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Dissertations / Theses on the topic '320503 Clinical Pharmacology and Therapeutics'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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1

Watson, Victoria. "The clinical pharmacology of Human Immunodeficiency Virus (HIV) therapy failure." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/18853/.

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The work in my thesis focuses on developing highly sensitive tests, using liquid chromatography-tandem mass spectrometry (LC-MS/MS) for the measurement of antiretroviral drugs within plasma, cells, and cerebral spinal fluid from clinical studies evaluating compartmentalised antiretroviral therapy (ART) pharmacokinetics and forgiveness for missed or late dosing. Firstly I developed and validated a LC-MS/MS assay to quantify the antiretroviral (ARV) drugs, lopinavir, darunavir, ritonavir and raltegravir in peripheral blood mononuclear cells (PBMCs). This intracellular assay included optimising m

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2

Alharf, Adel Abdullah. "Prevalence of and clinical characteristics associated with microalbuminuria in hypertension." Thesis, University of Glasgow, 2012. http://theses.gla.ac.uk/3643/.

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Cardiovascular disease is the leading cause of mortality. As blood pressure is one of the most important risk factors for cardiovascular disease, effective management of hypertension is critical in reducing this risk. In addition to high blood pressure, however, several factors have been identified as predictors of future cardiovascular events. These include high cholesterol, cigarette smoking, obesity and diabetes. Taken together, these traditional risk factors do not entirely explain the risk. Thus, many novel risk factors have been proposed for risk prediction of cardiovascular disease. Mic

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3

Saunders, Robert Edward. "Pharmacists in general medical practice : a case study of clinical commissioning groups." Thesis, Keele University, 2018. http://eprints.keele.ac.uk/5106/.

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Pharmacists have been identified to address the increasing workload in United Kingdom (UK) general practice. A pilot has been commissioned by National Health Service England (NHSE) to upskill pharmacists for this purpose. Evaluation is underway and early reports indicate that there have been integration issues. The value of pharmacists working in general practice and the level of training required for the role are not fully understood. The research reported in this thesis was started before the NHSE pilot. It was conducted to understand the background of Clinical Commissioning Group (CCG) prac

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4

Suggett, Emma Lucy. "Risk assessment of patients as a means of directing a clinical pharmacy service." Thesis, University of Birmingham, 2017. http://etheses.bham.ac.uk//id/eprint/7336/.

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The aim of this research was to develop a new work model for hospital pharmacists based on risk assessment of patients using an electronic prescribing and administration system (EPMA). Systematic review was performed to identify risk factors associated with clinical pharmacy intervention. Those factors which can be measured by the EPMA in a UK teaching hospital were subsequently identified. Data was extracted from the EPMA relating to risks in intervention recipients on medical and surgical wards and those patients present concurrently. Univariable and multivariable analysis was performed and

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5

Hattersley, John G. "Mathematical modelling of immune condition dynamics : a clinical perspective." Thesis, University of Warwick, 2009. http://wrap.warwick.ac.uk/2755/.

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This thesis describes the use of mathematical modelling to analyse the treatment of patients with immune disorders; namely, Multiple Myeloma, a cancer of plasma cells that create excess monoclonal antibody; and kidney transplants, where the immune system produces polygonal antibodies against the implanted organ. Linear and nonlinear compartmental models play an important role in the analysis of biomedical systems; in this thesis several models are developed to describe the in vivo kinetics of the antibodies that are prevalent for the two disorders studied. These models are validated against pa

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6

Griffin, Xavier L. "The clinical effectiveness of biological treatment adjuncts in the management of acute and un-united fractures." Thesis, University of Warwick, 2012. http://wrap.warwick.ac.uk/56285/.

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Background: Fractures are common. The annual incidence of fresh fractures is estimated to be 3.6 per 100 people in England and Wales. Traditional management, employing nonoperative immobilisation strategies, has been replaced by a much more operative approach. The aim of this thesis is to understand and add to the evidence that supports available biological adjuncts to fracture management. Exploration of the evidence through synthesis: Several systematic reviews have been performed to review the currently available evidence for the clinical effectiveness of biological adjuncts. Adjuncts were c

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7

Mazlan-Kepli, Wardati. "Antiplatelet therapy and clinical outcomes in cardiovascular diseases." Thesis, University of Glasgow, 2016. http://theses.gla.ac.uk/7831/.

