Drug and Alcohol Rehabilitation: Multiscale Simulation as a Framework for the Enhanced Design of Nanodiamond-Polyethylenimine-Based Gene Delivery.

Multiscale Simulation as a Framework for the Enhanced Design of Nanodiamond-Polyethylenimine-based Gene Delivery.

Filed under: Drug and Alcohol Rehabilitation

J Phys Chem Lett. 2012 Dec 4; 3(24): 3791-3797
Kim H, Man HB, Saha B, Kopacz AM, Lee OS, Schatz GC, Ho D, Liu WK

Nanodiamonds (NDs) are emerging carbon platforms with promise as gene/drug delivery vectors for cancer therapy. Specifically, NDs functionalized with the polymer polyethylenimine (PEI) can transfect small interfering RNAs (siRNA) in vitro with high efficiency and low cytotoxicity. Here we present a modeling framework to accurately guide the design of ND-PEI gene platforms and elucidate binding mechanisms between ND, PEI, and siRNA. This is among the first ND simulations to comprehensively account for ND size, charge distribution, surface functionalization, and graphitization. The simulation results are compared with our experimental results both for PEI loading onto NDs and for siRNA (C-myc) loading onto ND-PEI for various mixing ratios. Remarkably, the model is able to predict loading trends and saturation limits for PEI and siRNA, while confirming the essential role of ND surface functionalization in mediating ND-PEI interactions. These results demonstrate that this robust framework can be a powerful tool in ND platform development, with the capacity to realistically treat other nanoparticle systems.
HubMed – drug

 

Improving the accuracy of therapy descriptions in clinical trials using a bottom-up approach.

Filed under: Drug and Alcohol Rehabilitation

AMIA Annu Symp Proc. 2012; 2012: 1393-402
Tong M, Taira RK

Randomized clinical trial (RCT) reports commonly have complicated therapy descriptions that are written in free-text. Drug therapy is difficult to describe due to the dynamic nature of how protocols change and the many ways drugs can be administered. Details regarding protocol changes and drug administration must be explained clearly for reproducibility and reliability. A process model supplemented with concept ontologies can clarify the dynamics of how therapies change and make knowledge more explicit. We demonstrated the process to develop a representation model to reveal specific context concerning drug therapies within clinical trial report literature. A PubMed search was conducted to identify RCTs on non-small-cell lung cancer (NSCLC) pertaining to epithelial growth factor receptor (EGFR) mutations. Twenty-seven clinical trials were used to develop the model using a bottom-up approach. This representation describes drug dosage, administration details, and drug cycles within different experimental arms and control groups. We then presented preliminary evaluation of the clarity and understandability of the representation.
HubMed – drug

 

“I meant that med for Baylee not Bailey!”: A mixed method study to identify incidence and risk factors for CPOE patient misidentification.

Filed under: Drug and Alcohol Rehabilitation

AMIA Annu Symp Proc. 2012; 2012: 1294-301
Levin HI, Levin JE, Docimo SG

Computerized physician order entry (CPOE) systems can create unintended consequences. These include medication errors and adverse drug events. We look at a less understood error; patient misidentification. First, two email surveys were used to establish potential risk factors for this error. Next, an automated detection trigger was designed and validated with inpatient medication orders at a large pediatric hospital. The incidence was 0.064% per medication ordered. Finally, a case-control study identified the following as significant risk factors on multivariate analysis: patient age, last name spelling, bed proximity, medical service, time/date of order, and ordering intensity. These results can be used to improve patient safety by increasing awareness of high risk situations and guiding future research.
HubMed – drug

 

Methods for Identifying Suicide or Suicidal Ideation in EHRs.

Filed under: Drug and Alcohol Rehabilitation

AMIA Annu Symp Proc. 2012; 2012: 1244-53
Haerian K, Salmasian H, Friedman C

Electronic health records contain important data elements for detection of novel adverse drug reactions, genotype/phenotype identification and psychosocial factor analysis, and the role of each of these as risk factors for suicidality warrants further investigation. Suicide and suicidal ideation are documented in clinical narratives. The specific purpose of this study was to define an algorithm for automated detection of this serious event. We found that ICD-9 E-Codes had the lowest positive predictive value: 0.55 (90% CI: 0.42-0.67), while combining ICD-9 and NLP had the best PPV: 0.97 (90% CI: 0.92-0.99). A qualitative analysis and classification of the types of errors by ICD-9 and NLP automated coding compared to manual review are also discussed.
HubMed – drug

 

Emergency Department Physician Internet Use during Clinical Encounters.

Filed under: Drug and Alcohol Rehabilitation

AMIA Annu Symp Proc. 2012; 2012: 1176-83
Chisholm R, Finnell JT

This study explored the Internet log files from emergency department workstations to determine search patterns, compared them to discharge diagnoses, and the emergency medicine curriculum as a way to quantify physician search behaviors.The log files from the computers from January 2006 to March 2010 were mapped to the EM curriculum and compared to discharge diagnoses to explore search terms and website usage by physicians and students.Physicians in the ED averaged 1.35 searches per patient encounter using Google.com and UpToDate.com 83.9% of the time. The most common searches were for drug information (23.1%) by all provider types. The majority of the websites utilized were in the third tier evidence level for evidence-based medicine (EBM).We have shown a need for a readily accessible drug knowledge base within the EMR for decision support as well as easier access to first and second tier EBM evidence.
HubMed – drug

 

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