Does visual or mechanosensory disruption influence risk assessment in coral reef fishes: a preliminary study.

Interpreting and responding to environmental cues from different modalities has survival value. In fish, the role of multimodal perception has been studied in regard to both foraging and risk assessment, with modalities including vision, olfaction, and mechanoreception via lateral lines. We studied reef fish boldness by placing novel objects that obstructed vision, lateral line use, or both into a coral reef environment with native algal samples inside, and then quantifying exploration as a function of obstruction type and as a function of functional diet groups (herbivores, omnivores, carnivores).

Very High Warfarin Dosing Requirements in a Patient With Tuberculosis and a Pulmonary Embolism: A Case Report.

To describe a case of significantly increased warfarin requirements in a patient receiving rifampin for the management of tuberculosis. A 76-year-old male was admitted due to altered mentation, cough, and weight loss. He was diagnosed concurrently with tuberculosis and a pulmonary embolism.

Comparison of peer, self, and faculty objective structured clinical examination evaluations in a PharmD nonprescription therapeutics course.

Purpose: Objective structured clinical examinations (OSCE) are a valuable assessment within healthcare education, as they provide the opportunity for students to demonstrate clinical competency, but can be resource intensive to provide faculty graders. The purpose of this study was to determine how overall OSCE scores compared between faculty, peer, and self-evaluations within a Doctor of Pharmacy (PharmD) curriculum.

Methods: This study was conducted during the required nonprescription therapeutics course.

The Role of Consumerism in Pharmacy Education.

The notion of consumerism and that students are customers of pharmacy colleges was explored by proponents and opponents of the idea. First, a working definition of a "customer" in pharmacy education is pondered with respect to the roles and responsibilities of students and schools/colleges of pharmacy. Second, the pros and cons of "student-centered" education are considered in the light of students and their families being consumers of the educational experience.

Reduced-Dose Apixaban in the Treatment of Left Ventricular Thrombus: A Report of 2 Cases.

According to the American College of Cardiology and the American Heart Association, warfarin has historically been the standard of care anticoagulant for the treatment of left ventricular thrombus. The use of direct oral anticoagulants (DOACs) has become more prevalent, as they require less frequent laboratory monitoring, offer fixed-dose regimens, are associated with fewer drug-drug and drug-food interactions, and provide more favorable safety profiles when compared to warfarin. However, DOACs are not currently FDA-indicated in the treatment of left ventricular (LV) thrombus.

Traditional Lecture versus Case-Based Learning in a Therapeutic Drug Monitoring Course within an Integrated Pharmacy Curriculum.

: Case-based learning has been shown to increase student perception and performance in multiple topics in pharmacy education. However, no studies have evaluated the impact of virtual patients and case-based learning on student knowledge and knowledge retention of therapeutic drug monitoring and dosing. : Due to a curriculum overhaul promoting integration and application-based learning, the traditional third-year (P3) therapeutic drug monitoring course was reduced from four (4) credit hours to two (2), in order to add time to pharmacotherapy and skills labs.

Benefits of Utilizing Pharmacy Learners in an Inpatient Anticoagulation Education Service.

The 2019 Hospital National Patient Safety Goal 03.05.01 indicates education regarding anticoagulant therapy should be provided to patients and families.

Impact of Initial Therapy on Readmissions in Minority Versus White Populations With Heart Failure.

Minority populations are often underrepresented in landmark trials for the management of heart failure with reduced ejection fraction (HFrEF). Major trials shaping the guidelines sometimes include as few as 5% black patients. The purpose of this pilot study was to evaluate the initiation of guideline-directed medical therapy (GDMT) for HFrEF on hospital discharge for minority vs white populations and its impact on all-cause 30-day readmission rates to identify areas for larger future research studies and opportunities for pharmacist intervention.

Comparison of Student Pharmacists' Knowledge Retention Utilizing Electronic Health Records Versus Simultaneously Completing Simulated Experiences.

The purpose of this study was to determine whether the addition of standardized patients or the addition of interprofessional student teams with standardized patients to the use of a simulated electronic health record improved student knowledge retention and perceptions. This was a prospective cohort study assessing three cohorts of first-year student pharmacists in pharmacy skills laboratory activities that occurred in 2018, 2019, and 2021. The primary objective of the study was to compare knowledge retention of the case material between groups at one month.

Identifying barriers to utilization of a medication access program among referred patients surveyed after discharge from an acute care hospital.

Background: For uninsured residents of select counties in North Carolina, the Cumberland County Medication Access Program (CCMAP) provides prescriptions at no cost. Uninsured patients hospitalized at Cape Fear Valley Medical Center are referred to CCMAP at discharge by Cape Fear Valley Health System employees, primarily coordination of care personnel and outpatient pharmacy personnel. The purpose of this study was to describe the most frequently reported utilization barriers among surveyed patients referred to CCMAP after discharge from Cape Fear Valley Medical Center.

