Reflection on remote teaching and learning of a final-year BPharm clinical training module during a pandemic

No Abstrac

The significance of heat transport by shallow fluid flow at an active plate boundary: the Southern Alps, New Zealand

Fluid flow can influence fault behavior. Here we quantify the role of groundwater heat advection in establishing the thermal structure of the Alpine Fault, a major tectonic boundary in southern New Zealand that accommodates most of the motion between the Australian and Pacific Plates. Convergence on the Alpine Fault has rapidly uplifted the Southern Alps, resulting in high geothermal gradients and a thin seismogenic zone. A new equilibrium temperature profile from the 818-m-deep Deep Fault Drilling Project 2B borehole has been interrogated using one-dimensional analytical models of fluid and rock advection. Models indicate a total heat flux of 720-mW m2 results from groundwater flow with Darcy velocities approximating to 7.8 × 1010 m s1. Groundwaters advect significantly more heat than rock advection in the shallow orogen (<6-km depth) and are the major control on the subsurface temperature field

Location Preferences of Family Firms: Strategic Decision Making or “Home Sweet Home”?

Selecting a business location is among the most important strategic decisions for family firms. Yet the separate demands of the family and the business often prove difficult to balance. A comparison of location preferences in family and nonfamily firms provides insight into the family influence on strategic decision making.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67069/2/10_1111_j_1741-6248_1992_00271_x.pd

Dual transcriptional-translational cascade permits cellular level tuneable expression control.

The ability to induce gene expression in a small molecule dependent manner has led to many applications in target discovery, functional elucidation and bio-production. To date these applications have relied on a limited set of protein-based control mechanisms operating at the level of transcription initiation. The discovery, design and reengineering of riboswitches offer an alternative means by which to control gene expression. Here we report the development and characterization of a novel tunable recombinant expression system, termed RiboTite, which operates at both the transcriptional and translational level. Using standard inducible promoters and orthogonal riboswitches, a multi-layered modular genetic control circuit was developed to control the expression of both bacteriophage T7 RNA polymerase and recombinant gene(s) of interest. The system was benchmarked against a number of commonly used E. coli expression systems, and shows tight basal control, precise analogue tunability of gene expression at the cellular level, dose-dependent regulation of protein production rates over extended growth periods and enhanced cell viability. This novel system expands the number of E. coli expression systems for use in recombinant protein production and represents a major performance enhancement over and above the most widely used expression systems

The effectiveness of interventions that support penicillin allergy assessment and de-labelling of adult and paediatric patients by non-allergy specialists: A systematic review and meta-analysis.

INTRODUCTION: Penicillin allergy records are often incorrect and may result in harm. We aimed to systematically review the effectiveness and safety of non-allergist healthcare worker delivery of penicillin allergy de-labelling (PADL). METHODS: We searched EMBASE/ MEDLINE/ CINAHL (Ovid), PsycInfo, Web of Science and Cochrane CENTRAL from inception to 21/01/22, and unpublished studies and the grey literature. The proportion of penicillin allergic patients de-labelled and harmed was calculated using random effects models. FINDINGS: Overall, 5019 patients were de-labelled. Using allergy history alone, 14% (95% CI, 9.0-21%) of 4350 assessed patients were de-labelled without reported harm. Direct drug provocation testing resulted in de-labelling 27%; (95% CI, 18-37%) of 4207 assessed patients. Of 1373 tested, 98% were de-labelled (95% CI, 97-99%), harm, none serious, was reported in 1% (95% CI, 0-2%). Using skin testing followed by drug provocation testing de-labelled 41% (95% CI, 24-59%) of 2890 assessed patients. Of 1294 tested patients 95.0% (95% CI, 90%-99%) were de-labelled, reported harm was low.(0%; (95% CI 0%-1%). INTERPRETATION: PADL by non-allergists is efficacious and safe. The proportion of assessed patients who can be de-labelled increases with complexity of testing method, but substantial numbers can be de-labelled without skin testing. FUNDING: Source of funding: NIHR300542. Funder had no further role in the study

Farming on the edge: farmer attitudes to bovine tuberculosis in newly endemic areas

Defra's recent strategy to eradicate bovine tuberculosis (bTB) establishes three spatial zones: high-risk areas (HRAs) and low-risk areas, and an area referred to as ‘the edge’, which marks the areas where infection is spreading outwards from the HRA. Little is known about farmers in the edge area, their attitudes towards bTB and their farming practices. This paper examines farmers’ practices and attitudes towards bTB in standardised epidemiologically defined areas. A survey was developed to collect data on farmer attitudes, behaviours, practices and environmental conditions as part of an interdisciplinary analysis of bTB risk factors. Survey items were developed from a literature review and focus groups with vets and farmers in different locations within the edge area. A case-control sampling framework was adopted with farms sampled from areas identified as recently endemic for bTB. 347 farmers participated in the survey including 117 with bTB, representing a 70 percent response rate. Results show that farmers believe they are unable to do anything about bTB but are keen for the government intervention to help control the spread of bTB

Real-world performance and accuracy of stress echocardiography: The EVAREST observational multi-centre study

Aims - Stress echocardiography is widely used to identify obstructive coronary artery disease. High accuracy is reported in expert hands but is dependent on operator training and image quality. The EVAREST study provides UK-wide data to evaluate real-world performance and accuracy of stress echocardiography. Methods and Results - Participants undergoing stress echocardiography for coronary artery disease were recruited from 31 hospitals. Participants were followed up through health records which underwent expert adjudication. Cardiac outcome was defined as anatomically or functionally-significant stenosis on angiography, revascularisation, medical management of ischaemia, acute coronary syndrome or cardiac-related death within six months. 5131 patients (55% male) participated with a median age of 65 years (IQR 57 – 74). 72.9% of studies used dobutamine and 68.5% were contrast studies. Inducible ischaemia was present in 19.3% of scans. Sensitivity and specificity for prediction of a cardiac outcome were 95.4% and 96.0%, respectively, with an accuracy of 95.9%. Sub-group analysis revealed high levels of predictive accuracy across a wide range of patient and protocol sub-groups, with the presence of a resting regional wall motion abnormalitiy significantly reducing the performance of both dobutamine (p<0.01) and exercise (p<0.05) stress echocardiography (p<0.05). Overall accuracy remained consistently high across all participating hospitals. Conclusion – Stress echocardiography has high accuracy across UK-based hospitals and thus indicates stress echocardiography is being delivered effectively in real-world practice, reinforcing its role as a first-line investigation in the assessment of patients with stable chest pain

Review : Capripoxvirus Diseases: Current Status and Opportunities for Control

Lumpy skin disease, sheeppox and goatpox are high-impact diseases of domestic ruminants with a devastating effect on cattle, sheep and goat farming industries in endemic regions. In this article, we review the current geographical distribution, economic impact of an outbreak, epidemiology, transmission and immunity of capripoxvirus. The special focus of the article is to scrutinize the use of currently available vaccines to investigate the resource needs and challenges that will have to be overcome to improve disease control and eradication, and progress on the development of safer and more effective vaccines. In addition, field evaluation of the efficacy of the vaccines and the genomic database available for poxviruses are discussed.Peer reviewe