Utilizing Pharmacist-Led Telehealth Services in Ambulatory Patients with Heart Failure

Background: Heart failure is one of the leading causes of hospital admissions. Non-adherence to medications and poor dietary management for patients who suffer from this condition can lead to worsening of symptoms and hospitalization. Pharmacist interventions via telehealth have demonstrated a beneficial impact on disease management and adherence outcomes in patients with chronic conditions. Methods: This retrospective, descriptive cohort study reviewed subjects from a single-centered primary care office. Data was collected via electronic chart review between January and December 2021. Subjects eligible for inclusion were adults who were diagnosed with heart failure by their primary care provider and referred to a pharmacist for a telehealth visit. The primary outcome was the number of heart failure-related hospitalizations post-pharmacist intervention via telehealth. The secondary outcome was the number of cardiovascular-related hospitalizations post-pharmacist intervention via telehealth. Results: 37 patients were included for analysis. Only two patients were admitted for heart failure post-pharmacist intervention. Fifteen patients were admitted post-pharmacist intervention for a cardiovascular-related hospitalization. Conclusion: This report illustrates the employment of pharmacist-led telehealth services in the chronic heart failure population. This study encourages pharmacist-based interventions via telehealth in the ambulatory setting as few HF-related hospitalizations occurred in this cohort

The Pine Needle, February 1947

Libraries and archives collect materials from different cultures and time periods to preserve and make available the historical record. As a result, materials such as those presented here may reflect sexist, misogynistic, abusive, racist, or discriminatory attitudes or actions that some may find disturbing, harmful, or difficult to view. Both a humor and literary magazine, The Pine Needle was a University of Maine student-produced periodical that began publication in the fall of 1946, the first post-World War II semester that saw GIs returning to campus. The Needle reflected an edginess and rebellion not found in previous UMaine student publications. While past student publications relied on euphemisms for alcohol and dating on campus, The Needle overtly sexualized co-eds and discussed the use of drugs, tobacco, and alcohol by students. Cover art for this issue is an unsigned pen-and-ink illustration produced by a member of The Needle\u27s art staff. It depicts the five members of the editorial staff gathered around a wood coffin labeled, The Needle. Included in this issue is a piece about former History Professor C. Dewitt Hardy II\u27s (1911-1992), term paper assignment entitled, Social Problems in My Home Town. The work mentions the birth of Hardy\u27s son and future artist, Clarion Dewitt Hardy III (1940-2017)

A novel protamine variant reversal of heparin anticoagulation in human blood in vitro

AbstractPurpose: Protamine reversal of heparin anticoagulation during cardiovascular surgery may cause severe hypotension and pulmonary hypertension. A novel protamine variant, [+18RGD], has been developed that effectively reverses heparin anticoagulation without toxicity in canine experiments. Heretofore, human studies have not been undertaken. This investigation hypothesized that [+18RGD] would effectively reverse heparin anticoagulation of human blood in vitro. Methods: Fifty patients who underwent anticoagulation therapy during vascular surgery had blood sampled at baseline and 30 minutes after receiving heparin (150 IU/kg). Activated clotting times were used to define specific quantities of [+18RGD] or protamine necessary to completely reverse heparin anticoagulation in the blood sample of each patient. These defined amounts of [+18RGD] or protamine were then administered to the heparinized blood samples, and percent reversals of activated partial thromboplastin time, thrombin clotting time, and antifactor Xa/IIa levels were determined. In addition, platelet aggregation assays, as well as platelet and white blood cell counts were performed. Results: [+18RGD] and protamine were equivalent in reversing heparin as assessed by thrombin clotting time, antifactor Xa, antifactor IIa levels, and white blood cell changes. [+18RGD], when compared with protamine, was superior in this regard, as assessed by activated partial thromboplastin time (94.5 ± 1.0 vs 86.5 ± 1.3%δ, respectively; p < 0.001) and platelet declines (–3.9 ± 2.9 vs –12.8 ± 3.4 per mm3, respectively; p = 0.048). Platelet aggregation was also decreased for [+18RGD] compared with protamine (23.6 ± 1.5 vs 28.5 ± 1.9%, respectively; p = 0.048). Conclusions: [+18RGD] was as effective as protamine for in vitro reversal of heparin anticoagulation by most coagulation assays, was statistically more effective at reversal than protamine by aPTT assay, and was associated with lesser platelet reductions than protamine. [+18RGD], if less toxic than protamine in human beings, would allow for effective clinical reversal of heparin anticoagulation. (J Vasc Surg 1997;26:1043-8.

