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Designing a framework to support practice-based interprofessional education initiatives for student pharmacists : A modified Delphi study
Full text linkObjective To determine consensus among key stakeholders on statements to design a framework supporting practice-based interprofessional education (IPE) initiatives for student pharmacists. Methods The study used a 2-round modified Delphi technique. Statements were developed from published literature, a document analysis of international IPE frameworks, and findings from empirical studies completed as part of a wider program of research. This study was underpinned by the 3P (Presage-Process-Product) Model of Classroom Learning. A 4-point Likert scale was used. Data were analyzed using descriptive statistics. Consensus was preset at ≥70% agreement for individual statements. Panelists could provide comments at the end of each section; these were analyzed thematically. The Robert Gordon University School Ethics Review Committee granted ethical approval. Results Forty-five panelists consented to participate; a response rate of 82.2% (37/45) was achieved in round 1 and 71.1% (32/45) in round 2. In round 1, consensus was reached on 70/75 (93.3%) statements/substatements. In round 2, consensus was reached on 9/11 (81.8%) statements; 5 statements that did not achieve consensus in round 1, and 6 new statements based on panel members’ comments. The 2 statements that did not reach consensus related to summative assessment. Two themes were identified: “Realistic versus idealistic approach?” and “Looking at the bigger picture.” Conclusion Key stakeholders agree on the majority of presage, process, and product factors that must be considered during the development of practice-based IPE initiatives. Further investigation is needed to clarify any factors potentially contributing to a lack of agreement on statements relating to assessment
Accelerated deorbiting of MEO satellites using low-thrust propulsion and resonant perturbations
Full text linkIn the medium Earth orbit (MEO) region, lunisolar secular resonances can lead to long-term eccentricity growth over timescales of centuries. To accelerate the orbital decay of end-of-life satellites, this study proposes a strategy that uses low-thrust maneuvers to relocate them into resonant zones where orbital lifetimes are significantly reduced. Lifetime distribution maps for GPS- and Galileo-like orbits, constructed on the (Ω,) plane using a double-averaged Hamiltonian model, reveal extensive regions where the orbital lifetimes are less than 100 years or between 100 and 200 years. These resonant zones are, therefore, optimal targets for end-of-life post-mission disposal (PMD). By combining low-thrust maneuvers with natural dynamical resonances, the proposed strategy enables a substantial reduction in lifetime with minimal fuel consumption, offering a cost-effective approach to satellite deorbiting. Theoretical feasibility is demonstrated through representative transfer scenarios, although further analysis is needed to assess its practical implementation under operational constraints
Recommendations for developing asynchronous online consultations for chlamydia treatment for underserved populations : a Behaviour Change Wheel analysis
Full text linkIntroduction: People from underserved groups experience disproportionately poor sexual health and challenges accessing care. Asynchronous online consultations (a user completes a health questionnaire online, which is reviewed by a clinician) are being used within sexual healthcare to prescribe chlamydia treatment. Users require sufficient health and digital literacy to access online services and use them safely. Methods: We used the PROGRESS-Plus (PROGRESS: Place of Residence, Race/Ethnicity, Occupation, Gender/Sex, Religion, Education, Socio-economic Status, Social Network; Plus: e.g., Age, Sexual Orientation, Disability) framework to guide purposive recruitment of 35 participants from diverse underserved groups, from community settings and sexual health services in contrasting areas of the UK (15 October 2021–18 March 2022). We conducted qualitative semistructured interviews and thematic analyses to derive key barriers and facilitators to using asynchronous online consultations. We applied the Behaviour Change Wheel to specify recommendations to address them. Results: Over half of participants were from the most deprived areas and 40% were from minoritised ethnic groups. Key barriers included: lack of familiarity with online healthcare; perceived need to see a healthcare professional in person; privacy concerns; concerns about difficulty interpreting the questions; discomfort answering personal questions online. Key facilitators included: familiarity