Electrolyte disturbances: causes and management

This article details the clinical presentations of the most common electrolyte disturbances and how to treat them

Implementing blog writing as a tool for promoting student engagement and literacy development

This paper discusses the implementation of blog writing within a final year undergraduate module as a way of providing a type of inclusive writing. A mixed-methods approach is employed, with the aim of exploring whether blogging affords students with a means to engage with and take ownership of their writing and learning. Drawing on both tutor and students’ experiences and perceptions, we propose that blogging has the potential for fostering greater student engagement

A Formalization of the Theorem of Existence of First-Order Most General Unifiers

This work presents a formalization of the theorem of existence of most general unifiers in first-order signatures in the higher-order proof assistant PVS. The distinguishing feature of this formalization is that it remains close to the textbook proofs that are based on proving the correctness of the well-known Robinson's first-order unification algorithm. The formalization was applied inside a PVS development for term rewriting systems that provides a complete formalization of the Knuth-Bendix Critical Pair theorem, among other relevant theorems of the theory of rewriting. In addition, the formalization methodology has been proved of practical use in order to verify the correctness of unification algorithms in the style of the original Robinson's unification algorithm.Comment: In Proceedings LSFA 2011, arXiv:1203.542

Developing a feasible model for delivering quality hospital-based experiential learning for pharmacy undergraduate students funded by the healthcare education and training tariff

The Department of Health and Social Care (UK) provides funding to support clinical placements for healthcare students in England through their education and training tariff, which is administered by Health Education England (HEE). From September 2022, undergraduate pharmacy students became eligible for this funding to support their experiential learning. Development of quality, feasible experiential learning for pharmacy students within the context of the tariff proved challenging for both higher education institutions (HEIs) and hospital placement providers. Barriers to delivery were identified and addressed, such as no HEE published strategy for placement delivery, as well as the financial constraints of the tariff payments which made placements unattractive to providers. Pharmacy school inexperience of arranging longer placements and a substantial administrative burden added to the challenge. This report outlines the developmental process behind the experiential learning that is now delivered by Liverpool John Moores University and the local hospital providers

An evaluation of a nurse led unit: an action research study

This study is an exemplar of working in a participatory way with members of the public and health and social care practitioners as co-researchers. A Nurse Consultant Older People working in a nurse-led bed, intermediate care facility in a community hospital acted as joint project lead with an academic researcher. From the outset, members of the public were part of a team of 16 individuals who agreed an evaluation focus and were involved in all stages of the research process from design through to dissemination. An extensive evaluation reflecting all these stakeholders’ preferences was undertaken. Methods included research and audit including: patient and carer satisfaction questionnaire surveys, individual interviews with patients, carers and staff, staff surveys, graffiti board, suggestion box, first impressions questionnaire, patient tracking and a bed census. A key aim of the study has been capacity building of the research team members which has also been evaluated. In terms of impact, the co-researchers have developed research skills and knowledge, grown in confidence, developed in ways that have impacted elsewhere in their lives, developed posters, presented at conferences and gained a better understanding of the NHS. The evaluation itself has provided useful information on the processes and outcomes of intermediate care on the ward which was used to further improve the service

Pharmacokinetics and pharmacodynamics of direct oral anticoagulants

Introduction: Direct oral anticoagulants (DOACs) have overtaken vitamin K antagonists to become the most widely-used method of anticoagulation for most indications. Their stable and predictable pharmacokinetics combined with relatively simple dosing, and the absence of routine monitoring has made them an attractive proposition for healthcare providers. Despite the benefits of DOACs as a class, important differences exist between individual DOAC drugs in respect of their pharmacokinetic and pharmacodynamic profiles with implications for dosing and reversal in cases of major bleeding. Areas covered: This review summarizes the state of knowledge relating to the pharmacokinetics of dabigatran (factor IIa/thrombin inhibitor) and apixaban, edoxaban and rivaroxaban (factor Xa) inhibitors. We focus on pharmacokinetic differences between the drugs which may have clinically significant implications. Expert opinion: Patient-centered care necessitates a careful consideration of the pharmacokinetic and pharmacodynamic differences between DOACs, and how these relate to individual patient circumstances. Prescribers should be aware of the potential for pharmacokinetic drug interactions with DOACs which may influence prescribing decisions in patients with multiple comorbidities. In order to give an appropriate dose of DOAC drugs, accurate estimation of renal function using the Cockcroft-Gault formula using actual body weight is necessary. An increasing body of evidence supports the use of DOACs in patients who are obese, and this is becoming more routine in clinical practice

Defining Lineage Potential and Fate Behavior of Precursors during Pancreas Development

Pancreas development involves a coordinated process in which an early phase of cell segregation is followed by a longer phase of lineage restriction, expansion, and tissue remodeling. By combining clonal tracing and whole-mount reconstruction with proliferation kinetics and single-cell transcriptional profiling, we define the functional basis of pancreas morphogenesis. We show that the large-scale organization of mouse pancreas can be traced to the activity of self-renewing precursors positioned at the termini of growing ducts, which act collectively to drive serial rounds of stochastic ductal bifurcation balanced by termination. During this phase of branching morphogenesis, multipotent precursors become progressively fate-restricted, giving rise to self-renewing acinar-committed precursors that are conveyed with growing ducts, as well as ductal progenitors that expand the trailing ducts and give rise to delaminating endocrine cells. These findings define quantitatively how the functional behavior and lineage progression of precursor pools determine the large-scale patterning of pancreatic sub-compartments

RPO, Second-order Contexts, and Lambda-calculus

First, we extend Leifer-Milner RPO theory, by giving general conditions to obtain IPO labelled transition systems (and bisimilarities) with a reduced set of transitions, and possibly finitely branching. Moreover, we study the weak variant of Leifer-Milner theory, by giving general conditions under which the weak bisimilarity is a congruence. Then, we apply such extended RPO technique to the lambda-calculus, endowed with lazy and call by value reduction strategies. We show that, contrary to process calculi, one can deal directly with the lambda-calculus syntax and apply Leifer-Milner technique to a category of contexts, provided that we work in the framework of weak bisimilarities. However, even in the case of the transition system with minimal contexts, the resulting bisimilarity is infinitely branching, due to the fact that, in standard context categories, parametric rules such as the beta-rule can be represented only by infinitely many ground rules. To overcome this problem, we introduce the general notion of second-order context category. We show that, by carrying out the RPO construction in this setting, the lazy observational equivalence can be captured as a weak bisimilarity equivalence on a finitely branching transition system. This result is achieved by considering an encoding of lambda-calculus in Combinatory Logic.Comment: 35 pages, published in Logical Methods in Computer Scienc

A novel long non-coding natural antisense RNA is a negative regulator of Nos1 gene expression

Long non-coding natural antisense transcripts (NATs) are widespread in eukaryotic species. Although recent studies indicate that long NATs are engaged in the regulation of gene expression, the precise functional roles of the vast majority of them are unknown. Here we report that a long NAT (Mm-antiNos1 RNA) complementary to mRNA encoding the neuronal isoform of nitric oxide synthase (Nos1) is expressed in the mouse brain and is transcribed from the non-template strand of the Nos1 locus. Nos1 produces nitric oxide (NO), a major signaling molecule in the CNS implicated in many important functions including neuronal differentiation and memory formation. We show that the newly discovered NAT negatively regulates Nos1 gene expression. Moreover, our quantitative studies of the temporal expression profiles of Mm-antiNos1 RNA in the mouse brain during embryonic development and postnatal life indicate that it may be involved in the regulation of NO-dependent neurogenesis