Mentorship may offer protégés numerous benefits including improved self-esteem, increased interest in research, and/or enhanced productivity Without proper planning, reflection, and evaluation, however, mentorship programs may result in undesirable consequences In this paper we describe a mentorship program designed to improve psychosocial support and professional development for residents, that while initially successful, was terminated due to perceptions of inequity that led to strife among residents and ultimately created a toxic learning climate  https//wwwselleckchemcom/products/Rapamycinhtml  Leader-member exchange theory provides a lens through which to view our program's failure and to offer some potential solutions to mitigate such challenges for other programs Leader-member exchange theory focuses on the importance of relationships, communication, and awareness of biases to optimize interactions between dyads such as a mentor and a protégé We highlight opportunities during the stranger, acquaintance, and mature partnership phases that could have helped to save a residency mentorship programBackground One of the main roles of the medical information MI department within a pharmaceutical company is to develop scientific/standard response documents SRDs to provide comprehensive medical information to healthcare providers HCPs This study seeks to gain HCP feedback on the various elements in the format of an SRD Methods This study surveyed 400 healthcare providers 200 physicians, 100 pharmacists, and 100 nurse practitioners/advanced practice nurses and physician assistants regarding their opinions and preferences on the structure, content, layout, and delivery options of SRDs The survey also included questions assessing where HCPs access their medical information, their trust in the medical information they receive from MI Departments, and alternative methods for receiving medical information Results HCPs often self-search for medical information via an electronic device, which allows for SRDs to serve as a key resource HCPs, who had prior contact with a pharmaceutical company's MI department, have a high degree of trust in the SRDs that they had received However, perception of bias can have an impact on their level of trust HCPs prefer all relevant data such as real-world evidence, adverse drug reactions, and clinical trial data, while abstracts and data on file may not be needed, but the overall length should only be three to five pages HCPs find value in various SRD formatting characteristics, such as charts, tables, and infographics Conclusions Overall, HCPs seek medical information resources, such as SRDs, to aid in the delivery of personalized patient care HCPs prefer SRDs to be concise, but include comprehensive, unbiased medical information Through HCP feedback, MI Departments of pharmaceutical companies can continue to develop and update their SRDs to increase uptake and potentially impact clinical practiceBackground Vericiguat is a stimulator of soluble guanylate cyclase currently under investigation as a first-in-class therapy for worsening chronic heart failure NCT02861534 Patients with heart failure often require polypharmacy because of comorbidities Hence, understanding the clearance mechanisms, elimination, and potential for pharmacokinetic drug-drug interactions of vericiguat is important for dose recommendations in this patient population Methods Biotransformation and perpetrator properties of vericiguat were characterized in vitro using human hepatocytes, liver microsomes, and recombinant enzymes This was complemented by a human mass balance study and ten drug-drug interaction studies in healthy volunteers wherein vericiguat was co-administered orally with omeprazole, magnesium/aluminum hydroxide, ketoconazole, rifampicin, mefenamic acid, midazolam, warfarin, digoxin, sacubitril/valsartan, aspirin, or sildenafil Results In the human mass balance study, mean total radioactivity recovered was 983 of the dose administered 531 and 452 excreted via urine and feces, respectively The main metabolic pathway of vericiguat is glucuronidation via uridine diphosphate-glucuronosyltransferase 1A9 and 1A1 In vitro studies revealed a low risk of vericiguat acting as a perpetrator by inhibiting cytochrome P450s, uridine diphosphate-glucuronosyltransferase isoforms, or major transport proteins, or by inducing cytochrome P450s These observations were supported by phase I drug-drug interaction studies Phase I studies that assessed the propensity of vericiguat as a victim drug showed changes in the range that did not warrant recommendations for dose adjustment in phase III Conclusions A low pharmacokinetic interaction potential of vericiguat was estimated from in vitro data and confirmed in vivo Thus, vericiguat is suitable for a patient population with multiple comorbidities requiring polypharmacyPurpose We sought to determine the prevalence of low arousal threshold LAT in veterans with post-traumatic stress disorder PTSD and whether or not LAT is associated with decreased use of continuous positive airway pressure CPAP Methods We conducted a retrospective study of all veterans with documented PTSD who had an apnea hypopnea index gt; 5/h over a 27-month period Demographic, clinical characteristics, and CPAP usage were extracted from the medical records A multivariate analysis was conducted to assess predictors of CPAP use at 3 months in patients with LAT after adjusting for severity of PTSD Results LAT was identified in 55 of 119 patients with PTSD and newly diagnosed OSA LAT was associated with younger age odds ratio [OR] 091; 95 confidence interval [CI] 086-095, lower BMI OR 082; 95 CI 073-091, presence of insomnia OR 134; 95 CI 119-181, and use of antidepressant OR 114; 95 CI 109-201 PTSD severity, REM rebound, and the presence of baseline comorbid insomnia were each associated with CPAP use at 3 months Neither daytime sleepiness, body mass index BMI, nor LAT endotype was correlated with CPAP utilization Insomnia