Robustness Guided Verification

Exhaustive and thorough testing is the ideal form of testing for any system; it would not be possible for such a system to fail when all possible outcomes of its operation are known to succeed. However, with complex systems where the factors can be practically infinite, exhaustive testing is not feasible nor efficient. Novel approaches to testing systems and verifying that they adhere to their specifications are much needed. These approaches have to be able to test a wide variety of systems without necessarily knowing how these systems work. Such approaches to testing could potentially expose failures in systems with certain conditions that the tester could not have possibly imagined and consciously tested for. However, such approaches would be delegated to testing systems of high complexity, often with practically infinite parameter spaces. Therefore, testing algorithms have to be able to work with a limited set of possibilities, aiming to discover areas in which certain combinations of input parameters cause a failure in the system under test. Rare fail estimation is of particular importance in non-volatile memory cells such as the STT-MTJ based latch. Applying such novel approaches to non-volatile memory cells may accelerate yield estimation beyond what traditional tools are capable of. However, multiple tools are required to interoperate to integrate simulation of electric circuits with frameworks that implement such approaches. The tools required need to easily integrate Verilog-AMS models into ngspice, parametrize SPICE circuits from code, run several SPICE simulations in parallel. This allows to compute the ground truth in order to verify the accuracy of the Active Learning algorithm’s predictions, run SPICE simulations from within the Active Learning framework, be efficient with resource usage (such as memory), and execute in minimal time in order for the approach to be useful over more traditional approaches

Factors That Determine the Perceived Effectiveness of Peer Feedback in Collaborative Learning: a Mixed Methods Design

Introduction: Peer assessment has been promoted as a valuable approach to formative assessment to support learning and peer professionalism. This mixed methods study employed a conceptual framework to explore the factors that enhance the perceived effectiveness of formative peer assessment in the context of team-based learning as a form of collaborative learning. Materials and Methods: The volume and quality of written peer comments of two medical school classes at three time points were analyzed. Focus groups were then conducted to clarify issues that appeared in the quantitative data and to explore other emerging dimensions. Results: There was a notable deficiency in both the volume and quality of the comments provided, with no improvement over time. Several factors were identified, including some that are logistical and operational and can be corrected easily, such as the timing of the assignments. Others that stood out as major substantive issues and/or limitations related to the students’ conceptions of the purpose of the peer assessment and to their interpersonal variables. Discussion: There were social disincentives for students to provide constructive feedback to peers with whom a continuing working relationship is necessary. There was also an inconsistency between the quality of the peer feedback being typically shallow and lacking in substance, and students considering it beneficial. Conclusion: The findings identify factors that need to be addressed in order to ensure the quality and effectiveness of formative peer assessment among medical students. © 2020, International Association of Medical Science Educators

Experience with forced transition to online learning during the COVID-19 pandemic: Students’ cognitive performance and their perceptions of teaching

Introduction: The forced transition to online learning due to the COVID-19 pandemic has impacted medical education significantly. Methods: In this paper, the authors compare the performance of Year 1 and 2 classes of medical students who took the same courses either online (2019-2020) or face-to-face (2018-2019), and compare their evaluation of these courses. The authors also present results of three survey questions delivered to current Year 1 medical students on the perceived advantages and disadvantages of online learning and suggestions for improvement. Results: Performance and evaluation scores of Year 1 and 2 classes was similar irrespective of the mode of delivery of the course in question. 30 current (2019-2020) Year 1 students responded to the survey questions with a response rate of 25.4%. Some of the cited disadvantages had to do with technical, infrastructural and faculty know-how and support. But the more challenging limitations had to do with the process of learning and what facilitates it, the students’ ability to self-regulate and to motivate themselves, the negative impact of isolation, loss of socialisation and interaction with peers and faculty, and the almost total lack of hands-on experiences. Conclusion: Rapid transition to online learning did not affect student knowledge acquisition negatively. As such, the sudden shift to online education might not be a totally negative development and can be harnessed to drive a more progressive medical education agenda. These results are particularly important considering the several disadvantages that the students cited in relation to the online delivery of the courses. © 2021 TAPS. All rights reserved

Re-conceptualizing medical education in the post-COVID era

Purpose: The COVID-19 pandemic has forced changes in the delivery of medical education. We aimed to explore these changes and determine whether they will impact the future of medical education in any way. Methods: We invited leaders in medical education from all accessible US-based medical schools to participate in an online individual semi-structured interview. Results: Representatives of 16 medical schools participated. They commented on the adequacy of online education for knowledge transfer, and the logistical advantages it offered, but decried its negative influence on social learning, interpersonal relationships and professional development of students, and its ineffectiveness for clinical education. Most participants indicated that they would maintain online learning for didactic purposes in the context of flipped classrooms but that a return to in-person education was essential for most other educational goals. Novel content will be introduced, especially in telemedicine and social medicine, and the students’ roles and responsibilities in patient care and in curricular development may evolve in the future. Conclusions: This study is the first to document the practical steps that will be adopted by US medical schools in delivering medical education, which were prompted and reinforced by their experience during the COVID-19 pandemic. © 2023 Informa UK Limited, trading as Taylor & Francis Group