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Cardiovascular diseases (CVD) is a leading cause of death in the world. Despite effective treatment regimens for ischaemic heart disease (IHD) and ischaemic stroke, mortality and recurrence rates remain high. Antiplatelet therapy is on effective treatment and reduces the risk of recurrent heart attack and stroke. Nevertheless, there are patients who stopped or interrupted their antiplatelet therapy for certain reasons or some patients may be resistant or poor responders to antiplatelet therapy. Furthermore, there is evidence of rebound effect in platelet activity after antiplatelet cessation a

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8

Shilbayeh, Sirin. "Systematic overview of clinical trials of antiarrhythmic drugs." Thesis, University of Nottingham, 1998. http://eprints.nottingham.ac.uk/30616/.

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BACKGROUND Arrhythmia is a cardiovascular disorder which can lead to several complications. Over the past decade the introduction of many new drugs has raised concerns about their questionable benefits and cost-effectiveness. Classification of antiarrhythmic drugs has not been fully resolved. Although numerous clinical trials have been conducted, the value of antiarrhythmic drugs in many indications remains controversial. Two meta-analyses of clinical trials addressing the indication of quinidine (Class I) for maintenance of sinus rhythm after cardioversion have suggested high efficacy rates b

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9

Duncan, Porter. "The development of randomised clinical trials in the treatment of rheumatoid arthritis over 20 years (1991-2011) in a single centre." Thesis, University of Glasgow, 2013. http://theses.gla.ac.uk/3854/.

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Rheumatoid Arthritis (RA) is the commonest inflammatory polyarthritis in the UK, and is associated with significant symptoms, disability and premature mortality. Treatment options in 1980 were restricted to corticosteroids, non-steroidal anti-inflammatory drugs, and a small number of disease modifying anti-rheumatic drugs (DMARDs). There had been few large, well conducted randomised controlled studies such that our knowledge about the relative efficacy and safety of the drugs available was very limited. Trial design also left much to be desired, with inadequate methods of randomisation and/or

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10

Rushton, Alison. "An exploration of the construct of Masters level clinical practice." Thesis, University of Warwick, 2004. http://wrap.warwick.ac.uk/1221/.

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This study aimed to explore the construct of Masters level clinical practice. A mixed methods approach converging quantitative and qualitative data was undertaken. Consensus of behaviours indicative of the construct was explored through a quantitative Delphi study. Participants represented a total population sample of Masters course tutors in healthcare (n = 48). Round 1 requested behaviours indicative of the construct. Quantitative content analysis informed the behaviours explored in round 2, where participants rated their relative importance. Round 3 asked participants to rank the behaviours

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11

Madi, Mohammad Abdelfattah Atallah. "Investigating the impact of postgraduate musculoskeletal physiotherapy education on practitioners' clinical reasoning skills." Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8702/.

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Advancing clinical reasoning skills is one of the main outcomes of postgraduate master's level (M-level) programmes approved by the Musculoskeletal Association of Chartered Physiotherapists (MACP). While, the outcomes of these programmes were investigated in multiple retrospective studies, there is a limited understanding of the learning culture that drives change. Thus, the aim was to examine the learning culture of an MACP approved programme to capture the sociocultural mediators that advanced clinical reasoning skills. An empirical longitudinal mixed-methods theory-seeking case study was co

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12

Burke, Danielle Lisa. "Use of Bayesian methods for the design, analysis and synthesis of clinical trials." Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/5931/.

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This thesis explores Bayesian methods for the statistical design, analysis and synthesis of clinical trials, and compares these with a frequentist approach in several settings to determine key differences, advantages and limitations. A review of randomised trials indicates that Bayesian methods are rarely applied, but useful for making probability statements and incorporating prior evidence, especially in trials with small sample sizes. These advantages are illustrated in a trial in congenital lower urinary tract obstruction, which has few events but elicited prior distributions about treatmen

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13

Young, Ruth. "A comparison of the nature and severity of worries held by adolescents with and without intellectual disabilities as they approach the transition away from school : major research project and clinical research portfolio." Thesis, University of Glasgow, 2013. http://theses.gla.ac.uk/4652/.

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Background: The transition away from secondary school is an important time for adolescents, when identity is shaped and autonomy is increased. It is likely that this period can be particularly worrisome for people with intellectual disabilities (IDs) and it is possible that these worries will have an impact on mental well-being. This study sought to shed light on the content and implications of worries during the approach to transition. Methods: Twenty-five participants with mild to moderate IDs and 27 participants without IDs, all aged 15 to 18, were recruited from schools in the West of Scot

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14

Paul, Graham R. "Defining dosimetry and implications for aerosol presentation for non-clinical development of respiratory drugs." Thesis, Cardiff University, 2017. http://orca.cf.ac.uk/113410/.

