Application Timeline Research Articles

Inclusion of Histopathology in Dose Range-Finding Nonclinical Studies for Inhaled Drug Products.

Drug development is a lengthy process that promotes and protects the health and safety of future patients. Nonclinical safety studies follow essentially similar designs that fulfill regulatory requirements but are amended based on factors including the mechanism of action, class of molecule, and route of administration. Clinical observations, clinical pathology, and macroscopic pathology in dose range-finding (DRF) studies generally provide sufficient information to select doses for pivotal studies by most delivery routes. Inhaled drug candidates are recognized for producing adverse effects on the respiratory system at the microscopic level that may otherwise be unpredictable; therefore, unlike other routes of administration, inhalation DRF studies typically include histopathology of the respiratory tract. Histopathology evaluations can add several weeks to the Investigational New Drug (IND) application timeline along with additional costs but have been considered necessary to support accurate dose selection for adequate safety margins, thereby potentially avoiding additional studies and animal usage by ensuring achievement of a NOAEL in the pivotal studies. Therefore, DRF inhalation studies initiated from 2018 to 2021 at Labcorp were reviewed to determine whether inclusion of histopathology on preliminary inhalation studies was necessary for subsequent dose selection. Histopathology findings in the DRF impacted dose selection in pivotal inhalation studies for approximately 45% of rat and dog studies. This review identified histopathology findings in rat and dog that support continued inclusion of respiratory tract histopathology in DRF studies. Future investigations will evaluate potential surrogate endpoints for these findings, which could reduce nonclinical drug development timelines by several weeks.

Formation of creative thinking of schoolchildren using interactive timelines in the conditions of additional education

The problem and the aim of the study. Preparing a graduate who can apply acquired knowledge in practice in new non-standard situations is one of the key tasks facing a digital school teacher. The information environment of additional education makes it possible to organize didactic interaction with online tools in a special way, during which its participants receive opportunities to demonstrate creativity and generate original ideas and solutions. The purpose of the study is to identify the potential of using interactive time tapes in classes in the additional education system to develop the creative thinking of schoolchildren. Research methods. The methodology is based on an analysis of the didactic possibilities of additional education and interactive services for the formation of creative thinking; on clarifying the training program and ways of organizing activities in the classroom when creating timelines. To develop a timeline, an online application Timeline JS is used. The experiment involved 60 schoolchildren from the creativity studios “Word” and “Miniature” (Russian Federation). To assess the maturity of creative thinking, the “Test of Divergent (Creative) Thinking” technique is used (author – F. Williams, adaptation – E. E. Tunik). For statistical processing of data, Pearson's χ2 (chi-square) criterion is used. Results. An important feature of the proposed work system is the integration of timelines into various areas of the studio activities: social-pedagogical, technical, physical education and sports, etc. Schoolchildren from the experimental group study according to the following plan: studying ready-made timelines; analysis of relevant Internet resources; creation of an interactive scale; discussion of the designed timeline; foresight session to identify options for its possible application. Statistically significant differences were revealed in the qualitative changes that occurred in the pedagogical system (χ2 = 6.154; p < 0.05). In conclusion, the possibilities of interactive timelines for the development of creative thinking are formulated: reusability; retrospective and multimedia presentation, etc. The difficulties that complicate the use of online services are described: time costs, the need to develop criteria for systematically assessing the effectiveness of using interactive applications for the appropriate purpose, etc.

The Neuromuscular Portal and Match: Working Toward a More Fair, Equitable, and Transparent Process.

Prior to 2021, the neuromuscular medicine fellowship application process suffered from non-standardized timelines and substantial variability. To rectify this, the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) established a standardized application timeline and an online application portal in 2020-2021, followed by the introduction of a partial match process. In 2021-2022, AANEM launched a traditional, binding, two-way match system for fellowship positions allocation based on the Gale-Shapley stable matching algorithm. Surveys assessing perceptions of fairness in the application portal and match process were dispatched to applicants and program directors following the 2021 and 2022 recruitment cycles. In the 2020-21 cycle, 90% of program directors and 95% of applicants affirmed the standardized timeline benefited applicants. However, 57% of applicants deemed the process as unfair. All programs and most applicants (58%) favored a transition to a two-way match. The implementation of the two-way match in 2021-22 attracted participation from 97% of programs, with 80% of applicants and 95% of programs viewing the process as fair to applicants. A significant majority of both applicants (86%) and programs (94%) supported maintaining the standardized timeline and two-way match. We advocate for the universal adoption of the AANEM Match for neuromuscular fellowship recruitment and a standardized fellowship application timeline across all neurologic specialties to promote transparency, fairness, and equity for applicants.

