Implementation of an adherence pharmacy referral protocol for patients taking sacubitril/valsartan.

Background: Heart failure is a prevalent disease state associated with limitations in function, hospitalization, and death. The 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America guidelines recommend medications including sacubitril/valsartan to decrease morbidity and mortality in patients with heart failure. However, if patients are nonadherent to treatment or experience barriers to care, they will forgo these benefits.

Sleep drive is coupled to tissue damage via shedding of Caenorhabditis elegans EGFR ligand SISS-1.

The benefits of sleep extend beyond the nervous system. Peripheral tissues impact sleep regulation, and increased sleep is observed in response to damaging conditions, even those that selectively affect non-neuronal cells. However, the 'sleep need' signal released by stressed tissues is not known.

Urothelial carcinoma in situ with "early papillary formation" vs "lateral spread/shoulder lesion" of prior high-grade noninvasive papillary urothelial carcinoma: A survey of pathologist and urologist interpretations.

Objectives: Urothelial carcinoma in situ (CIS) with early papillary formation is terminology sometimes used to suggest incipient high-grade papillary urothelial carcinoma (PUC) but may lead to confusion between true CIS and lateral flat spread of PUC.

Methods: It remains unclear how pathologists and urologists interpret this scenario, so a survey was circulated to 68 pathologists (group 1 = 28 academic genitourinary pathologists; group 2 = 17 pathologists with a self-reported genitourinary focus; group 3 = 23 pathologists self-reported as not genitourinary specialists) and 32 urologists.

Results: Regarding atypical urothelial lesions that appear mainly flat but contain possible papillae, group 3 was more likely to label this as CIS compared with groups 1 and 2 (35% for group 3 vs 13% for groups 1 and 2), while groups 1 and 2 more often adopted another descriptive diagnosis, such as "CIS with early papillary features" (38% for groups 1 and 2 vs 13% for group 3).

Management of pleural effusion in mechanically ventilated critically ill patients: A systematic review and guideline.

Background: Mechanically ventilated critically ill patients often develop pleural effusions, which may impact lung compliance and expansion. This systematic review explores the management of pleural effusion in the critically ill population.

Methods: A comprehensive literature search was performed.

Becoming a person-centred facilitator of learning in a hospital setting: Findings from a participatory action-oriented study with hospital-based educators.

Aim: Investigate the experience of hospital-based educators becoming person-centred facilitators of learning.

Background: Hospital-based educators working with staff are not well-prepared for their role. No person-centred pedagogical approaches exist specifically for use in hospital settings.