with online consultations; perceived low sexually transmitted infection risk; perceived increase in convenience, control and privacy; simple wording and design; and support while completing them. Recommendations included: increasing awareness and familiarity by promoting them offline and online and providing demonstrations and instructions on how to use them; encouraging people to choose them by highlighting available support, equivalence to in-person consultations and privacy and convenience; and reducing attrition by using simple wording and design, providing additional explanations and offering audio and visual alternatives to text. Conclusions: Incorporating these evidence-based, theoretically informed recommendations could widen access to underserved groups and increase the usability and safety of asynchronous online consultations for chlamydia treatment. Recommendations are likely to benefit all users and could be of use across health more broadly
Experimental estimation of preferences on population health ethics
No full textWe develop a novel social choice experiment capable of estimating preference parameters on population ethics. Our experiment poses three within-subject treatments in which participants allocate scarce resources to determine the health-related quality-of-life, and existence, of two population groups. Within a flexible social welfare function, we estimate participant-level preferences for inequality aversion, average vs total welfare maximisation, and minimum ‘critical level’ thresholds. By combining random behavioural and random utility models we also explicitly model ‘noise’ in decision making. Using a sample of British adults (n = 115, obs. = 5060), we find that 98.7% of respondents are inequality averse, prioritising the worst-off at the expense of efficiently maximising overall health. The modal group of participants (39.2%) maximise total welfare and have a critical level threshold of zero, however there is extensive heterogeneity in participants’ population preferences. We demonstrate how these preferences could be used to aid policymaking, where difficult trade-offs emerge between equity and efficiency, average and total welfare, and population sizes
Exploiting the inherent cyber resilience of inverter-dominated microgrids against PLL attack
Full text linkThis letter assesses the impact of phase locked-loop (PLL) cyberattacks on inverter-dominated microgrids considering the current limitation of the grid forming (GFM) and grid following (GFL) inverters. By reducing the PI gains of the PLL, an adversary can induce significant voltage sags by exploiting the dynamic coupling between the GFL’s synchronization loop and the GFM’s droop controller. The study demonstrates that preemptive tuning of lower droop gains in GFM inverters can mitigate the effects of such attacks. Leveraging this inherent cyber-resilience of inverter-dominated microgrids, an active decentralized droop adjustment mechanism is proposed. Power hardware-in-the-loop experiments validate the time-domain analysis and the effectiveness of the proposed mitigation strategy
Recent biotechnological advances in bioprospecting secondary metabolites from endolichenic fungi for drug discovery applications
No full textEndolichenic fungi (ELF) are symbiotic organisms residing in lichens. Since the initial report of its application in natural products and drug discovery, they have emerged as unique valuable sources of compounds with a wide range of structural diversity and biological activities. In this review, we critically examine current strategies to expand ELF metabolite diversity, with emphasis on the One Strain, Many Compounds (OSMAC) approach and metabolomics-guided profiling. We highlight how co-culture systems, epigenetic modifiers, and advanced metabolite data acquisition platforms can open new avenues for chemical space exploration. Genomic and transcriptomic studies, though still limited in ELF, reveal untapped biosynthetic potential and point toward integrative omics pipelines. Recent computational and artificial intelligence tools further accelerate genome–metabolome mining, structural elucidation, and prediction of bioactivity. We propose a forward-looking framework that combines OSMAC, integrative omics, and AI to maximize the natural product bioprospecting potential of ELF, while also uncovering their ecological roles within the lichen holobiome
Potential ways to improve the supply and use of quality-assured antibiotics across sectors in developing countries to reduce antimicrobial resistance