Antiracism in Action: Development and Outcomes of a Mentorship Program for Premedical Students Who Are Underrepresented or Historically Excluded in Medicine.

Black, Latinx, and Native American and Alaska Native people are underrepresented in medicine. The increasingly competitive medical school application process poses challenges for students who are underrepresented in medicine or historically excluded from medicine (UIM/HEM). The University of California, San Francisco-University of California, Berkeley (UCSF-UCB) White Coats for Black Lives Mentorship Program provides a novel and antiracist approach to mentorship for these premedical students. The program recruited UIM/HEM premedical and medical students through a survey advertised by email, on the program's website, social media, and by word of mouth. The program paired students primarily with race-concordant mentors, all of whom were UCSF medical students. From October 2020 to June 2021, program mentees engaged in skills-building seminars based on an antiracism framework and received support for preparing medical school applications. The program administered preprogram and postprogram surveys to mentees, which were analyzed via quantitative and qualitative methods. Sixty-five premedical mentees and 56 medical student mentors participated in the program. The preprogram survey received 60 responses (92.3% response rate), and the postprogram survey received 48 responses (73.8% response rate). In the preprogram survey, 85.0% of mentees indicated that MCAT scores served as a barrier "a great deal" or "a lot," 80.0% indicated lack of faculty mentorship, and 76.7% indicated financial considerations. Factors that improved most from preprogram to postprogram were personal statement writing (33.8 percentage-point improvement, P < .001), peer mentorship (24.2 percentage-point improvement, P = .01), and knowledge of medical school application timeline (23.3% percentage-point improvement, P = .01). The mentorship program improved student confidence in various factors influencing the preparation of medical school applications and offered access to skills-building resources that mitigated existing structural barriers.

The Committee on Advanced Subspecialty Training-accredited postgraduate neurosurgery fellowship application experience: a national survey.

The neurosurgery fellowship application process is heterogenous. Therefore, the authors conducted a survey of individuals graduating from Committee on Advanced Subspecialty Training (CAST)-accredited fellowships in the past 5 years to examine 1) experiences with the fellowship application process, 2) perspectives on the process, 3) reasons for pursuing a given subspecialty and fellowship, and 4) post-fellowship practices. A survey querying demographics, experiences with and perspectives on the fellowship application process, and factors contributing to the pursuit of a given fellowship was distributed to individuals who had graduated from CAST-accredited fellowships in the past 5 years. The survey response period was May 22, 2021-June 22, 2021. Of 273 unique individuals who had graduated from CAST-accredited fellowships in the past 5 years, 65 (29.7%) were included in this analysis. The most common postgraduate year (PGY) during which respondents applied for fellowship positions was PGY5 (43.8%), whereas the most common training level at which respondents accepted a fellowship position was PGY6 (46.9%), with a large degree of variability for both (range PGY4-PGY7). Only 43.1% respondents reported an application deadline for their fellowship. A total of 77.4% respondents received 1-2 fellowship position offers, and 13.4% indicated that there was a match process. In total, 64.5% respondents indicated that the fellowship offer timeline was mostly or very asynchronous. The time frame for applicants to decline or accept a fellowship offer was heterogeneous and mismatched among institutions. Respondents agreed that a more standardized application timeline would be beneficial (median response "agree"), and 83.1% of respondents indicated that PGY5 or PGY6 was the appropriate time to interview for a fellowship. Respondents reported heterogeneous experiences in applying for a fellowship, indicated that a standardized application timeline including interviews at PGY5 or PGY6 would be beneficial, and preferred streamlining the fellowship application process.

