Curriculum mapping of accredited pharmacy programs in the United States.

INTRODUCTION: No current guidance exists to inform the content area credit hours for doctor of pharmacy (PharmD) programs in the United States (US). METHODS: Public websites were accessed for all Accreditation Council for Pharmacy Education (ACPE) accredited PharmD programs in the US to record the credit hours devoted to drug therapy, clinical skills, experiential learning, scholarship, social and administrative sciences, physiology/pathophysiology, pharmacogenomics, medicinal chemistry, pharmacology, pharmaceutics, and pharmacokinetics/pharmacodynamics in the didactic curricula. Due to the high prevalence of programs that integrate drug therapy, pharmacology, and medicinal chemistry into a single course, we subdivided programs based upon whether drug therapy courses were "integrated" or "non-integrated." A regression analyses was conducted to explore the relationship between each content area and North American Pharmacist Licensure Examination (NAPLEX) pass rates and residency match rates. RESULTS: Data were available for 140 accredited PharmD programs. Drug therapy had the highest credit hours in programs with both integrated and non-integrated drug therapy courses. Programs with integrated drug therapy courses had significantly more credit hours in experiential and scholarship and fewer credit hours in stand-alone courses for pathophysiology, medicinal chemistry, and pharmacology. Credit hours in content areas did not predict NAPLEX pass rate nor residency match success rate. CONCLUSIONS: This is the first comprehensive description of all ACPE accredited pharmacy schools with credit hours broken down by content areas. While content areas did not directly predict success criteria, these results may still be useful to describe curricular norms or inform the design of future pharmacy curricula.

Etiology of subjective taste loss.

BACKGROUND: Taste complaints are commonly encountered in clinical practice. Although changes in taste function may arise from varied etiologies, numerous other factors may impact patients' taste perceptions, the most common of which is olfactory dysfunction. Thus, patients with taste complaints may or may not have measurable deficits in taste function. This poses a challenge to providers faced with evaluation of patients with taste disorders, and may delay diagnosis and management. METHODS: We retrospectively examined records of 1108 patients evaluated at the Virginia Commonwealth University Health System Smell and Taste Clinic and compared patients' subjective taste complaints with results of objective testing of the senses of taste and smell. RESULTS: A total of 358 patients had a subjective taste complaint and results from both gustatory and olfactory function tests. Patients were grouped by subjective complaint as "taste only" (n = 63) or "taste and smell" (n = 295). Of patients reporting a "taste-only" complaint, 25.4% had abnormal gustatory function, whereas 44.4% had abnormal olfactory function. For those reporting taste-and-smell complaints, only 9.5% had abnormal gustatory function, whereas 86.8% had abnormal olfactory function. CONCLUSION: This study supports the hypothesis that patients who present with a taste complaint are more likely to have an underlying olfactory than gustatory impairment. However, those with a taste-only complaint are more likely to have objective gustatory deficits than those with a taste-and-smell complaint. These findings may prove useful to healthcare providers who evaluate patients presenting with complaints of taste loss.

Oxygen consumption of desert pupfish at ecologically relevant temperatures suggests a significant role for anaerobic metabolism.

Oxygen consumption is oftentimes used as a proxy for metabolic rate. However, pupfish acclimated to ecologically relevant temperatures may employ extended periods of anaerobism despite the availability of oxygen-a process we called paradoxical anaerobism. In this study, we evaluated data from pupfish exhibiting stable oxygen consumption. Routine oxygen consumption ([Formula: see text]) of a refuge population derived from Cyprinodon spp. acclimated to 28 and 33 °C was evaluated at the ecologically relevant assay temperatures of between 25 and 38 °C. Different interpretations of the data are available depending on normalization. For instance, [Formula: see text] of smaller fish, measured per fish, was remarkably stable over a wide range of assay temperatures and was not different between acclimation groups. However, when measured on a mass-specific basis, [Formula: see text] in these same smaller fish increases more predictably as temperature increased. [Formula: see text] of refuge fish and the closely related pupfish, C. nevadensis mionectes, measured near their respective acclimation temperatures, were essentially identical. However, [Formula: see text] of 28 °C acclimated fish of both species, when measured at 34 °C, was greater than that of the 33 °C acclimated fish measured at 28 °C. We suggest that this observed 'efficiency' may result from significant anaerobic metabolism use. Experiments investigating factorial aerobic scope ([Formula: see text]/[Formula: see text]) yielded values less than 1 in 21-36% of the 33 °C acclimated fish. These values indicate a substantial contribution of anaerobic metabolism to energy utilization by these fish. However, muscle lactate levels are not elevated in exercising fish-a result that is consistent with paradoxical anaerobism use.

The rotational dynamics of H2 adsorbed in covalent organic frameworks.

