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Miranda So PharmD MPH (Epidemiology)

@mirandapharmdmph.bsky.social
2.4K followers 1.1K following 318 posts

Manager, ID/Antimicrobial Stewardship Pharmacist, Assistant Professor, Runner, Knitter Clinical & research: immunocompromised hosts; public health; epidemiology; study design. #IDSky #PharmSky 🇨🇦 www.linkedin.com/in/miranda-so-phar…

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Reposted by Miranda So PharmD MPH (Epidemiology)
Joseph Marcus @josephmarcusid.medsky.social · 26/02/2026
Important review of stewardship in ECMO #IDSky 🔑 points: -ID should be part of multi-disciplinary team -More interventions not associated with 👍 outcomes -Lots of gaps in 📚 Thanks to @mirandapharmdmph.bsky.social and team for writing! www.clinicalmicrobiologyandinfection.org/article/S119...
clinicalmicrobiologyandinfection.org
Antimicrobial stewardship during extracorporeal membrane oxygenation: challenges and new perspectives
Extracorporeal membrane oxygenation (ECMO) has emerged as a crucial modality in managing severe cardiac and respiratory failure; however, nosocomial infections and complex antimicrobial prescribing ch...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 25/01/2026
Yesterday’s run 🏃🏻‍♀️ before the major storm kicks in today. ❄️❄️❄️
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 02/01/2026
www.nytimes.com/2026/01/02/w... Fantastic story. 🏃🏻‍♀️
nytimes.com
50 Years Ago, He Was an Olympian. At 80, He’s Just as Happy to Finish Last.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 18/12/2025
Thoroughly enjoyed this by @paulsaxmd.bsky.social in @nejm.org blogs.nejm.org/hiv-id-obser... My in-laws often complain about the lack of physical exam by their MDs as an inadequacy. Yet my 1st year nursing student daughter is learning to use the stethoscope and sphyngomanometer in her skills lab.
blogs.nejm.org
What Use Is the Physical Examination in Current Medical Practice?
Share Tweet Pin Mail SMS A very interesting, quite scholarly perspective appeared in the NEJM last month called, “Strategies to Reinvigorate the Bedside Clinical ...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 17/12/2025
www.medscape.com/viewarticle/... As a runner 🏃🏻, this seems like good news but will have to read the paper itself to understand more.
medscape.com
Marathon Running Does Not Appear to Damage Heart
Ten-year follow-up of male marathoners showed no long-term negative effects on heart health.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 14/12/2025
First proper ❄️ winter run this season. Very refreshing 10km.
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Reposted by Miranda So PharmD MPH (Epidemiology)
International Society for Heart and Lung Transplantation (ISHLT) @ishlt.bsky.social · 10/12/2025
📢 Registration for #ISHLT2026 is NOW OPEN! Join your global, multidisciplinary colleagues in Toronto. ✨ New this year: you can book your hotel at exclusive room rates while registering. ➡️ Register by 4 February 📅 to qualify for the early registration fee: 🔗 bit.ly/4aFzxTd #TransplantSky #MedSky
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 08/12/2025
Yes, yes I can outrun the LRT 🏃🏻‍♀️and I’m a slow runner! 😂 www.cbc.ca/news/canada/...
cbc.ca
Could you outrun the train? Finch LRT takes 55 minutes to cover 10.3-km route | CBC News
Northwest Toronto's newly-opened light-rail transit (LRT) line is getting its first taste of rush hour Monday — but it doesn't appear to be rushing.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 06/12/2025
www.cbc.ca/news/canada/... What a lovely story. 👏👏👏
cbc.ca
Lost for 5 months in the Northern Rockies, this cat is heading home to Oklahoma for Christmas | CBC News
After five months lost in northeastern B.C, a beloved family cat is heading home for the holidays. Since July, Shadow the cat has been surviving in the wilderness of the Northern Rockies.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 03/12/2025
At a few recent talks, I showed the overlapping distribution between level of deprivation and density of #antibiotics use using the example of England (and others from HIC). A targeted approach is needed to better support clinicians in #antimicrobialstewardship www.theguardian.com/society/2025...
theguardian.com
Blackpool report: why do England’s deprived areas have the most troubled hospitals?