The neuromuscular fellowship portal and match.

For many years, Neuromuscular Medicine programs lacked a standardized means of handling fellowship applications and offering positions. Programs interviewed applicants and made offers as early as the first half of Post Graduate Year 3 (PGY3), a suboptimal timeline for applicants who may have had little prior exposure to neuromuscular or electrodiagnostic medicine. In 2021, the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) developed the Neuromuscular Fellowship Portal to standardize a later timeline and establish a process for fellowship applications and offers. In its first year, the Neuromuscular Fellowship Portal used a unique one‐way match, in which the portal released serial offers to applicants based on rank order lists submitted by programs. Fifty‐two Neuromuscular Medicine programs and seven electromyography (EMG)‐focused Clinical Neurophysiology programs participated. Sixty‐eight positions were filled, a similar number to previous years. A survey of fellowship directors and applicants following this process showed overwhelming support for the standardized timeline and application portal, but all program directors and most applicants favored moving to a traditional match. To maintain the existing application timeline and minimize costs for all parties, the AANEM Neuromuscular Fellowship Portal will host a two‐way match, based on existing commercial match algorithms, in 2022. A match will afford a fair and efficient process for all involved. Both Neuromuscular Medicine and EMG‐focused Clinical Neurophysiology programs will be encouraged to participate. The process undertaken by the AANEM can stand as an example for other neurologic subspecialties who are interested in standardizing their application timeline.

A Survey of Forensic Psychiatry Fellowship Program Directors on Selecting Fellowship Applicants.

In the 2019-2020 academic year, there were 48 accredited forensic psychiatry fellowship programs in the United States. Programs vary in application requirements and timeline. There are no published objective data on factors that fellowship program directors (PDs) use when selecting fellows. We created an electronic survey that was emailed to PDs via a list from the Association of Directors of Forensic Psychiatry Fellowships. The survey was open November 6, 2019 to December 31, 2019. Twenty-five PDs participated from programs ranging in size from one to six positions, receiving zero to 30 applications. The most important factors when selecting a candidate to interview were "perceived commitment to specialty" and "perceived interest in your program." The most important factors when offering a position were "interpersonal skills" and "interactions during interview." The least important factors in both categories were USMLE/COMLEX scores and honor society membership(s). "Lack of a set timeline" during the application process was the most frequently cited difficulty (via multiple choice) during the application and interview process. Our study is the first to provide quantitative data regarding factors that forensic psychiatry fellowship PDs use to evaluate applicants in decisions regarding offering interviews and positions.

The Evolving Status of Fellowships and Mini-Fellowships in Diagnostic Radiology: A Survey of Program Directors and Chief Residents

Recent changes in radiology fellowships include musculoskeletal radiology adopting a match system, interventional radiology transitioning away from diagnostic radiology to offer direct-entry programs, and a common fellowship application timeline created by the Society for Chairs of Academic Radiology Departments (SCARD). The concept of mini-fellowships has also emerged with the elimination of the oral American Board of Radiology examinations that had been administered in the final year of residency training prior to 2014. This paper seeks to assess the opinions of fellowship program directors, residency program directors, and chief residents regarding these recent changes. This is a cross-sectional study using a web-based survey posed to fellowship program directors, residency program directors, and chief residents in 2020. Questions sought to explore current attitudes toward the following topics: (1) a common fellowship application timeline; (2) a common fellowship match; and (3) the status of mini-fellowships in diagnostic radiology. In addition, the number of fellowship positions for each subspecialty was estimated using subspecialty society directories, Accreditation Council for Graduate Medical Education (ACGME) data, and individual program websites. Deidentified responses were collected electronically and aggregated. The three respondent groups preferred a common fellowship application timeline at rates of 67% among fellowship program directors, 80% residency program directors, and 74% residents. A common match system across all subspecialties was preferred at rates of 50% fellowship program directors, 74% residency program directors, and 26% chief residents. There was widespread reported compliance with the SCARD fellowship timeline policy. Subspecialty programs using the match system reported interviewing greater numbers of applicants per position. Fellowship directors and chief residents reported that the most common duration of mini-fellowship experiences was 2 to 3 months. There is a division between chief residents and program directors regarding the preference for a common radiology match. Adopting a radiology-wide fellowship match would increase the number of interviews required. The SCARD fellowship timeline policy has been successful, and there is support across stakeholders regarding the common timeline. Mini-fellowships are highly variable in length and structure.