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Strategies for expediting preclinical development of drugs include using alternative (different to clinical) formulations or exposure routes to reduce compound usage. This may alter pharmacokinetics and hence efficacy and/or toxicopathology compared with the final formulation. Three p38 mitogen-activated kinase inhibitors (similar in vitro potency) with different physicochemical properties were administered to rats as dry powder or nebulised aerosols to investigate the influence of changes in particulate form on in vivo endpoints. When rats settled in restraint tubes before aerosol administra

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15

Ogese, Monday. "Definition of antigenic determinants in drug hypersensitive patients : an integrated clinical, chemical and cellular approach to quantify and characterize the drug signals presented to T-Lymphocytes." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/18733/.

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Idiosyncratic drug hypersensitivity remains a major challenge as it causes high morbidity and mortality. This is complicated by the multiple risk factors implicated and the inability to predict these reactions during the early stages of drug development. Thus, this study attempted to delineate the molecular pathomechanism(s) involved in sulfamethoxazole (SMX) hypersensitivity. The reactive metabolite, nitroso-SMX (SMX.NO) generated through the hepatic bioactivation of SMX has long been hypothesised as a major trigger of these reactions. SMX hypersensitivity has been used as a paradigm to study

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16

Quinn, Terence J. "Improving outcome assessment for clinical trials in stroke." Thesis, University of Glasgow, 2010. http://theses.gla.ac.uk/1648/.

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Abstract Clinical trials are at the centre of advances in our understanding of stroke and its optimal treatment. In this thesis the uses and properties of outcome assessment scales for stroke trials are described, with particular attention given to the modified Rankin Scale (mRS). Through comprehensive literature review I will show that mRS is the most frequently used functional outcome scale in clinical trials but efficacy of the scale is potentially limited by inter-observer variability. Using a “mock” clinical trial design I demonstrate that inter-observer mRS variability in contemporary pr

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17

Chan, Yuen Ling (Tracey). "The biological features and clinical significance of natural killer cell reconstitution following allogenic stem cell transplantation." Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8714/.

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Natural killer (NK) cells reconstitute rapidly following allogeneic stem cell transplantation (allo-SCT) at a time when alloreactive T cell immunity is being established. Important differences are seen in the patterns of reconstitution between T cell deplete, T cell replete and umbilical cord stem cell transplants. 82 patients who received T cell-deplete allo-SCT were studied to determine the functional and transcriptional profile of the reconstituting NK cells and to assess the relationship with clinical outcome. NK cells at day 14 (D14-NK) were donor-derived, intensely proliferating and expr

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18

Kamudoni, Paul. "Development, validation and clinical application of a patient-reported outcome measure in hyperhidrosis : the Hyperhidrosis Quality of Life Index (HidroQoL ©)." Thesis, Cardiff University, 2014. http://orca.cf.ac.uk/58233/.

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Consideration of broader outcomes of disease, especially those exclusively experienced and reported by the patient, such as HRQOL, is not only consistent with the ‘whole person’ view of health contained in the 1948 WHO definition, but is also a prerequisite to building health-care systems that are responsive to the needs of the patients. For chronic skin diseases, such as hyperhidrosis, these provide a useful indicator of how a patient feels and functions disease for both practical and methodological reasons. The aims of this study therefore were to investigate the impact of hyperhidrosis on p

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19

Reynolds, James Patrick. "Development of a novel means of drug administration to the female genital tract." Thesis, University of Brighton, 1995. https://research.brighton.ac.uk/en/studentTheses/8abe45cb-6f5f-45f6-8a50-81d11fecc4d1.

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The treatment of menopausal symptoms by combined hormone replacement therapy (HRT) utilises drug formulations whereby a progestii1 is added to the oestrogen component to decrease the risk of endometrial carcinoma prnduced by the oestrogen. However, administration of large doses of progestins can increase low density lipid cholesterol, as well as reduce some of the beneficial effects of oestrogens. Local administration of progestins to the uterus may allow a much smaller dose to be used reducing the antagonism produced by progestins on desired oestrogenic effects. The simplest way to administer

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20

McKenzie-Mills, Marie. "Developing a community of practice for trainers : towards a culture of conscience in clinical research." Thesis, University of Warwick, 2009. http://wrap.warwick.ac.uk/3171/.

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This developmental research study concerned how trainers, drawn mainly from the commercial (pharmaceutical) sector of the field of clinical research, shared understandings of practice in a professionally localised community, as part of their continuing professional development. Trainers in this community had a heterogeneous range of identities including full-time and part-time trainers: clinical research trainers, training managers; clinical research managers, clinical research associates, compliance managers, auditors and others. The main aim was to explain conditions shaping this community a

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21

Pontefract, Sarah Katie. "The impact of computerised physician order entry with integrated clinical decision support on pharmacist-physician communication in the hospital setting." Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8167/.

