Impact of high-stakes exams, incentives, and preparation on student performance: Insights from the pharmacy curriculum outcomes assessment.

INTRODUCTION: Efforts to ensure success of pharmacy students in passing pharmacy standardized exams require substantial investments. Engaging students effectively can be a challenge when there are no consequences for non-participation or poor performance. This study examined how engagement reinforcement, including high-stake exam requirements, instructional strategies, and incentives, impacted student performance on the Pharmacy Curriculum Outcomes Assessment (PCOA). METHODS: PCOA scores, milestone exams, grade point averages (GPAs), and PCOA preparedness assessments for cohorts (Co) that received high-stakes exams, incentives, and preparation (Co2019, Co2020, and Co2021) was compared with those that did not receive these interventions (Co2017 and Co2018). Students' perceptions regarding reinforcement, incentive, and preparedness were evaluated using an anonymous survey. RESULTS: Analyzing data from 545 students over five years, mandated PCOA preparedness, high-stakes PCOA requirements, and incentives for Co2019, Co2020, and Co2021 improved scores by 11% to 18% compared to Co2017 and Co2018. This corresponded to a rise in performance from the 12th to 27th percentile for Co2017 and Co2018 to the 39th to 49th percentile for Co2019, Co2020, and Co2021. In these later cohorts, PCOA scores consistently correlated with the school's milestone exams and students' cumulative GPAs (correlation coefficients 0.47-0.70, P < .001), while no such correlation was observed in Co2017 and Co2018. Faculty-led PCOA preparation yielded better results (48.2% in Co2020, 45.8% in Co2021) than self-learning (42% in Co2019). Students using faculty-prepared assessments reported increased confidence in biomedical and pharmaceutical sciences. CONCLUSIONS: This study highlights the importance of high-stakes requirements, incentives, and thorough preparation in improving PCOA results.

Physical Stability and Release Profile of Compounded Gabapentin Containing Pluronic Lecithin Organogel for Neuropathic Pain Management.

The objective of this study was to evaluate the physical stability and drug-release profile of gabapentin from different compounded formulations of Pluronic lecithin organogel containing gabapentin, thus confirming the stability of the preparations. Eight different formulations of compounded Pluronic lecithin organogel containing gabapentin alone or gabapentin in combination with other drugs were prepared using the cold incorporation method. Organoleptic properties, pH values, rheology, and gelation temperature were studied at 1, 7, and 14 days after preparation. The release of gabapentin out of Pluronic lecithin organogel was measured by diffusion across cellulose membranes (0.45 um) in the Franz diffusion cell system. The organoleptic properties were constant during the stability study in all formulations. The values of pH varied depending on the formulation, with slight increases after the the 7th day of the study. Gelation temperature, rheology, and drug release of gabapentin out of Pluronic lecithin organogel were remarkably dependent on the nature of combination in formulations during the time of assay. Formulations of Pluronic lecithin organogel containing only gabapentin or gabapentin with another drug were physically stable for 14 days. However, 3- and 4-combined drug formulations demonstrated an altered pseudoplastic behavior and instability during the study period.

Student perceptions of the utility of the Pharmacy Curriculum Outcomes Assessment.

INTRODUCTION: This study assessed student perceptions, preparation, and result use strategies of the Pharmacy Curriculum Outcomes Assessment (PCOA). Secondarily, it studied the effect of schools/colleges of pharmacy (S/COP) PCOA management on student perceptions. METHODS: A 52-item electronic questionnaire assessed PCOA preparation of final year students, review/use of results, remediation participation, self-reported motivation, and perceptions of the exam's ability to measure PCOA blueprint areas and North American Pharmacy Licensure Examination (NAPLEX)/advanced pharmacy practice experience (APPE) readiness. Programs were given a questionnaire to determine their PCOA practices. RESULTS: The student survey was completed by 341 students (40% response rate). Students prepared very little for the PCOA and few reported participation in PCOA-based remediation (6%). Students perceived the PCOA to measure the four domains moderately well, although administrative sciences were significantly lower. Students reported less confidence in the exam's ability to measure APPE/NAPLEX-readiness. Although few used the PCOA to guide their NAPLEX preparation (18%), they were more likely to do so than for APPEs (4%). Students reported a higher perceived increase in motivation if PCOA results were connected to APPE placement, remediation, and progression as opposed to prizes, rewards, or other recognitions. CONCLUSION: This is the first multi-institutional study to review student perceptions about the PCOA. These data can be used along with other PCOA data to help schools develop incentive, remediation, and examination administration procedures depending on the programs desired use for the PCOA exam.

Gabapentin in Elastic Liposomes: Preparation, Characterization, Drug Release, and Penetration Through Porcine Skin.