was the only factor associated with decreased CPAP use in patients with PTSD and LAT P = 004 Conclusion The LAT endotype is common among veterans with PTSD An improved understanding of how insomnia in this population affects CPAP utilization would be instrumental in designing targeted therapy to improve sleep qualityPurpose Obstructive sleep apnea hypopnea syndrome has been reported to be associated with pulmonary hypertension PH Adiponectin Ad has many protective roles in the human body, including its function as an anti-inflammatory and an anti-oxidant, as well as its role in preventing insulin resistance and atherosclerosis This study aimed to investigate the molecular mechanism of chronic intermittent hypoxia CIH-induced pulmonary injury and the protective role of Ad in experimental rats Methods Thirty male Sprague-Dawley rats were randomly divided into three groups with 10 rats in each group normal control NC group, CIH group, and CIH + Ad group Rats in the NC group were kept breathing room air for 12 weeks link2 Rats in the CIH group were intermittently exposed to a hypoxic environment for 8 h/day for 12 weeks Rats in the CIH + Ad group received 10 μg Ad twice weekly via intravenous injection After 12 weeks of CIH exposure, we detected the pulmonary function, pulmonary artery pressure, lung histology, pulmuse abnormal pulmonary function or PH, early lung injury was detected at the molecular level in rats exposed to CIH Treatment with Ad ameliorated the pulmonary injury by activating the SIRT3/SOD2 pathway, reducing ROS generation, and inhibiting ROS-associated lung cell apoptosisPurpose Pulse oximetry is the current standard for detecting drops in arterial blood oxygen saturation SpO2 associated with obstructive sleep apnea and hypopnea events in polysomnographic PSG testing However, cellular energy monitoring CE monitoring, a measure related to cellular hypoxia in the skin, is likely to be more responsive to inadequate breathing during sleep because during hypoxic challenge, such as occurs during apneic events, regulatory mechanisms restrict blood flow to the skin to preferentially maintain SpO2 for more vital organs We carried out initial proof of concept testing to determine if CE monitoring has promise for being more responsive to hypoxic challenge occurring during sleep-disordered breathing SDB than pulse oximetry Methods We assessed both CE monitoring and pulse oximetry in a series of conditions which affect oxygen supply 1 breathing nitrogen or 100 oxygen, 2 physical exertion, and 3 studying a night of sleep in an individual known to be a loud snorer We also present the results of a preliminary study comparing CE monitoring to pulse oximetry in eight individuals undergoing standard clinical overnight polysomnography for suspected SDB Results CE monitoring is responsive to changes in cellular oxygen supply to the skin and detects hypoxia during SDB events that is not detected by pulse oximetry Conclusion CE monitoring is a promising tool for identifying pathology at the mild end of the SDB spectrumVitamin D deficiency is widespread in geriatric patients While vitamin D deficiency is prevalent in about 50 of healthy older adults, the prevalence in geriatric patients with hip fracture increases to over 80 This is partly due to the fact that sunlight is unreliable as the main source of vitamin D In addition to insufficient sun intensity from November to April, skin aging plays an important role; it causes a 4-fold reduction in the skin's own vitamin D production during sunshine exposure in older adults compared with younger people link3 Immobility and institutionalization are additional risk factors for vitamin D deficiency in geriatric patients At the same time, vitamin D deficiency  less then 20 ng/ml increases parathyroid hormone levels and thus promotes bone loss and the risk of fracture Severe vitamin D deficiency  less then 10 ng/ml may also lead to reversible muscle weakness resulting in an increased risk of falling Since falls affect at least every second geriatric patient and hip fractures increase exponentially after the age of 75, the correction of vitamin D deficiency is an important medical and public health effort in these patients Several randomized intervention trials, comparing 800-1000 IU vitamin D/day versus placebo or calcium, showed a significant reduction in falls and hip fractures in adults ≥65 years of age who had an increased risk of vitamin D deficiency and of falls or fractures In geriatric patients, implementing vitamin D supplementation at this dosage is currently preferred A bolus dose of over 24,000 IU/month should be avoided due to the increased risk of falls and fractures These recommendations remain relevant after a critical review of the four most recent meta-analysesMany important biological functions and processes are reflected in cell and tissue mechanical properties such as elasticity and viscosity However, current techniques used for measuring these properties have major limitations, such as that they can often not measure inside intact cells and/or require physical contact-which cells can react to and change Brillouin light scattering offers the ability to measure mechanical properties in a non-contact and label-free manner inside of objects with high spatial resolution using light, and hence has emerged as an attractive method during the past decade This new approach, coined "Brillouin microscopy," which integrates highly interdisciplinary concepts from physics, engineering, and mechanobiology, has led to a vibrant new community that has organized itself via a European funded COST Action network Here we share our current assessment and opinion of the field, as emerged from a recent dedicated workshop In particular, we discuss the prospects towards improved and more bio-compatible instrumentation, novel strategies to infer more accurate and quantitative mechanical measurements, as well as our current view on the biomechanical interpretation of the Brillouin spectra