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An analysis of over 34,000 free-text messages assigned by pharmacists to prescription orders over a 12-month period showed a sub-optimal exchange of information with the physician. Focus groups and observational research were conducted to provide a more in-depth understanding of the factors involved. The use of CPOE did not reduce opportunities for personal interaction. The capability to communicate electronically facilitated a non-interruptive workflow, beneficial for staff time and for limiting distractions. It also improved clinical documentation, which helped coordinate care of patients be

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22

Egharevba, Terry. "Stakeholder perceptions towards conducting pharmaceutical industry-sponsored clinical trials in Sub-Saharan Africa." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8451/.

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Clinical trials are prospective studies in volunteers to test the safety and efficacy of a drug or intervention in a well-defined, controlled experiment. Pharmaceutical companies spend billions of dollars each year on clinical trials. Yet, despite the rising levels of chronic diseases and evidence suggesting that black patients may respond to treatments differently than their white counterparts, Sub-Saharan Africa is still represented in very few industry-sponsored trials. In addition to any immediate potential therapeutic benefit and the ability to grant patients greater access to drugs that

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23

Aldekhail, Nasser Mohammed N. "Pharmacotherapy and weight management : efficacy and clinical effectiveness in patients with obesity and type 2 diabetes." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/8659/.

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The prevalence of obesity worldwide has more than doubled since 1980. The World Health Organisation (WHO) estimates that more than one in ten adults in the global population is obese. Cardiovascular and metabolic health can be improved with moderate weight loss; losses of 5%–10% have been found to improve conditions such as diabetes, hypertension and cholesterol and low-density lipoprotein (LDL) levels. Within the UK, a number of weight management programmes that depend on lifestyle intervention (tier 2) and others that supplement this with drug therapy (tier 3) and surgery (tier 4) are availa

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24

Dale, James Edward. "Tailoring therapy to individual patient's needs : intensive management of early rheumatoid arthritis using either clinical, laboratory or musculoskeletal ultrasound assessment of disease activity." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/4991/.

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Background: Outcomes in the management of early rheumatoid arthritis (RA) have been significantly improved through the use of composite disease activity measures (such as the DAS28) and aggressive DMARD escalation until a lower disease activity target has been achieved. Imaging studies suggest that the DAS28 may be insensitive to low levels of subclinical active disease that is associated with an increased risk of flare and progressive joint damage. Further, in some cases, elevations of the DAS28 may not necessarily be related to on going active synovitis. In both instances, relying upon the D

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25

Madela, Karolina. "Design, synthesis and biological evaluation of novel anti-HCV nucleosides and nucleotides : from bench to the clinical trials." Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/38691/.

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The search for new anti-HCV therapeutics continues, as current standard of care based on pegINF and ribavirin is limited and can cause significant side effects. Several families of modified nucleoside are known to inhibit HCV RNA dependent RNA polymerase (RdRp). The 2’-C-!-methylguanosine (2’CMeG) has been identified as one of the most potent RdRp inhibitors (IC50 = 0.26 μM as NTP). Despite its very good activity at the triphosphate level its poor cell uptake and presumably poor phosphorylation lead to significant decrease in active in HCV replicon assays (EC50 = 3.5μM). The ProTide approach w

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26

Qian, Cheng. "Determining principles for the development of virtual environments for future clinical applications." Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/5965/.

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The aim of the present research was to determine a range of principles for the development of virtual natural environments (VNEs), using low-cost commercial-off-the-shelf simulation technologies, for bedside and clinical healthcare applications. A series of studies have been conducted to systematically investigate different aspects of the VNEs on a wide variety of participants, ranging from undergraduate and postgraduate students, hospital patients and clinicians, to West Country villagers. The results of these studies suggest that naturalistic environmental spatial sounds can have a positive

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27

Resteghini, Peter. "Injection therapy in the management of osteoarthritis of the knee." Thesis, University of Brighton, 2010. https://research.brighton.ac.uk/en/studentTheses/9c772b34-7dca-4761-a83a-725b7080d613.

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Osteoarthritis is common with radiographic features practically universal in at least some joints in people aged over 60 years. One of the main therapeutic interventions used in the management of osteoarthritis is the injection of corticosteroid and hyaluronan (Gossec 2006). However, there exist few studies that seek to explore possible factors that influence outcome following injection. This study examined the factors that may influence the outcomes following injection of either corticosteroid or hyaluronan in the management of osteoarthritis of the knee.

