MATILDA.FT: A mesoscale simulation package for inhomogeneous soft matter.

In this paper, we announce the public release of a massively parallel, graphics processing unit (GPU)-accelerated software, which is the first to combine both coarse-grained particle simulations and field-theoretic simulations in one simulation package. MATILDA.FT (Mesoscale, Accelerated, Theoretically Informed, Langevin, Dissipative particle dynamics, and Field Theory) was designed from the ground-up to run on CUDA-enabled GPUs with Thrust library acceleration, enabling it to harness the possibility of massive parallelism to efficiently simulate systems on a mesoscopic scale. It has been used to model a variety of systems, from polymer solutions and nanoparticle-polymer interfaces to coarse-grained peptide models and liquid crystals. MATILDA.FT is written in CUDA/C++ and is object oriented, making its source-code easy to understand and extend. Here, we present an overview of the currently available features, and the logic of parallel algorithms and methods. We provide the necessary theoretical background and present examples of systems simulated using MATILDA.FT as the simulation engine. The source code, along with the documentation, additional tools, and examples, can be found on the GitHub MATILDA.FT repository.

Poor tolerability of cystic fibrosis transmembrane conductance regulator modulator therapy in lung transplant recipients.

Elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) is a highly effective therapy for patients with cystic fibrosis (CF) with potential benefits in lung transplant recipients (LTRs) for extrapulmonary CF manifestations; however, tolerability and efficacy in this population are largely unknown. We report our experience with ELX/TEZ/IVA in LTRs for extrapulmonary complications of CF including tolerability, drug-drug interactions, and therapeutic benefit. All LTRs at a single center initiated on ELX/TEZ/IVA were reviewed. Adverse events and patient-reported outcomes attributed to ELX/TEZ/IVA were documented. Pulmonary function, tacrolimus requirements in mg/kg/dl, body mass index (BMI), and reason for initiation were assessed at the initiation of ELX/TEZ/IVA, and at 12 months post-initiation or at the time of discontinuation for those in whom therapy was discontinued. Thirteen LTRs were initiated on ELX/TEZ/IVA at a mean of 115 ± 92 months post-transplant. All were initiated on ELX/TEZ/IVA for sinus or sinus and gastrointestinal CF manifestations. Five (38.4%) patients discontinued therapy due to declining pulmonary function (2/5, 40%), mood disturbances (2/5, 40%), or lack of benefit (1/5, 20%). Of the eight patients who remain on ELX/TEZ/IVA, four reported adverse effects and three LTRs temporarily held therapy. Six (46.2%) LTRs reported improvement in sinus symptoms, while four (30.7%) reported improved gastrointestinal symptoms. Weight declined in the cohort overall. Tacrolimus dose requirements decreased following initiation of ELX/TEZ/IVA therapy, with a 50% decline in dose requirements observed. In our experience, ELX/TEZ/IVA in LTRs is poorly tolerated with modest perceived extrapulmonary benefit and a significant effect on tacrolimus dose requirements. More data are needed to determine the benefits of ELX/TEZ/IVA therapy in LTRs.

A Practical Review for Implementing Peer Assessments Within Teams.

Objective. The objective of this review is to maximize the benefit of peer assessments in teamwork settings in professional pharmacy curricula.Findings. Best practices do not exist for using peer assessments in academic settings. The studies on peer assessments that we reviewed applied various conditions: Some studies used peer assessments of teams for formative assessments, while others used them for summative assessments; some assessed teamwork at a limited number of time points, while some assessed multiple time points; some attached student names to the assessments, while some were anonymous; and some explained why the tool was being used, while others offered no explanation.Conclusion. To use peer assessments most beneficially, instructors must define the purpose for their use, explain the purpose of teamwork, orient students to the tool being used, assess teamwork over time, provide feedback, minimize grades associated with the assessment, and use partial anonymity when collecting feedback.

Impact of a Nurse Care Coordinator Supporting a Clinical Pharmacist Practitioner in Further Managing HCV-Infected Patients.

Patients undergoing chronic hepatitis C treatment require monitoring to ensure that treatment is both safe and effective. However, many of these patients are lost to follow-up. The aim of this study was to investigate the impact of implementing a Nurse Care Coordinator's role in a pharmacy-based collaborative team to enhance the care of hepatitis C-infected patients. This was a 6-month retrospective chart review from July 2018 to January 2019, where 116 patients receiving hepatitis C treatment were referred to the Nurse Care Coordinator for further management. The Nurse Care Coordinator provided more than a 5-fold increase in contact method by telephone call. Of the 116 referred hepatitis C-infected patients, 44.8% (n = 52) of patients were referred due to a missed post-treatment Week 12 follow-up appointment to assess for cure. The Nurse Care Coordinator successfully rescheduled 96.2% (50/52) of follow-up appointments to assess for cure; 90% (45/50) of those patients adhered to scheduled appointment; and 97.8% (44/45) of patients had undetectable hepatitis C virus RNA, indicating cure. The primary success rate of the intended Nurse Care Coordinator arrangement was 97.4% (n = 113), where 89.4% (101/113) of patients successfully adhered to the intervention. This study demonstrates the positive impact the Nurse Care Coordinator had in successfully re-engaging previously lost to follow-up patients back into clinic.

Creep attenuation in glassy polymer nanocomposites with variable polymer-nanoparticle interactions.

The use of nanoparticle reinforced polymer matrices in continuous fiber composites for infrastructure applications requires a comprehensive understanding of viscoelastic creep. Critical parameters affecting the mechanical reinforcement offered by nanoparticles include nanoparticle size and concentration, as well as the interaction between the nanoparticle surface and polymer matrix. Here, we study the viscoelastic creep of nanocomposite systems comprised of glassy thermoplastic polymers and spherical silica nanoparticles of varying sizes and surface functionalization using a dynamic mechanical analysis (DMA) accelerated testing methodology. Significant differences in the nanoparticle dispersions in these nanocomposites were observed via transmission electron microscopy (TEM) and small-angle X-ray scattering (SAXS) and are attributed to differences in the polymer-polymer and polymer-particle interaction strengths. The DMA measurements indicate a decrease in compliance at short times with increased nanoparticle loading that is largely independent of nanoparticle dispersion morphology and polymer-particle interaction strength. Conversely, long term creep behavior shows a much stronger dependence on these parameters with the creep onset time increasing by up to three orders of magnitude. For similar nanoparticle loadings, the time to critical deformation in systems with well-distributed, networked nanoparticle morphologies was larger by an order of magnitude compared to systems exhibiting strong nanoparticle aggregation. The networked systems delayed the time to critical deformation by three orders of magnitude over that of neat polymer. The increase in time to critical deformation is also greater in composites with smaller nanoparticles at similar loadings, which we attribute to the development of percolated nanoparticle networks. These results demonstrate the significant effects polymer-particle interactions and dispersion morphologies can have on the long-term creep compliance of thermoplastic nanocomposites.

Incorporating Oral Health Considerations for Medication Management in Care Transitions.

Transitions of care involve multifaceted considerations for patients, which can pose significant challenges if factors like oral health are overlooked when evaluating medication management. This article examines how oral health factors should be considered in medication management of patients who may be at risk for hospital readmission. This article also explores successes and challenges of a pharmacy consult service integrated into a dental clinic practice, and the opportunities within that setting to improve overall patient outcomes including those related to care transitions.