Clinicians in deprived areas are overwhelmed by generational ill health and poverty
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 03/12/2025
Three university students debating loudly in the quiet zone of the train about when to use t-test, one-way ANOVA and two-way ANOVA. Trying to memorize the rules before their exam. Fond memories for me from undergrad stats course. 🥸 TBH I didn’t understand those concepts till much later! #biostats
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 02/12/2025
www.cbc.ca/radio/asitha...
cbc.ca
Any Canadian who asks for HIV prevention drugs should get them, doctors say | CBC Radio
For the first time since 2017, Canadian doctors have released updated clinical guidelines for antiretroviral medications used to prevent HIV.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 25/11/2025
www.theguardian.com/global-devel... #AntibioticResistance
theguardian.com
Antibiotic resistance: how a pioneering trial is using old drugs to save babies from sepsis
The infection is responsible for 800,000 newborn deaths each year, but clinics in eight countries are working together to find new treatments
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Reposted by Miranda So PharmD MPH (Epidemiology)
CMI Communications @cmicomms.bsky.social · 16/10/2025
📣 New #Communicable drops Mon 20 Oct! @angelahuttner.bsky.social & @erinmccreary.bsky.social welcome Barbara Trautner @bwtrautner.bsky.social & Valéry Lavergne, the co-chairs of the first IDSA guidelines for complicated UTIs, to discuss this important milestone! #IDSky #UTIsky #MedSky #clinmicro
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 14/10/2025
www.theguardian.com/lifeandstyle... I’ve only ever done half marathons. While they were not necessarily “fun” in the physical sense, they were fun in the “look what I’ve accomplished!” 🙌sense. I aim to improve my PB each time but enjoying the journey is much more important! 🏃🏻‍♀️🏃🏻‍♀️🏃🏻‍♀️
theguardian.com
Running on empty: why are so many marathon runners so miserable?
One in four endurance runners displays ‘worryingly high’ levels of anxiety and depression, according to a study led by a man who has himself run more than 400 marathons. Isn’t exercise supposed to mak...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 30/09/2025
This brings me joy! 🐕🦮🐕‍🦺🏊‍♀️🏊‍♂️🏊 www.theguardian.com/lifeandstyle...
theguardian.com
‘He loves splashing around’: UK pools host doggy dips for pets and owners
Gourock outdoor pool in Inverclyde drops its humans-only policy on last day of the swim season – part of a trend at lidos around the country
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Reposted by Miranda So PharmD MPH (Epidemiology)
JAMA @jama.com · 12/09/2025
Antimicrobial resistance is the ability of germs to evade the treatment effects of antimicrobial drugs. This JAMA Patient Page describes antimicrobial resistance, its risk factors, and how to decrease the spread of antibiotic resistance. ja.ma/46ieWAE
Info sheet: "Antimicrobial resistance occurs when germs evade drug treatments." Risk factors include antibiotics, catheters, hospitalization, weakened immunity, age, and chronic conditions. Reduce resistance by avoiding overuse, washing hands, and getting vaccinated.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 12/09/2025
Excellent pro-con debate on selective digestive tract decomtaination (SDD) www.cmi-comms.org/article/S295... @cmicomms.bsky.social
cmi-comms.org
Selective digestive tract decontamination in the intensive care unit: Life saver or recipe for disaster?
‘Selective digestive tract decontamination’ (SDD) refers to the use of antibiotics to decrease bacterial load in the gut with the intention of reducing the risk of pneumonia (from microaspiration) and...