A Novel Ticket System for Capping Residency Interview Numbers: Reimagining Interviews in the COVID-19 Era.

The 2019 novel coronavirus (COVID-19) pandemic has led to dramatic changes in the 2020 residency application cycle, including halting away rotations and delaying the application timeline. These stressors are laid on top of a resident selection process already under duress with exploding application and interview numbers-the latter likely to be exacerbated with the widespread shift to virtual interviewing. Leveraging their trainee perspective, the authors propose enforcing a cap on the number of interviews that applicants may attend through a novel interview ticket system (ITS). Specialties electing to participate in the ITS would select an evidence-based, specialty-specific interview cap. Applicants would then receive unique electronic tickets-equal in number to the cap-that would be given to participating programs at the time of an interview, when the tickets would be marked as used. The system would be self-enforcing and would ensure each interview represents genuine interest between applicant and program, while potentially increasing the number of interviews-and thus match rate-for less competitive applicants. Limitations of the ITS and alternative approaches for interview capping, including an honor code system, are also discussed. Finally, in the context of capped interview numbers, the authors emphasize the need for transparent preinterview data from programs to inform applicants and their advisors on which interviews to attend, learning from prior experiences and studies on virtual interviewing, adherence to best practices for interviewing, and careful consideration of how virtual interviews may shift inequities in the resident selection process.

Introducing the National Headache Fellowship Opportunities Website.

To build a national Headache Medicine fellowship opportunities website that promotes a unified application timeline and a more transparent application process. In July 2019, the Consortium of Academic Headache Program Directors unanimously accepted the recommendations of the American Academy of Neurology Fellowship Application Timing Position Statement. To implement the unified application timeline, the American Headache Society agreed to host a fellowship opportunities website with information on the application process and resources for each fellowship program. We designed a main landing page that features the unified timeline for applications and offers. The page also features icons for all participating US fellowship programs (identified using the United Council for Neurologic Subspecialties certification database). The icons serve as links to each fellowship program's individual webpage. We sent an electronic form to each fellowship program director, asking them to submit program information to be included on each fellowship program's individual webpage. Key contents on each program webpage include an image of the program, brief program description, names of applicants who have filled positions, and open positions. Each institution webpage also includes an electronic form that allows applicants to directly send their name, contact, and a brief message to the program director. We launched the website on May 15, 2020. As of June 19, 2020, the website featured 24 participating headache fellowship programs, including 5 pediatric programs and 19 adult training programs, from all regions of the US. The website serves as a central resource for Headache Medicine fellowship applicants and promotes a unified application timeline and a more transparent application process.

Students’ Perspectives and Concerns for the 2020 to 2021 Radiation Oncology Interview Season

PurposeRecently, the Coalition for Physician Accountability Work Group on Medical Students in the Class of 2021 recommended limiting visiting medical student rotations, conducting virtual residency interviews, and delaying the standard application timeline owing to the ongoing coronavirus disease 2019 (COVID-19) pandemic. These changes create both challenges and opportunities for medical students and radiation oncology residency programs. We conducted a comprehensive needs assessment to prepare for a virtual recruitment season, including a focus group of senior medical students seeking careers in oncology. Methods and MaterialsA single 1.5-hour focus group was conducted with 10 third- and fourth-year medical students using Zoom videoconferencing software. Participants shared opinions relating to visibility of residency programs, virtual clerkship experiences, expectations for program websites, and remote interviews. The focus group recording was transcribed and analyzed independently by 3 authors. Participants’ statements were abstracted into themes via inductive content analysis. ResultsInductive content analysis of the focus group transcript identified several potential challenges surrounding virtual recruitment, including learning the culture of a program and/or city, obtaining accurate information about training programs, and uncertainty surrounding the best way to present themselves during a virtual interview season. In the present environment, the focus group participants anticipate relying more on departmental websites and telecommunications because in-person interactions will be limited. In addition, students perceived that the educational yield of a virtual clerkship would be low, particularly if an in-person rotation had already been completed at another institution. ConclusionsWith the COVID-19 crisis limiting visiting student rotations and programs transitioning to hosting remote interviews, we recommend programs focus resources toward portraying the culture of their program and city, accurately depicting program information, and offering virtual electives or virtual interaction to increase applicant exposure to residency program culture.