Full text linkAntimicrobial resistance (AMR) is growing across countries, especially among low- and middle-income countries (LMICs), increasing morbidity, mortality and costs.[1-5] Consequently, a range of measures and initiatives are required to address this urgent public health problem to prevent AMR becoming the next pandemic, especially amongst critical African and Asian countries.[5-9] We have already published Editorials in Advances in Human Biology regarding the potential measures that Governments and Health Authorities could instigate to improve the quality and efficiency of their medicine use, including antibiotics.[10] In addition, potential programmes to reduce the high levels of inappropriate dispensing of antibiotics amongst community pharmacies, especially in LMICs, to reduce AMR.[11] This includes the potential ways to effectively address the challenges with patients in LMICs often requesting antibiotics from prescribers or community pharmacy personnel for typically self-limiting conditions, exacerbated by their limited knowledge of antibiotics and AMR
Tenascin-c functionalised self-assembling peptide hydrogels for critical-sized bone defect reconstruction
Full text linkCritical-sized bone defects cannot heal spontaneously and receive poor clinical prognosis due to limitations in modern treatment strategies. Next-generation therapies are applying biomaterials incorporating BMP-2 to effectively promote and support bone regeneration, but adverse effects are linked to uncontrolled BMP-2 egress from the biomaterial. Implementing extracellular matrix proteins to biomaterials is a favourable approach to alleviate these drawbacks, and self-assembling peptide hydrogels are rapidly emerging as modulable and versatile biomaterials. Here, we describe the creation of a tenascin-c-functionalised peptide hydrogel designed to regenerate critical-sized bone defects. A recombinant fragment of tenascin-c spanning from the 3rd to 5th fibronectin-like domains is integrated into the fibre network. We demonstrate that this nascent construct effectively retains BMP-2 to differentiate mesenchymal stem cells into mature osteoblasts and achieves complete unionisation of murine critical-sized bone defects under low BMP-2 dose. All in all, we demonstrate tenascin-c as a suitable candidate to functionalise biomaterials intended for bone engineering applications and the promising potential of self-assembling peptide hydrogels in treating critical-sized bone defects
Theory and method of distributed virtual zero-sequence synchronous generators for cooperative fault arc suppression in active distribution networks
Full text linkSingle-line ground (SLG) faults in distribution networks may cause hazards such as fire, electric shock, and overvoltage. Active power electronic converters (PECs) can suppress the fault current and fault voltage. However, the application is limited due to the low suppression rate and high cost of additional power electronic equipment. This article proposes to employ distributed power electronics of active distribution networks to cooperatively eliminate fault. In this method, PECs are modeled as virtual zero-sequence synchronous generators (VZSGs), and the line-to-ground impedances (LGIs) are modeled as zero-sequence loads. A theory of distributed VZSGs supplying zero-sequence loads, which can realize fault current and voltage suppression, is proposed. The required supply current can be adaptively allocated between these VZSGs based on their reserve capacity ratio, and their supply current can be dynamically corrected based on the droop coefficients of VZSGs when the LGI changes. The fault current and voltage suppression rate is improved because the adaptive calculation of the VZSGs reference value combines the voltage- and current-based suppression methods. Simulation study and experimental validation results demonstrate that not only is the proposed method cost-effective, but it also efficiently improves the fault current and voltage suppression rate for various fault conditions
Sub-kHz linewidth intracavity VECSEL-pumped OPO
No full textWe report low noise and narrow linewidth performance of an actively stabilized optical parametric oscillator, intracavity-pumped by a visible AlGaInP-based vertical-external-cavity surface-emitting laser (VECSEL). Under dual-locking conditions, where the VECSEL and intracavity resonant idler are stabilized using the Pound–Drever–Hall and side-of-fringe locking techniques, respectively, narrow linewidths of 6.21(1) kHz (VECSEL) and 151(1) Hz (idler) are achieved for integration times as long as 4 s, illustrating the transfer of noise from the VECSEL fundamental to the OPO non-resonant signal. In this regime, the relative intensity noise of all three interacting waves is <−120 dBc/Hz for all frequencies above 1 kHz, indicating that this coherent laser system is well-suited for quantum optics experiments, potentially those involving squeezed light generation
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