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Reposted by Miranda So PharmD MPH (Epidemiology)
Bluesky @bsky.app · 08/09/2025
v1.108 is rolling out today 🚚 Now live, at long last: Bookmarks, aka Saved Posts. For all those posts you'll definitely plan to come back to! Update the app and give it a try. The button is right down there 👇
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 09/09/2025
www.cbc.ca/player/play/... As a runner 🏃🏻‍♀️ I love this story so much! May be I will sign up for next year !! 🇨🇦
cbc.ca
#TheMoment Mark Carney surprised a volunteer at an Ontario race
Agnes Jung tells The National about the moment she ran alongside Prime Minister Mark Carney when he appeared at the Haliburton Forest Trail Race in Ontario.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 03/09/2025
A remarkable and moving human interest story. The Millionaire Who Left Wall Street to Become a Paramedic www.nytimes.com/2025/09/02/n...
nytimes.com
The Millionaire Who Left Wall Street to Become a Paramedic
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Reposted by Miranda So PharmD MPH (Epidemiology)
JAMA @jama.com · 20/08/2025
Climate-related disasters have impacted nearly two-thirds of US drug production facilities from 2019 to 2024, highlighting vulnerabilities in the #pharmaceutical supply chain. ja.ma/470sGSI
JAMA Research Letter: Climate Change and Health. Threats of Weather Disasters for Drug Manufacturing Facilities in the US. Figure 2 shows disaster declarations (2019-2024) on US maps, highlighting all disasters, severe storms, fires, and hurricanes.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 18/08/2025
A beautiful late afternoon run today. 🏃🏻‍♀️ Full view of Toronto by the lakefront. P.S. There is a hint of fall 🍂🍂🍂🍁🍁🍁 in the air.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 07/08/2025
Nice book for users of medical literature (clinicians), and producers of medical literature (researchers) alike. Tom and David Chivers explained statistical concepts with common examples from the news, often with humour. I LOL while listening to it on a run🏃‍♀️ www.goodreads.com/book/show/57...
goodreads.com
How to Read Numbers: A Guide to Stats in the News (and …
‘Even one glass of wine a day raises the risk of cancer…
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 04/08/2025
Went down a small rabbit hole to refresh my understanding of case-cohort design for a project. Here is a nice review in the journal #Epidemiology, comparing case-cohort to nested case-control, which is more common. #ResearchMethods fascinates me! journals.lww.com/epidem/abstr...
journals.lww.com
The Case for Case–Cohort: An Applied Epidemiologist’s Guide ... : Epidemiology
recision for addressing a singular research question, but case–cohort studies have broader efficiency and superior flexibility. Despite this, case–cohort designs are comparatively underutilized in the...
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Reposted by Miranda So PharmD MPH (Epidemiology)
Rahul Ganatra @rbganatra.bsky.social · 04/08/2025
Fewer than 10% of published observational studies in this sample used DAGs to justify confounder selection. This is a huge missed opportunity for both readers and researchers. DAGs are invaluable in research design and critical appraisal.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 04/08/2025
Hazy sunset due to #wildfires 🏃🏻‍♀️
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 03/08/2025
Interesting study in @jamanetworkopen.com on vancomycin PO to prevent recurrent C. difficile infection. Speaks to the challenges of study design to evaluate effects of prophylaxis. I commend the authors for their efforts. jamanetwork.com/journals/jam...
jamanetwork.com
Oral Vancomycin for Prevention of Recurrent Clostridioides difficile Infection
This randomized clinical trial examines whether prophylactic oral vancomycin vs placebo reduces recurrent Clostridioides difficile infection in adults receiving antibiotics for another indication.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 03/08/2025
Enjoyed reading this review from @jamanetworkopen.com ! I have been providing an educational series for team members about reseach methods. We had lots of discussions about how to manage confounding in observational studies. jamanetwork.com/journals/jam...
jamanetwork.com
Confounder Selection in Observational Studies in High-Impact Journals
This cross-sectional study investigates whether there have been improvements over time in the methods reported for selecting confounders in observational studies published in the highest impact factor...
