Systematic mining of patterns of polysubstance use in a nationwide population survey.

OBJECTIVES: To identify patterns of association and transition in polysubstance use based on National Survey of Drug Use and Health (NSDUH) in the United States. METHODS: We developed a new computational platform for PolySubstance Use data Mining for Associations and Transitions (PSUMAnT). It is based on the computation of weighted support, a measure of popularity, for the use of every combination of one or more substances, termed as a drugset, over a period of 5 decades (1965-2014) based on NSDUH data. It uses an efficient bitstring representation with exact and approximate string matching capabilities to search for patterns of association between drugsets and demographics of user groups at different time-intervals. Moreover, it introduces a quantitative definition of a rule of transition between pairs of substances used within a given time-interval, and provides a function for mining them. RESULTS: We identified the frequent drugsets from individual substance use database, and determined their representation among different demographic groups at different intervals. An interesting pattern of use of pain relievers and tranquilizers was detected for the age-group of 26-34 years. In addition, transition rules for heroin use in the last decade (2004-2015) of the given data were mined. CONCLUSIONS: Computation of weighted supports over time for every possible combination of substances in the survey, and their association with specific user groups, allows PSUMAnT to generate and test novel, interesting hypotheses in polysubstance use. PSUMAnT can be used for mining combinations of substances used among diverse demographic groups including those that have received less attention in this problem.

Comparing Environmental Policies to Reduce Pharmaceutical Pollution and Address Disparities.

Pharmaceutical products, including active pharmaceutical ingredients and inactive ingredients such as packaging materials, have raised significant concerns due to their persistent input and potential threats to human and environmental health. Discourse on reducing pharmaceutical waste and subsequent pollution is often limited, as information about the toxicity of pharmaceuticals in humans is yet to be fully established. Nevertheless, there is growing awareness about ecotoxicity, and efforts to curb pharmaceutical pollution in the European Union (EU), United States (US), and Canada have emerged along with waste disposal and treatment procedures, as well as growing concerns about impacts on human and animal health, such as through antimicrobial resistance. Yet, the outcomes of such endeavors are often disparate and involve multiple agencies, organizations, and departments with little evidence of cooperation, collaboration, or oversight. Environmental health disparities occur when communities exposed to a combination of poor environmental quality and social inequities experience more sickness and disease than wealthier, less polluted communities. In this paper, we discuss pharmaceutical environmental pollution in the context of health disparities and examine policies across the US, EU, and Canada in minimizing environmental pollution.

Evaluating Students' COVID-19 Knowledge, Attitudes and Practices (COVKAP) during the COVID-19 Pandemic.

The COVID-19 pandemic led to significant disruption in students' lives through lockdowns, restricted movement, remote instruction, and mixed information. Therefore, this study aimed to capture the knowledge, attitudes, and practices of student pharmacists during 2020-2021. A 43-item COVID-19 Knowledge, Attitudes, and Practices (COVKAP) survey previously developed was administered at four schools of pharmacy across the U.S. during Fall 2020 and Spring 2021. A total of 418 responses were analyzed from graduating classes of 2021-2024. There were no significant differences in correct COVID-19 knowledge responses across the four graduating years. Respondents' attitudes around COVID-19 were homogenous with the exception for their belief in their preparedness to administer COVID-19 vaccines. Respondents reported wearing masks daily (76.8%), infrequently visiting restaurants (82.1%), practicing social distancing daily (45.7%), and referring to medical journals for information (72%). In conclusion, during the pandemic, student pharmacists experienced significant changes in their academic lives. Their knowledge and subsequent attitudes and practices were consistent with the state of evidence during Fall 2020 and Spring 2021. Subsequently, as newer information has emerged, the authors suggest that the COVKAP survey may be modified and administered frequently to address student needs and concerns as the pandemic evolves.

Quo vadis? Short-term medical missions in a globalized world and the role of pharmacy.

Short-term medical missions (STMMs) have evolved in the past few decades to provide non-emergent care including routine and follow-up primary care for acute and chronic conditions, along with treatment of neglected tropical diseases. Many STMMs operate outside the local health care infrastructure and may have limited local partnerships. STMM outcomes in improving local population health are often inferred but not well documented. Concerns such as ethical conduct, provider bias, and lack of adequate training and preparation continue to be raised. When disruptions occur (e.g., the COVID-19 pandemic), STMMs need to develop and prepare for challenges such as the inability to travel and provide care. Pharmacists as health professionals play a unique role when volunteering in STMMs. However, pharmacists' roles in STMMs need further development along with a framework to guide STMM work. Often driven by a few dynamic individuals, STMMs need to be aware of local geo-socio-political issues and develop local partnerships toward a meaningful legacy of building sustaining, long-lasting systems that will continue to serve others beyond the life of the STMMs and their founders.

Circular functional analysis of OCT data for precise identification of structural phenotypes in the eye.

Progressive optic neuropathies such as glaucoma are major causes of blindness globally. Multiple sources of subjectivity and analytical challenges are often encountered by clinicians in the process of early diagnosis and clinical management of these diseases. In glaucoma, the structural damage is often characterized by neuroretinal rim (NRR) thinning of the optic nerve head, and other clinical parameters. Baseline structural heterogeneity in the eyes can play a key role in the progression of optic neuropathies, and present challenges to clinical decision-making. We generated a dataset of Optical Coherence Tomography (OCT) based high-resolution circular measurements on NRR phenotypes, along with other clinical covariates, of 3973 healthy eyes as part of an established clinical cohort of Asian Indian participants. We introduced CIFU, a new computational pipeline for CIrcular FUnctional data modeling and analysis. We demonstrated CIFU by unsupervised circular functional clustering of the OCT NRR data, followed by meta-clustering to characterize the clusters using clinical covariates, and presented a circular visualization of the results. Upon stratification by age, we identified a healthy NRR phenotype cluster in the age group 40-49 years with predictive potential for glaucoma. Our dataset also addresses the disparity of representation of this particular population in normative OCT databases.

Student Pharmacists during the Pandemic: Development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey.

BACKGROUND: The COVID-19 pandemic has caused innumerable changes to all aspects of human life and behavior, including academic life. This study describes the development of a COVID-19 Knowledge, Attitudes, and Practices (COVKAP) Survey among U.S. student pharmacists. The survey was administered at Doctor of Pharmacy programs in three states-Tennessee, Ohio, and Pennsylvania. METHODS: The COVKAP survey-an online cross-sectional survey-was distributed to U.S. student pharmacists enrolled in three different colleges of pharmacy in three states during the fall semester of 2020. The survey was developed using literature review and Dillman's recommendations for survey design. The COVKAP survey consisted of 23 closed and Likert-scale questions, and three open-ended questions. The research team conducted descriptive and inductive thematic analyses on the quantitative and qualitative data, respectively using SPSS (v27) and Dedoose® software. RESULTS: A total of 421 responses were received. Respondents were predominantly female (72%) and White (79%). The average age of respondents was 23.4 years. The qualitative analysis revealed three themes: (1) Wellbeing and mental health struggles; (2) Being part of the decision-making process; (3) Necessity of adequate protection measures. CONCLUSIONS: Preliminary study findings indicate that student pharmacists' concerns and the challenges that they face in their academic pursuits are largely similar across the three states in this study and inform about the importance of recognizing and mitigating the impact of widespread disruption in education. This disruption provides an opportunity for pharmacy academia to examine practices and methods that can be improved upon to help students become successful practitioners.