Sushi in the United States, 1945-1970

Sushi first achieved widespread popularity in the United States in the mid-1960s. Many accounts of sushi’s US establishment foreground the role of a small number of key actors, yet underplay the role of a complex web of large-scale factors that provided the context in which sushi was able to flourish. This article critically reviews existing literature, arguing that sushi’s US popularity arose from contingent, long-term, and gradual processes. It examines US newspaper accounts of sushi during 1945–1970, which suggest the discursive context for US acceptance of sushi was considerably more propitious than generally acknowledged. Using California as a case study, the analysis also explains conducive social and material factors, and directs attention to the interplay of supply- and demand-side forces in the favorable positioning of this “new” food. The article argues that the US establishment of sushi can be understood as part of broader public acceptance of Japanese cuisine

A novel causal mechanism for grey squirrel bark stripping: The Calcium Hypothesis

AbstractGrey squirrels, Sciurus carolinensis, damage trees in the UK by stripping bark and eating the underlying phloem; squirrel motivation for damage is, however, unknown. Damage can result in deterioration of timber quality and a significant economic toll on the forestry industry. Prediction of severe damage followed by targeted killing of squirrels is the current recommended management option. However, the use of warfarin (an anticoagulant poison) is now restricted in the UK and other more humane methods of killing are labour-intensive, so an alternative solution is needed. A better understanding of what motivates grey squirrels to strip bark may enable a preventive approach to be developed. Whilst the bark stripping literature has explored predictive factors affecting the likelihood of damage, causal understanding is lacking. The aim of this review is to introduce the Calcium Hypothesis as a possible explanation for bark stripping, with a view to informing the prevention of damage. The Calcium Hypothesis states that grey squirrels damage trees to ameliorate a calcium deficiency. The main predictive factors of bark stripping behaviour each inform and lend support to the Calcium Hypothesis. Calcium is stored in tree phloem, and damage increases with phloem width, providing squirrels with more calcium per unit area ingested. Calcium levels increase in trees as active growth resumes after winter dormancy, this occurs immediately prior to the main bark stripping season of May–July, and trees growing most vigorously are at increased risk of damage. It is likely grey squirrels also have a requirement for calcium during the bark stripping season. Adult females will be under post-parturition pressures such as lactation, and juveniles will be going through their main period of bone growth, both of which likely represent a requirement for calcium – which supports an observed positive correlation between juvenile abundance and bark stripping. A high autumnal seed crop increases juvenile recruitment the following spring, and could also induce a requirement for calcium to a population due to the high phosphorus to calcium ratio of seeds. To further investigate the hypothesis, the extent to which grey squirrels can utilise calcium oxalate, as calcium occurs in bark, should be determined, and also the extent to which grey squirrels undergo seasonal periods of calcium deficiency. Increasing our causal understanding of bark stripping could inform the future development of preventive measures to aid forest management

Learning for a Better Future

Various international scholars and associates of the PASCAL (Place, Social Capital and Learning Regions) International Observatory (Africa hub), under the auspices of the Centre for Local Economic Development (CENLED) based at the University of Johannesburg (UJ), have contributed chapters in this scholarly book. The book aims to demonstrate how a combination of globalisation, pandemics and the impact of innovation and technologies are driving towards a world in which traditional ideas are being challenged. The book carries forward a dual context and relevance: to South African social, educational, economic and cultural development, and the broader international context and action directed at how lifelong learning for all can be fostered in communities as a foundation for a just, human-centred, sustainable world. The distinctive contribution of this book to the production of a local body of knowledge lies in the symbiotic relationships between these objectives, so that South Africa could serve as a test case in working towards approaches that have a wider international significance

Molecular cloning and characterization of PtrLAR3, a gene encoding leucoanthocyanidin reductase from Populus trichocarpa, and its constitutive expression enhances fungal resistance in transgenic plants

The flavonoid-derived proanthocyanidins (PAs) are one class of the major defence phenolics in poplar leaves. Transcriptional activation of PA biosynthetic genes, resulting in PA accumulation in leaves, was detected following infection by the fungal Marssonina brunnea f.sp. multigermtubi using digital gene expression analysis. In order to study PA biosynthesis and its induction by fungi, a putative leucoanthocyanidin reductase gene, PtrLAR3, was isolated from Populus trichocarpa. Sequence comparison of PtrLAR3 with other known leucoanthocyanidin reductase proteins revealed high amino acid sequence similarity. Semi-quantitative reverse-transcription (RT) PCR and quantitative real-time PCR analysis demonstrated that PtrLAR3 was expressed in various tissues and the highest level of expression was observed in roots. Overexpression of PtrLAR3 in Chinese white poplar (Populus tomentosa Carr.) led to a significant plant-wide increase in PA levels. In vitro assays showed that crude leaf extracts from 35S:PtrLAR3 transformants were able to inhibit significantly the hyphal growth of M. brunnea f.sp. multigermtubi compared to the extracts from control plants. The transgenic 35S:PtrLAR3 poplar plants displayed a significant (P < 0.05) reduction in their disease symptoms compared with the control. RT-PCR analysis showed that PtrLAR3 expression was up-regulated in all transformants. These results suggested that constitutive expression of endogenous PtrLAR3 could be exploited to improve resistance to fungal pathogens in poplar

Learning for a Better Future

Various international scholars and associates of the PASCAL (Place, Social Capital and Learning Regions) International Observatory (Africa hub), under the auspices of the Centre for Local Economic Development (CENLED) based at the University of Johannesburg (UJ), have contributed chapters in this scholarly book. The book aims to demonstrate how a combination of globalisation, pandemics and the impact of innovation and technologies are driving towards a world in which traditional ideas are being challenged. The book carries forward a dual context and relevance: to South African social, educational, economic and cultural development, and the broader international context and action directed at how lifelong learning for all can be fostered in communities as a foundation for a just, human-centred, sustainable world. The distinctive contribution of this book to the production of a local body of knowledge lies in the symbiotic relationships between these objectives, so that South Africa could serve as a test case in working towards approaches that have a wider international significance