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Reposted by Miranda So PharmD MPH (Epidemiology)
ASHE Journal @ashejournal.bsky.social · 31/07/2025
@bryanpwhite.bsky.social et al: In a cohort (n=127) of OPAT patients on daptomycin 7.4 mg/kg for an average of 37 days, the rate of CK elevation was 11.8% at a median of 13 days (IQR 9-16) supporting weekly lab monitoring on daptomycin for OPAT. doi.org/10.1017/ash....
doi.org
Incidence and risk factors for musculoskeletal adverse effects associated with daptomycin in patients receiving outpatient parenteral antimicrobial therapy | Antimicrobial Stewardship & Healthcare Epidemiology | Cambridge Core
Incidence and risk factors for musculoskeletal adverse effects associated with daptomycin in patients receiving outpatient parenteral antimicrobial therapy - Volume 5 Issue 1
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 30/07/2025
A patient’s lived experience with #cysticfibrosis www.theguardian.com/lifeandstyle...
theguardian.com
I spent my childhood in and out of hospital. At 19, I finally realised I had a terminal disease
Born with cystic fibrosis, Yvonne Hughes was lucky to survive her teens. She definitely didn’t expect to make it into her 50s. The comedian talks about the years she spent struggling to breathe – and ...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 30/07/2025
Great review on #antimicrobialstewardship strategies related to new agents and PK/PD modelling. www.mdpi.com/2079-6382/14...
mdpi.com
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 21/07/2025
Always appreciate how lovely the Toronto summer is. 🇨🇦
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 16/07/2025
This series from @nytimes.com is so educational (and frankly, frightening) for healthcare professionals. We need to listen to patients. #PatientEngagement #PatientSafety podcasts.apple.com/ca/podcast/t...
podcasts.apple.com
S02 Episode 3: The Guidelines
Podcast Episode · The Retrievals · S2 E3 · Subscribers Only · 55m
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 05/07/2025
The UK COVID-19 inquiry continues to be +++educational for me. The struggle with making wide-ranging governmental policies based on ever-changing evidence, which led to rapidly evolving and sometimes conflicting recommendations is palpable. I can empathize. covid19.public-inquiry.uk/public-heari...
covid19.public-inquiry.uk
Public hearings - UK Covid-19 Inquiry
The independent public inquiry to examine the Covid-19 pandemic in the UK
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 02/07/2025
Second time I've baked bread ever. Decided to try this super simple vegan recipe on Canada Day! Baking bread feels like a chemistry experiment.... lovingitvegan.com/easy-no-fail...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 01/07/2025
Got a 10km Canada Day run in this morning. A bit hot and sticky but just the way I like it! 🏃🏻‍♀️ lots of fellow runners, walkers and cyclists.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 23/06/2025
Wow. What a story. #sepsis www.cbc.ca/news/canada/...
cbc.ca
FIRST PERSON | When the day came that my son no longer needed a heart monitor, everyone was happy but me | CBC News
Natasha Chiam struggled to let go of the reassurance from the monitor that all was good with her child, when just a week earlier, his little seven-year-old heart had stopped. More than 10 years later,...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 22/06/2025
An interesting notion: balancing the need to jumpstart sepsis management vs. #antimicrobialstewardship. To me, rather than characterizing it as a "tension", I would reframe it - we are on the same side to optimize care, for which we need SYSTEM-LEVEL interventions. www.thelancet.com/journals/lan...
thelancet.com
Designing better systems to navigate the sepsis–antimicrobial stewardship tension
Sepsis is a leading cause of preventable death and requires timely antimicrobial treatment to reduce mortality. Despite extensive sepsis management guidelines, high-income countries continue to have c...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 22/06/2025
Hugely insightful review of #Antimicrobialstewardship in the ICU. Excellent analysis of the concept of de-escalation - be more mindful re: what antibiotics we are de-escalating with, especially the impact of anti-anaerobic options. annalsofintensivecare.springeropen.com/articles/10....