In the outpatient pharmacy compounding, gabapentin, an anti-epileptic agent, has been commonly prescribed to be prepared alone or in combination with other agents in Pluronic lecithin organogel for transdermal pain management and palliative care. The objective of this study was to formulate and characterize gabapentin encapsulated elastic liposomes and then compare the gabapentin-based liposomes with compounded gabapentin-based Pluronic lecithin organogel regarding their efficiency in transdermal delivery of gabapentin. We demonstrated that our small 100-nm unilamellar vesicles of gabapentin encapsulated approximately 6.9 mg/mL Å} 0.2 mg/mL with up to 70% of encapsulation efficiency. Gabapentin released slowly from liposomes over 12 hours while it rapidly released from Pluronic lecithin organogel within 4 hours. We also showed that after 24 hours liposomes significantly accelerated the percutaneous penetration of gabapentin through the porcine skin leading to higher cumulative drug concentrations (~98% of drug permeated with a mean flux of 188.94 µg/cm2/h Å} 42.16 µg/cm2/h) as compared to Pluronic lecithin organogel (~55 % of drug permeated with a mean flux of 56.32 µg/cm2/h Å} 41.93 µg/cm2/h). In conclusion, the elastic liposomal formulation showed higher efficiency than the compounded Pluronic lecithin organogel in the transdermal delivery of gabapentin through porcine skin.

Enhanced selective cellular uptake and cytotoxicity of epidermal growth factor-conjugated liposomes containing curcumin on EGFR-overexpressed pancreatic cancer cells.

Pancreatic cancer is one of the most malignant cancers with a high mortality rate. Some types of pancreatic cancer cells overexpress epidermal growth factor receptor (EGFR), which is a potential target for anticancer agents. In this study, we examined the effect of epidermal growth factor (EGF)-conjugated liposomes containing curcumin (EGF-LP-Cur) on three different EGFR-expressed human pancreatic cancer cell lines, BxPC-3, Panc-1 and Mia Paca-2. We have demonstrated that it is feasible to prepare liposomal vesicles of EGF-LP-Cur and that it is stable in the liquid vehicle at ambient conditions for three weeks. In addition, the formulation of curcumin had higher cytotoxicity on BxPC-3 than on any other cells. It is also shown that the cellular uptake of curcumin on BxPC-3, which is essential for the cytotoxicity, is associated with EGFR-mediated mechanism of action. In summary, our results have showed that targeting EGFR with EGF-conjugated curcumin liposomes enhanced the antitumor activity of curcumin against human pancreatic cancer cells.

Coordination of Cell Cycle Progression and Mitotic Spindle Assembly Involves Histone H3 Lysine 4 Methylation by Set1/COMPASS.

Methylation of histone H3 lysine 4 (H3K4) by Set1 complex/COMPASS is a hallmark of eukaryotic chromatin, but it remains poorly understood how this post-translational modification contributes to the regulation of biological processes like the cell cycle. Here, we report a H3K4 methylation-dependent pathway in Saccharomyces cerevisiae that governs toxicity toward benomyl, a microtubule destabilizing drug. Benomyl-sensitive growth of wild-type cells required mono- and dimethylation of H3K4 and Pho23, a PHD-containing subunit of the Rpd3L complex. Δset1 and Δpho23 deletions suppressed defects associated with ipl1-2 aurora kinase mutant, an integral component of the spindle assembly checkpoint during mitosis. Benomyl resistance of Δset1 strains was accompanied by deregulation of all four tubulin genes and the phenotype was suppressed by tub2-423 and Δtub3 mutations, establishing a genetic link between H3K4 methylation and microtubule function. Most interestingly, sine wave fitting and clustering of transcript abundance time series in synchronized cells revealed a requirement for Set1 for proper cell-cycle-dependent gene expression and Δset1 cells displayed delayed entry into S phase. Disruption of G1/S regulation in Δmbp1 and Δswi4 transcription factor mutants duplicated both benomyl resistance and suppression of ipl1-2 as was observed with Δset1 Taken together our results support a role for H3K4 methylation in the coordination of cell-cycle progression and proper assembly of the mitotic spindle during mitosis.

A thermo-sensitive polymeric gel containing a gadolinium (Gd) compound encapsulated into liposomes significantly extended the retention of the Gd in tumors.

Gadolinium neutron capture therapy (Gd-NCT) is a promising approach to fight cancer. One key factor for the success of Gd-NCT is to deliver and maintain a sufficient amount of Gd inside tumors. A large amount of Gd can be readily introduced into tumors by direct intratumor injection. However, an innovative approach is needed to maintain the Gd in the tumors. We encapsulated a Gd compound into a liposome formulation and then dispersed the liposomes into a thermo-sensitive polymeric gel. In murine tumor models, we showed that this liposome-in-thermo-sensitive gel system significantly extended the retention of the Gd compound in tumors. This similar concept may be applied to prolong the retention of other cytotoxic chemicals in tumors, and thus, improve their anti-tumor efficacy.