Study on New Drug Application Timeline in Korea between 2011 and 2017

Study on New Drug Application Timeline in Korea between 2011 and 2017

Нейросетевой метод решения задачи мэппинга параллельных приложений

The article is about the problem of improving parallel applications efficiency. It proposes an approach to solve this problem. The approach aims to reduce communication overheads of data exchange between parallel program processes during its execution on high-performance computing system. Growing number of computer nodes leads increasing impact of the communication overhead on application performance. As a sequence the problem of parallel processes allocation to hardware nodes (mapping problem) becomes very actual. The new approach for mapping problem is proposed in this work. The key characteristic of the approach is to extract a communication pattern by phase analysis of application using a convolutional neural network to fast choosing the most relevant mapping algorithm for extracted pattern. Investigation of results of point-to-point communications between parallel program processes is used to build a communication pattern. The application timeline is broken into equal intervals. Communication patterns are created for each interval. Then Haar 2D wavelet transform is applied to these patterns for generating features. Features are clustered, after that, timeline is splitted into phases. Each phase has its own communication pattern. The selection of the most relevant mapping algorithm is performed by using convolutional neural network. It supposes some knowledge about different types of parallel applications and most suitable mapping algorithms. This knowledge must be represented by a set of pattern classes (classes of matrices), each class has the mapping algorithm, which fits best for application with this type of pattern. This set can be a training sample for the neural network. Thus the neural network classifies an input application communication pattern and finds a mapping algorithm for the application. The stages of proposed approach are implemented in this work. This implementation is demonstrated for some tests.

Right to Appeal, Non-Treatment, and Violence Among Forensic and Civil Inpatients Awaiting Incapacity Appeal Decisions in Ontario.

Background: Mental health legislation in Ontario, Canada, permits inpatients to refuse treatment while appealing their incapacity finding to the Consent and Capacity Board (CCB). Lack of treatment during this period poses safety concerns, as inpatients who remain untreated are at higher risk of engaging in violent behavior. The present study explored the relationship between non-treatment and violence among forensic and civil inpatients awaiting their CCB hearing at the largest psychiatric hospital in Canada. Methods: We investigated the electronic health records of 285 inpatients whose CCB applications were heard between 2014 and 2016 to better understand violent outcomes among inpatients and determine whether application timelines differed between forensic and civil inpatients. Results: Three key findings were observed. First, forensic inpatients had more episodes of violence requiring seclusion and restraint during the application timeline compared with civil inpatients. Second, forensic inpatients waited longer than civil inpatients for their appeal to be heard at the CCB. Finally, unwillingness to accept PRN medications and comorbid psychiatric conditions were potent risk factors for violence among all inpatients during the appeals process. Conclusions: Compared with civil inpatients, forensic inpatients waited longer for CCB appeals. They also scored higher on one measure of violent behavior. These findings provide context for the ongoing challenge of clinicians tasked with providing care for inpatients appealing findings of incapacity under mental health legislation in Ontario. We argue for a more streamlined approach to processing appeals for both forensic and civil patients. Better standardization or even revision of current mental health legislation may help eliminate clinical disparities between patient groups.