A combined inelastic neutron scattering (INS) and theoretical study was carried out on H2 adsorbed in two covalent organic framework (COF) materials: COF-1 and COF-102. These COFs are synthesized from self-condensation reactions of 1,4-benzenediboronic acid (BDBA) and tetra(4-(dihydroxy)borylphenyl)methane (TBPM) molecules, respectively. Molecular simulations of H2 adsorption in COF-1 revealed that the H2 molecules occupy the region between two eclipsed layers of the COF. The most favorable H2 binding site in COF-1 is located between two B3O3 clusters of the eclipsed layers. Two distinct H2 binding sites were identified in COF-102 from the simulations: the B3O3 clusters and the phenyl rings of the tetraphenylmethyl units. Two-dimensional quantum rotation calculations for H2 adsorbed at the considered sites in both COFs resulted in rotational transitions that are in good agreement with those that appear in the corresponding INS spectra. Such calculations were important for interpreting the INS spectra in these materials. Calculation of the rotational potential energy surface for H2 bound at the most favorable adsorption site in COF-1 and COF-102 revealed unusually high rotational barriers that are attributed to the nature of the B3O3 rings. The values for these barriers to rotation are greater than or comparable to those observed in some metal-organic frameworks (MOFs) that possess open-metal sites. This study demonstrates the power of using INS experiments in conjunction with theoretical calculations to gain valuable insights into the nature of the binding sites and, for the first time, the rotational dynamics of H2 adsorbed in COFs.

Exceptional ammonia uptake by a covalent organic framework.

Covalent organic frameworks (COFs) are porous crystalline materials composed of light elements linked by strong covalent bonds. A number of these materials contain a high density of Lewis acid boron sites that can strongly interact with Lewis basic guests, which makes them ideal for the storage of corrosive chemicals such as ammonia. We found that a member of the covalent organic framework family, COF-10, shows the highest uptake capacity (15 mol kg⁻¹, 298 K, 1 bar) of any porous material, including microporous 13X zeolite (9 mol kg⁻¹), Amberlyst 15 (11 mol kg⁻¹) and mesoporous silica, MCM-41 (7.9 mol kg⁻¹). Notably, ammonia can be removed from the pores of COF-10 by heating samples at 200°C under vacuum. In addition, repeated adsorption of ammonia into COF-10 causes a shift in the interlayer packing, which reduces its apparent surface area to nitrogen. However, owing to the strong Lewis acid-base interactions, the total uptake capacity of ammonia and the structural integrity of the COF are maintained after several cycles of adsorption/desorption.

Dorsomedial hypothalamus mediates autonomic, neuroendocrine, and locomotor responses evoked from the medial preoptic area.

Previous studies suggest that sympathetic responses evoked from the preoptic area in anesthetized rats require activation of neurons in the dorsomedial hypothalamus. Disinhibition of neurons in the dorsomedial hypothalamus in conscious rats produces physiological and behavioral changes resembling those evoked by microinjection of muscimol, a GABA(A) receptor agonist and neuronal inhibitor, into the medial preoptic area. We tested the hypothesis that all of these effects evoked from the medial preoptic area are mediated through neurons in the dorsomedial hypothalamus by assessing the effect of bilateral microinjection of muscimol into the DMH on these changes. After injection of vehicle into the dorsomedial hypothalamus, injection of muscimol into the medial preoptic area elicited marked increases in heart rate, arterial pressure, body temperature, plasma ACTH, and locomotor activity and also increased c-Fos expression in the hypothalamic paraventricular nucleus, a region known to control the release of ACTH from the adenohypophysis. Prior bilateral microinjection of muscimol into the dorsomedial hypothalamus produced a modest depression of baseline heart rate and body temperature but completely abolished all changes evoked from the medial preoptic area. Microinjection of muscimol just anterior to the dorsomedial hypothalamus had no effect on autonomic and neuroendocrine changes evoked from the medial preoptic area. Thus, activity of neurons in the dorsomedial hypothalamus mediates a diverse array of physiological and behavioral responses elicited from the medial preoptic area, suggesting that the latter region represents an important source of inhibitory tone to key neurons in the dorsomedial hypothalamus.

A crystalline imine-linked 3-D porous covalent organic framework.

A new crystalline porous three-dimensional covalent organic framework, termed COF-300, has been synthesized and structurally characterized. Tetrahedral tetra-(4-anilyl)-methane and linear terephthaldehyde building blocks were condensed to form imine linkages in a material whose X-ray crystal structure shows five independent diamond frameworks. Despite the interpenetration, the structure has pores of 7.2 A diameter. Thus, COF-300 shows thermal stability up to 490 degrees C and permanent porosity with a surface area of 1360 m(2) g(-1).

Reticular synthesis of covalent organic borosilicate frameworks.

