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Background and aims Colour Doppler imaging (CDI) is a frequently cited methodology for quantifying ocular blood flow velocities. This investigation reviews the feasibility of creating a normative database of CDI parameters in glaucoma patients and controls. A literature search was conducted for CDI studies involving glaucomatous eyes. Using data from these studies, a weighted mean was derived for the peak systolic velocity, end diastolic velocity and Pourcelot's resistive index in the ophthalmic, central retinal and posterior ciliary arteries. A multivariate analysis was performed to identify whether methodological characteristics contributed to the inter-study variance in CDI values. Data from 3061 glaucoma patients and 1072 controls were included. The mean values for glaucomatous eyes were within one standard deviation of the values for controls for most CDI parameters. Gender mix (p=0.043), intraocular pressure status (p=0.017), frequency of the ultrasound transducer (p=0.02) and whether the patients were on antihypertensive therapy (p=0.004) contributed to the variance. Methodological differences create inter-study variance in CDI values, complicating the construction of a normative database and limiting its utility. Because the mean values for glaucomatous and normal eyes have overlapping ranges, caution should be used when classifying glaucoma status based on a single CDI measurement. [ABSTRACT FROM AUTHOR]

Purpose: To explore factors influencing career goals and goal attainment for pharmacy learners (eg, students, residents, fellows) who identify as part of the Black, Indigenous, and People of Color (BIPOC) community., Methods: In late 2021 and early 2022, US-based pharmacy learners were invited to participate in two focus groups. In the first focus group, participants were asked to reflect on career goal influences, barriers, and facilitators. In the second focus group, participants were asked to provide suggestions for educational institution and healthcare organization improvement to support career goal attainment for learners in the BIPOC community. Focus group transcripts were coded using both deductive and inductive coding and thematic analysis., Results: Fifteen learners were included in the first focus group, and 10 learners were included in the second. The most common career goal motivators were self-efficacy factors. Barriers and facilitators were often closely related. The most common barriers were financial, lack of representation, and lack of support. Common facilitators included mentorship and informal networking opportunities. Participants suggested multiple strategies for educational institutions and healthcare organizations to support BIPOC learner success, including genuine investment, representation, financial support, improved access to professional development opportunities, partnering with other professional organizations, and prioritizing diversity, equity, and inclusion (DEI) initiatives., Conclusion: Institutions should prioritize effective, positive mentoring relationships and exposure to BIPOC professionals. Training programs and associations should consider improving financial support and lowering the cost of involvement to reduce barriers. All stakeholders should prioritize DEI in their organizational culture to promote career advancement of BIPOC learners and professionals., (© American Society of Health-System Pharmacists 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Purpose: The primary aim of this study was to investigate the accuracy of the volumetric method for intravenous (IV) preparations and explore the utility of gravimetric methods in the medication preparation process within multiple institutions. Secondary outcomes of this study were syringe size percent variations and impact on drug expenditures., Methods: A prospective, noninterventional, multisite study was conducted between March 2015 and December 2016 to generate baseline estimates of accuracy and precision in the volumetric medication preparation process. Five hospitals in the United States were recruited for study participation. During the data collection process, technicians were required to measure the syringe at 3 different points: when the new empty syringe was connected to a closed-system transfer device (CSTD), when the filled syringe containing the prepared dose of medication was connected to a CSTD, and when the used syringe with residual medication was connected to a CSTD. The actual dose of drug dispensed (in mg) was divided by the specific gravity of the medication to determine the actual volume of medication dispensed., Results: A total of 4,443 compounded sterile products representing 60 medications across 5 hospitals were eligible for the study. Of the evaluated preparations, 91.92% were within 5% of the prescribed dose and 96.56% were within 10% of the prescribed dose. The outliers ranged from -144.10% to 233.72%., Conclusion: The potential for significant over- and undertreatment of an individual patient receiving IV chemotherapy exists, indicating the need for an additional measurement method, such as real-time gravimetric verification, to ensure an accurate dose is administered to every patient., (© American Society of Health-System Pharmacists 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: To describe the clinical presentation and management of late (>3.0 years) acute graft rejection in keratolimbal allograft (KLAL) recipients., Methods: This was a multicenter, retrospective observational case series. Six eyes of 6 patients with ocular surface transplant at a mean age of 36.2 years were seen at 3 tertiary referral centers for acute graft rejection between 2007 and 2013. Main outcome measures included strength of systemic immunosuppression (SI) at the time of rejection, time to rejection, and clinical presentation of rejection., Results: Preoperative diagnoses included total limbal stem cell deficiency because of aniridia (n = 2) or chemical injury (n = 4). After an initially successful outcome, patients experienced late acute graft rejection at a mean time of 67.8 ± 24.1 months (range: 41-98) after KLAL while receiving suboptimal levels of SI because of medication taper (n = 5) or noncompliance (n = 1). Objective findings included an epithelial rejection line (n = 6), edema (n = 2), corneal epithelial irregularities (n = 2), and neovascularization (n = 1). Antirejection management consisted of topical corticosteroids (n = 6) and augmentation of SI therapy (n = 5)., Conclusions: These cases of late acute graft rejection in KLAL patients support the notion that allodonor cells can persist over the long run and remain at risk for immunologic rejection. It further underscores the fact that long-term success with KLAL may require extension of SI beyond the first few years, albeit at lower levels individualized to each patient., Competing Interests: Edward J. Holland is a consultant for and receives lecture fees from Allergan; consultant for and receives lecture fees from Abbott Medical Optics; consultant and receives grant support from Alcon Laboratories; consults for Senju Pharmaceutical Co, Ltd; consults for TearScience; consults for TearLab. For the remaining authors none were declared.

Scaling networks of cosmic defects, such as strings and textures, actively generate scalar, vector, and tensor metric perturbations throughout the history of the Universe. In particular, vector modes sourced by defects are an efficient source of the cosmic microwave background B-mode polarization. We use the recently released BICEP2 and POLARBEAR B-mode polarization spectra to constrain properties of a wide range of different types of cosmic strings networks. We find that in order for strings to provide a satisfactory fit on their own, the effective interstring distance needs to be extremely large--spectra that fit the data best are more representative of global strings and textures. When a local string contribution is considered together with the inflationary B-mode spectrum, the fit is improved. We discuss implications of these results for theories that predict cosmic defects.