Preparing students for residency interviews through a residency interview boot camp

Background and purposeTo describe the offering of the residency boot camp activity at one college of pharmacy for students in their fourth professional year. Educational activity and settingStudent pharmacists in their final professional year of pharmacy school were invited to participate in a voluntary residency boot camp activity. Originally, the activity consisted of four parts: (1) guidance on preparing for residency interviews; (2) a 1:1 mock interview with a resident, faculty member, residency preceptor or area program director; (3) a review of the student's curriculum vitae (CV) and letter of intent; and (4) a review of the application timeline and process. Based on the feedback, the activity was changed to include five parts: (1) orientation/welcome session, (2) mock interview, (3) case presentation, (4) podium presentation, and (5) a debriefing session on the day's activities and to answer any remaining student questions about the residency application process. In the second offering of the residency boot camp, students were invited to complete a voluntary pre- and post-assessment of their perceived readiness for residency interviews. The activity has evolved based on student feedback to focus predominately on the group and 1:1 interviews. FindingsSince starting the activity in 2013, 14 of the 21 students (67%) from the class of 2014, 16 of the 25 students (64%) from the class of 2015 and 24 of the 26 students (92%) from the class of 2016 that applied for residency training participated in the residency boot camp activity. For the Fall 2014 offering where a survey was conducted, the pre- and post-survey instrument used a Likert Scale, ranging from “strongly disagree” (score of 1) to “strongly agree” (score of “5”). Discussionand conclusions: Simulated exercises such as a residency boot camp can expose student pharmacists to important interview readiness skills. Student pharmacists involved in this activity demonstrated a perceived positive effect of such activities.

Matching Residents to Pathology Fellowships

Mandates for pathology training are a topic sure to surface “hot button” issues whatever the venue or whatever the combination of viewpoints gathered around the water cooler. A national pathology fellowship match administered by the National Residency Matching Program (NRMP) is the latest in a series of controversies affecting residents preparing for a future in our discipline and the programs entrusted with their education and professional development. Crawford and coauthors,1 representing the Association of Pathology Chairs (APC) and its program directors section (PRODS), argue in this issue of the Journal that a pan-pathology fellowship match is the best solution for problems exacerbated by changes in credentialing requirements for board certification in pathology. Other opinion leaders and organizations, including the Association of Directors of Anatomic and Surgical Pathology (ADASP), are unconvinced. The primary rationale for a pan-pathology fellowship match offered by Crawford and colleagues1 is the perception of “widespread dissatisfaction” among affected residents driven primarily by a single event in 2007 at which only a small fraction of the national resident pool was present and fewer still accounted for the residents sufficiently motivated to “overrun” the microphone. More inclusive data drawn from American Society for Clinical Pathology (ASCP) Resident In-Service Examination surveys showed that, in fact, only a minority of pathology residents were in favor of a fellowship match when asked in 2007 (39%), 2008 (26%), and 2010 (47%).1 Paradoxically, the same survey results showed that a consistent majority supported having a uniform fellowship application timeline. In an independent survey targeting members of the College of American Pathologists (CAP) Residents Forum and the ASCP Resident Liaison Network, only 43% of resident respondents were in favor of a match despite also identifying absence of clear and consistent application deadlines as an issue for fellowship applicants.2 These results resonate …

How do non-muscular torques contribute to the kinetics of postural recovery following a support surface translation?

The common platform translation paradigm used in balance control studies employs a disturbance event that applies non-muscular forces to the body for the duration of the disturbance. Previous research has explored the process of constructing the balance recovery by considering these perturbations to be trigger events, not events with an ongoing force application timeline. The purpose of this study was to quantify the effect of muscular and non-muscular torques on post-perturbation balance with particular interest in the role of the external perturbation in balance recovery. Five young adult males experienced backward translations of the support surface at three different speeds. Integration intervals were defined for each segment and angular impulses were calculated for a period of increasing angular momentum (destabilization), and a period of decreasing angular momentum (restabilization). Destabilization of distal segments was primarily due to impulse generated by the motion of the support surface. For the trunk, however, muscle and motion-dependent sources contributed most to increasing momentum. Restabilization of distal segments was achieved by muscle and platform impulses while trunk restabilization was achieved by muscle and motion-dependent terms in opposition to gravity. Increased platform speed resulted in increased muscular contribution only in the control of the trunk, while demand on distal musculature decreased with change in platform speed as the platform contribution to restabilization increased in these segments. Therefore, impulses from non-muscular sources, including the perturbation itself, are significant modifiers of the response to balance disturbances and must be accounted for in balance research.