Implementation and justification of a curriculum-wide electronic health record platform.

Background And Purpose: In order to develop practice-ready pharmacists as mandated by the Accreditation Council for Pharmacy Education Accreditation Standards, exposing students to health information technologies used in clinical practice, like electronic health records (EHRs), is imperative. While the benefits of using EHRs have been described in the literature, limited information or guidance exists on how these tools can incorporate various activities and topics to be implemented throughout an entire curriculum. The purpose of this report is to describe the curriculum-wide implementation of a simulated EHR software, including the novel learning experiences and costs incurred by the college.

Pharmacotherapy Considerations in Heart Failure with Mildly-Reduced Ejection Fraction.

Heart failure with mildly reduced ejection fraction (HFmrEF) has been classified using various definitions since its first mention in the literature in 2014. This group was most recently defined in the as HF with a left ventricular ejection fraction of 41% to 49%. An increasing emphasis has been placed on HFmrEF over the past several years, with many recent publications suggesting that common therapies used in HF with reduced ejection fraction provide benefit in this population as well.

Low Serum Albumin Predicts Severe Outcomes in COVID-19 Infection: A Single-Center Retrospective Case-Control Study.

Background: Coronavirus disease 2019 (COVID-19) can cause serious complications such as multiorgan failure and death which are difficult to predict. We conducted this retrospective case-control observational study with the hypothesis that low serum albumin at presentation can predict serious outcomes in COVID-19 infection.

Methods: We included severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed, hospitalized patients from March to July 2020 in a tertiary care hospital in the USA.

Evaluation of traditional initial vancomycin dosing versus utilizing an electronic AUC/MIC dosing program.

Background: Area under the curve to minimum inhibitory concentration (AUC/MIC) has been recommended by the 2020 updated vancomycin guidelines for dosing vancomycin for both efficacy and safety. Previously, AUC/MIC has been cumbersome to calculate so surrogate trough concentrations of 15-20 mg/dL were utilized. However, trough-based dosing is not a sufficient surrogate as AUC/MIC targets of 400-600 can usually be reached without achieving troughs of 15-20 mg/dL.

Utilization of a Dextrose-Only Purge Solution for an LVAD in Patients With Suspected HIT: A Case Series.

The Impella devices are percutaneous intravascular ventricular assist devices indicated for use in patients with cardiogenic shock that occurs following acute myocardial infarction (MI) or open heart surgery. These devices must be used with a purge solution that contains heparin per manufacturer recommendation, which will prevent blood from reaching the motor causing pump thrombosis and mechanical failure. We describe the utilization of a dextrose-only purge solution plus systemic argatroban in 2 patients with suspected heparin-induced thrombocytopenia (HIT).

The Impact of Interprofessional Monitoring and Education on the Usage of Systemic Glucocorticoids in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Retrospective, Medication Use Review.

Background Systemic corticosteroid therapy for chronic obstructive pulmonary disease (COPD) exacerbations is routine in clinical practice, however, dosing is variable. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) panel recommends a short course of systemic corticosteroids for acute COPD exacerbation treatment. Despite these recommendations, institutions continue to use higher doses and longer durations of systemic corticosteroid therapies.

Evaluation of a vancomycin dosing nomogram in obese patients weighing at least 100 kilograms.

Background: There remains variability in both practice and evidence related to optimal initial empiric dosing strategies for vancomycin.

Objective: Our primary objective was to describe the percentage of obese patients receiving vancomycin doses consistent with nomogram recommendations achieving targeted initial steady-state serum vancomycin concentrations. Secondary objectives were to describe the primary endpoint in subgroups based on patient weight and estimated creatinine clearance, to describe the rate of supratherapeutic vancomycin accumulation following an initial therapeutic trough concentration, and to describe the rate of vancomycin-related adverse events.

Mirtazapine-Induced Pancreatitis-A Case Report.

Acute pancreatitis has numerous etiologies, with the most common including gallstones, alcohol abuse, and medications such as angiotensin-converting enzyme (ACE) inhibitors, statins, and diuretics. Mirtazapine has been associated with increased serum cholesterol and serum triglyceride levels. However, few studies have reported dangerously elevated triglyceride levels resulting in acute pancreatitis.

Impact of Standardized Simulated Patients on First-Year Pharmacy Students' Knowledge Retention of Insulin Injection Technique and Counseling Skills.

To compare pre- and post-intervention test scores assessing insulin injection technique and counseling skills among P1 students with (intervention) or without (control) simulated patients, and to compare counseling checklist and knowledge retention test scores between groups. This study utilized cluster randomization. In addition to traditional instruction, the intervention group counseled a simulated patient on the use of insulin using the teach-back method.