This paper reports the synthesis and characterization of a new crystalline 3D covalent organic framework, COF-202: [C(C6H4)4]3[B3O6 (tBuSi)2]4, formed from condensation of a divergent boronic acid, tetra(4-dihydroxyborylphenyl)methane, and tert-butylsilane triol, tBuSi(OH)3. This framework is constructed through strong covalent bonds (Si-O, B-O) that link triangular and tetrahedral building units to form a structure based on the carbon nitride topology. COF-202 demonstrates high thermal stability, low density, and high porosity with a surface area of 2690 m2 g-1. The design and synthesis of COF-202 expand the type of linkage that could be used to crystallize new materials with extended covalent organic frameworks.

Designed synthesis of 3D covalent organic frameworks.

Three-dimensional covalent organic frameworks (3D COFs) were synthesized by targeting two nets based on triangular and tetrahedral nodes: ctn and bor. The respective 3D COFs were synthesized as crystalline solids by condensation reactions of tetrahedral tetra(4-dihydroxyborylphenyl) methane or tetra(4-dihydroxyborylphenyl)silane and by co-condensation of triangular 2,3,6,7,10,11-hexahydroxytriphenylene. Because these materials are entirely constructed from strong covalent bonds (C-C, C-O, C-B, and B-O), they have high thermal stabilities (400 degrees to 500 degrees C), and they also have high surface areas (3472 and 4210 square meters per gram for COF-102 and COF-103, respectively) and extremely low densities (0.17 grams per cubic centimeter).

Microinjection of prostaglandin E2 and muscimol into the preoptic area in conscious rats: comparison of effects on plasma adrenocorticotrophic hormone (ACTH), body temperature, locomotor activity, and cardiovascular function.

The preoptic area (POA) is thought to play an important role in thermoregulation and fever. Local application of prostaglandin E2 (PGE2) to this region elicits increases in core body temperature, heart rate, and plasma levels of adrenocorticotrophic hormone (ACTH). Similar effects on body temperature and heart rate have also been reported after local application of the GABAA receptor agonist muscimol to the preoptic area. The purpose of this study was to assess and compare the effects of microinjection of PGE2 and muscimol into the preoptic area in the same chronically instrumented conscious rats on plasma levels of ACTH. Injection of either PGE2 (150 pmol/100 nL) or muscimol (20 or 80 pmol/100 nL) into the same sites in the preoptic area evoked increases in body temperature, heart rate, blood pressure, and plasma levels of ACTH, while significant increases in locomotor activity were apparent only after muscimol. These data confirm and extend previous findings and support the notion that neurons in the region of the preoptic area exert tonic inhibition on downstream mechanisms capable of increasing the activity of the hypothalamic-pituitary-adrenal (HPA) axis as well as sympathetic thermogenic and cardiac activity.

Micronutrient deficiencies and gender: social and economic costs.

Vitamin and mineral deficiencies adversely affect a third of the world's people. Consequently, a series of global goals and a serious amount of donor and national resources have been directed at such micronutrient deficiencies. Drawing on the extensive experience of the authors in a variety of institutional settings, the article used a computer search of the published scientific literature of the topic, supplemented by reports and published and unpublished work from the various agencies. In examining the effect of sex on the economic and social costs of micronutrient deficiencies, the paper found that: (1) micronutrient deficiencies affect global health outcomes; (2) micronutrient deficiencies incur substantial economic costs; (3) health and nutrition outcomes are affected by sex; (4) micronutrient deficiencies are affected by sex, but this is often culturally specific; and finally, (5) the social and economic costs of micronutrient deficiencies, with particular reference to women and female adolescents and children, are likely to be considerable but are not well quantified. Given the potential impact on reducing infant and child mortality, reducing maternal mortality, and enhancing neuro-intellectual development and growth, the right of women and children to adequate food and nutrition should more explicitly reflect their special requirements in terms of micronutrients. The positive impact of alleviating micronutrient malnutrition on physical activity, education and productivity, and hence on national economies suggests that there is also an urgent need for increased effort to demonstrate the cost of these deficiencies, as well as the benefits of addressing them, especially compared with other health and nutrition interventions.

Reversing productivity losses from iron deficiency: the economic case.

Iron deficiency anemia (IDA) depresses human productivity, but policymakers do not generally view this effect as an impediment to sustained economic growth. Economic logic should be enfolded in public advocacy for increased investment in the prevention and control of IDA. This paper argues that integrated strategies are required, with each intervention clearly related to particular groups at risk, and benefits carefully calibrated with costs. Protecting women's lives through supplementation has the first call on public resources, but the most productive investments reduce population prevalence at least cost, and these lie with food-based approaches within the competence of the processed food and seed industries. The public and private sectors must embark on modernization of the food industry in developing countries and reorientation of the international agricultural research complex so that iron-enriched essential foods will be affordable and accessible to the poor, especially children. The costs of IDA, the availability of cost-effective strategies and the benefits of sustained iron nutrition improvement to individuals, families and nations are reviewed. The roles of iron supplementation, food fortification, plant breeding and biotechnology, both actual and imminent, are described. The paper concludes that a recast Green Revolution directed toward dietary quality may be the key to enhancing the learning and earning capacity of young people in the developing world.