annalsofintensivecare.springeropen.com
Antibiotic stewardship in the ICU: time to shift into overdrive - Annals of Intensive Care
Antibiotic resistance is a major health problem and will be probably one of the leading causes of deaths in the coming years. One of the most effective ways to fight against resistance is to decrease ...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 20/06/2025
Excellent review on the importance of #antimicrobialstewardship at the end of life in from a global perspective in @thelancetinfdis.bsky.social Useful framework for clinicians suggested. www.thelancet.com/journals/lan...
thelancet.com
Antimicrobials in serious illness and end-of-life care: lifting the veil of silence
Global rates of antimicrobial consumption increased by 65% between 2000 and 2015, by 16% between 2016 and 2023, and are estimated to increase by an additional 52% by 2030. Antimicrobial use and misuse...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 18/06/2025
Excellent episode! Thank science for how far we have come in maternal-newborn health and infant mortality! Sanitation Obstetric care Neonatal care Screening Antibiotics Vaccines #PublicHealthSky #MedSky podcasts.apple.com/ca/podcast/i...
podcasts.apple.com
Midwives & Mothers: A History of Birth in Ireland
Podcast Episode · Irish History Podcast · 2025-05-28 · 29m
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Reposted by Miranda So PharmD MPH (Epidemiology)
American Society of Transplantation @astinfo.bsky.social · 17/06/2025
The Caregiver Toolkit is a valuable resource for patients and their loved ones navigating the transplant journey. 💡 A great resource to share with your patients and their families! 🔗
myast.org
Caregiver Toolkit
Make a difference in the field of transplantation by donating to support our cause.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 15/06/2025
This is so lovely: www.nytimes.com/interactive/... I miss my dad everyday.
nytimes.com
The Subtle Art of the Dad Text
When it comes to corny jokes, random photos and sincere pep talks, father knows best.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 13/06/2025
Very much enjoyed the Brahms at last evening’s performance by the #TorontoSymphonyOrchestra 🇨🇦 👏👏👏 especially the Piano Concerto No1 with Víkingur Ólafsson!
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 07/06/2025
While I have been playing pickle ball consistently over the last year, running 🏃🏻‍♀️ remains my most favourite activity: green space and nature! Listen to the birdsong! Other thoughts and reflections on 🏃🏻‍♀️: www.cambridge.org/core/journal...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 02/06/2025
Here is an excellent, informative viewpoint comes from #antimicrobialstewardship colleagues in Alberta Health Services: jamanetwork.com/journals/jam...
jamanetwork.com
Nitrites for Urinary Tract Infection
This Viewpoint examines the urinary nitrite test and questions its effectiveness and relevance in distinguishing between urinary tract infection and asymptomatic bacteriuria.
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 02/06/2025
I am involved in an initiative on #antimicrobialstewardship in nursing homes w/ #infectionprevention colleagues. UTI and asymptomatic bacteriuria are two big hitters. As I compiled resources for the NH, I came across this excellent paper from colleauges at @uhn.ca www.amjmed.com/article/S000...
amjmed.com
The Use of Urinalysis and Urine Culture in Diagnosis: The Role of Uncertainty Tolerance
A scenario all too familiar to hospital-based physicians: A patient presents to the hospital unwell enough to be admitted with either a nonlocalizing febrile illness or altered mental status in the se...
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Miranda So PharmD MPH (Epidemiology) @mirandapharmdmph.bsky.social · 28/05/2025
Fascinating story about academic research and researchers’ behaviour. www.theguardian.com/science/2025...
theguardian.com
The curse of Toumaï: an ancient skull, a disputed femur and a bitter feud over humanity’s origins
The long read: When fossilised remains were discovered in the Djurab desert in 2001, they were hailed as radically rewriting the history of our species. But not everyone was convinced – and the bitter...
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