A significant improvement in nurses' global satisfaction with pharmacist availability for unit consultations was reported (3.0 versus 4.0 on a 5.0 Likert scale; p = 0.028). CONCLUSION: The implementation of telepharmacy services in a multihospital health system expanded hours of service, improved the speed of processing of physician medication orders, and increased clinical pharmacy services and cost avoidance. Surveys of health care staff found that telepharmacy services were well received.