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28

Ma, Da, and 马达. "In vivo and ex vivo studies of intraocular tamponade agents and their clinical relevance in intraocular drug delivery." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B4454618X.

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29

Cardoso, André Filipe da Silva Lopes. "Estágio em coordenação de ensaios clínicos." Master's thesis, Universidade de Aveiro, 2014. http://hdl.handle.net/10773/12947.

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Mestrado em Biomedicina Farmacêutica<br>This report presents my experience during an internship at the Clinical Investigation Centre of the Department of Neurology at Hospital of Santa Maria, together with some activities at the Laboratory of Clinical Pharmacology and Therapeutics and at the Pharmacovigilance Unit of Lisbon and Tejo Valley . The internship took place between September 2013 and June 2014. The internship is part of the curricular activities of the second year of the Masters in Pharmaceutical Biomedicine, University of Aveiro . This report will address CT and OS coordinati

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30

Isah, Esther Ebole. "Physicians‟ information practices : a case study of a medical team at a Teaching Hospital." Doctoral thesis, Högskolan i Borås, Institutionen Biblioteks- och informationsvetenskap / Bibliotekshögskolan, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-3630.

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This thesis is a user study within library and information science on participatory practices of a professional group in work activity. This has been investigated only to a minor extent in previous library and information science research. The qualitative empirical focus alternates between physicians‟ engagements in work practice and workplace learning within patient care. The overall research problem was to learn how people in workplaces interacted with information that was embedded, intricately intertwined, and tightly bound to the ongoing routines of their everyday work. This thesis aims at

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31

MacGibbon, Geraldine Anne. "Mechanisms of cell death in Alzheimer's disease." 1998. http://hdl.handle.net/2292/3164.

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Alzheimer's disease (AD) is a progressive neurodegenerative disorder, which is characterised clinically by dementia and progressive memory loss, and pathologically by neuronal degeneration, plaques (insoluble β-amyloid (Aβ) protein) and neurofibrillary lesions (abnormally phosphorylated tau protein). The mechanisms by which cells die in AD remain largely unknown and controversial. There is some evidence to suggest that cell death in AD brains may occur by apoptosis, and that Aβ might be involved in this process. Apoptosis, a type of cell death characterised by distinct morphological and bioche

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(9086249), Chandrali S. Bhattacharya. "MEASUREMENT OF STEREOSELECTIVE BUPROPION DISPOSITION IN RAT BRAIN TO SUPPORT TRANSLATIONAL PBPK/PD MODEL DEVELOPMENT AND APPLICATION." Thesis, 2020.

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<div><b>Background:</b> Bupropion, an atypical antidepressant and smoking cessation aid, is associated with wide inter-subject variability in its efficacy and safety. Variability in response to bupropion therapy is thought to be driven by variability in metabolism. Bupropion undergoes complex phase 1 and 2 stereoselective metabolism. Though bupropion`s pharmacology is not fully understood, much of it is thought to be due to its metabolites, specially, S, S-hydroxybupropion. In vitro studies (functional assays measuring IC50 at dopamine transporter-DAT, norepinephrine transporter-NET, various

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(8810045), Tori Morgan Kroon. "Global Deletion of Sost Increases Intervertebral Disc Hydration But May Trigger Chondrogenesis." Thesis, 2020.

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Intervertebral discs (IVD) degenerate earlier than many other musculoskeletal tissues and will continue to degenerate with aging. IVD degeneration affects up to 80 percent of the adult population and is a major contributing factor to low back pain. Anti-sclerostin antibody is an FDA-approved treatment for osteoporosis in postmenopausal women at high-risk for fracture and, as a systemic stimulant of the Wnt/LRP5/b-Catenin signaling pathway, may impact the IVD. Stabilization of b-Catenin in the IVD increases Wnt signaling and is anabolic to the extracellular matrix (ECM), while deletion of b-ca

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(11267001), Saugat Adhikari. "DESIGNING COMBINATION DRUG REGIMENS TO IMPROVE GLIOBLASTOMA CHEMOTHERAPY: A PHARMACOKINETIC PHARMACODYNAMIC MODELING APPROACH." Thesis, 2021.

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<p>Despite advancements in therapies, such as surgery, irradiation (IR) and chemotherapy, outcome for patients suffering from glioblastoma (GBM) remains fatal; the median survival time is only about 15 months. Even with novel therapeutic targets, networks and signaling pathways being discovered, monotherapy with such agents targeting such pathways has been disappointing in clinical trials. Poor prognosis for GBM can be attributed to several factors, including failure of drugs to cross the blood-brain-barrier (BBB), tumor heterogeneity, invasiveness, and angiogenesis. Development of tumor resis

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