Respecting patient choices: Using the 'Go Wish' cards as a teaching tool

Background: Individuals have different values and priorities that can have an important impact on their medical management. Understanding this concept can help physicians provide medical care that is in line with the goals of their patients. Communicating this message effectively to students is challenging. Objective: To report our experience with using Go Wish cards in the medical education setting. Design: A thematic analysis of student reflection papers using grounded theory. Setting/Subjects: Second-year medical students participated in an activity using the Go Wish cards as part of a course module on palliative care. The activity aimed to encourage students to reflect on their own choices at the end of life and to highlight that different people have different priorities. Results: Forty-two students (42%) mentioned the Go Wish activity in their reflections on the module. They reported that the activity demonstrated the different priorities at the end of life, it illustrated the importance of providing personalised care, it promoted self-discovery, it transformed their view of death and dying, and it increased their appreciation of the importance of palliative care. Conclusion: Go Wish cards can be used to help illustrate the variability in priorities of patients. They can be used as an effective to teach medical students about the importance of considering patient preferences when illness progresses. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted

Pharmacological regulation of cytochrome P450 metabolites of arachidonic acid attenuates cardiac injury in diabetic rats

Diabetic cardiomyopathy (DCM) is a well-established complication of type 1 and type 2 diabetes associated with a high rate of morbidity and mortality. DCM is diagnosed at advanced and irreversible stages. Therefore, it is of utmost need to identify novel mechanistic pathways involved at early stages to prevent or reverse the development of DCM. In vivo experiments were performed on type 1 diabetic rats (T1DM). Functional and structural studies of the heart were executed and correlated with mechanistic assessments exploring the role of cytochromes P450 metabolites, the 20-hydroxyeicosatetraenoic acids (20-HETEs) and epoxyeicosatrienoic acids (EETs), and their crosstalk with other homeostatic signaling molecules. Our data displays that hyperglycemia results in CYP4A upregulation and CYP2C11 downregulation in the left ventricles (LV) of T1DM rats, paralleled by a differential alteration in their metabolites 20-HETEs (increased) and EETs (decreased). These changes are concomitant with reductions in cardiac outputs, LV hypertrophy, fibrosis, and increased activation of cardiac fetal and hypertrophic genes. Besides, pro-fibrotic cytokine TGF-ß overexpression and NADPH (Nox4) dependent-ROS overproduction are also correlated with the observed cardiac functional and structural modifications. Of interest, these observations are attenuated when T1DM rats are treated with 12-(3-adamantan-1-yl-ureido) dodecanoic acid (AUDA), which blocks EETs metabolism, or N-hydroxy-N’-(4-butyl-2-methylphenol)Formamidine (HET0016), which inhibits 20-HETEs formation. Taken together, our findings confer pioneering evidence about a potential interplay between CYP450-derived metabolites and Nox4/TGF-β axis leading to DCM. Pharmacologic interventions targeting the inhibition of 20-HETEs synthesis or the activation of EETs synthesis may offer novel therapeutic approaches to treat DCM. © 2021 Elsevier Inc

Equal antipyretic effectiveness of oral and rectal acetaminophen: a randomized controlled trial [ISRCTN11886401]

BACKGROUND: The antipyretic effectiveness of rectal versus oral acetaminophen is not well established. This study is designed to compare the antipyretic effectiveness of two rectal acetaminophen doses (15 mg/kg) and (35 mg/kg), to the standard oral dose of 15 mg/kg. METHODS: This is a randomized, double-dummy, double-blind study of 51 febrile children, receiving one of three regimens of a single acetaminophen dose: 15 mg/kg orally, 15 mg/kg rectally, or 35 mg/kg rectally. Rectal temperature was monitored at baseline and hourly for a total of six hours. The primary outcome of the study, time to maximum antipyresis, and the secondary outcome of time to temperature reduction by at least 1°C were analyzed by one-way ANOVA. Two-way ANOVA with repeated measures over time was used to compare the secondary outcome: change in temperature from baseline at times1, 2, 3, 4, 5, and 6 hours among the three groups. Intent-to-treat analysis was planned. RESULTS: No significant differences were found among the three groups in the time to maximum antipyresis (overall mean = 3.6 hours; 95% CI: 3.2–4.0), time to fever reduction by 1°C or the mean hourly temperature from baseline to 6 hours following dose administration. Hypothermia (temperature < 36.5°C) occurred in 11(21.6%) subjects, with the highest proportion being in the rectal high-dose group. CONCLUSION: Standard (15 mg/kg) oral, (15 mg/kg) rectal, and high-dose (35 mg/kg) rectal acetaminophen have similar antipyretic effectiveness

Identifying the core concepts of pharmacology education : a global initiative

Background and Purpose: In recent decades, a focus on the most critical and fundamental concepts has proven highly advantageous to students and educators in many science disciplines. Pharmacology, unlike microbiology, biochemistry or physiology, lacks a consensus list of such core concepts . Experimental approach: We sought to develop a research-based, globally relevant list of core concepts that all students completing a foundational pharmacology course should master. This two-part project consisted of exploratory and refinement phases. The exploratory phase involved empirical data mining of the introductory sections of five key textbooks, in parallel with an online survey of over 200 pharmacology educators from 17 countries across six continents. The refinement phase involved three Delphi rounds involving 24 experts from 15 countries across six continents. Key Results: The exploratory phase resulted in a consolidated list of 74 candidate core concepts. In the refinement phase, the expert group produced a consensus list of 25 core concepts of pharmacology. Conclusion and Implications: This list will allow pharmacology educators everywhere to focus their efforts on the conceptual knowledge perceived to matter most by experts within the discipline. Next steps for this project include defining and unpacking each core concept and developing resources to help pharmacology educators globally teach and assess these concepts within their educational contexts