Miracle-dz/UniFAR-FTUs huggingface dataset:
Epidemiological study of under nutrition among under five years children in an urban slum

Background: Child undernutrition is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. Prevalence of under nutrition is very high in India; especially in urban slums. Objective: To estimate the prevalence and factors affecting undernutrition among under five years children using WHO growth standards. Materials and Methods: Community-based cross sectional study was done during November-2008 to December-2009 in urban field practice area of Medical College Pune, India. All the under five years children (336) were enumerated by house-to-house survey. Parents were informed about the objectives of the study and their written consent was obtained. Anthropometric measurements of the children who were available during the study period were carried out as per WHO guidelines. Various indices of nutritional status were expressed in standard deviation units (z scores) from the reference median. The children were examined for nutritional deficiencies and other morbidities. Epi-Info 2002 and Primer of Bio-statistics software package was used for statistical analysis. Results: Total 336 children were enumerated by house-to-house visit. Only 319 children were available during the study, out of which 208 (65.2%) were undernourished. Undernutrition was significantly (P < 0.001) higher among boys than among girls. It was maximum in 49-60 months age group. The higher the level of the mother's education, the lower was the level of child weight for age (P = 0.003). The overall prevalence of morbidities was 43.4%. Conclusion: Malnutrition continues to be a public health problem in children particularly in marginalized groups.
Barriers to the utilization of dental services in Shimla, India

Objective: The objective of this study was to determine the barriers to regular dental attendance for check- up in a rural population in Shimla Himachal Pradesh. Materials and Methods: A cross-sectional questionnaire survey was conducted among 319 adults in the area of Thari Panchayat, Shogi, Shimla. The data was analyzed by SPSS version 13. Statistical tests used were chi square and multiple-variate analysis. Results: The response rate of the study was 96.8%. 46 (15.1%) visited a dentist within the previous one year. The most common reasons for the last dental visit were pain or a dental emergency (208, 68.5%). The most commonly reported reason for not seeking dental care was "no need to visit a dentist unless there is pain" by 190 (62.5%) in bivariate analysis as well as in multiple logistic regression analysis (Odds ratio: 1.95; CI: 1.71-2.22). Conclusion: Our findings suggest that only a small portion of population visited dentist in previous one year. They believe that visiting a dentist is necessary only for pain relief. Thus it is important to give them awareness programmes about the good oral health and motivating them to use the services available.
Accountability in the Bangladeshi privatized healthcare sector

Purpose – The purpose of this paper is to examine the perceived Bangladesh privatized healthcare sector accountability gap.Design/methodology/approach – Data were collected from 533 patients using services in 45 Dhaka city privatized hospitals. A questionnaire was designed based on 60 patient focus study group and the literature.Findings – Structural equation modeling provides a comprehensive picture that allows healthcare constructs and accountability to be tested. The goodness‐of‐fit statistics supported the four factors of professionals, administration and management, legal enforcement, ethics and government, which were significantly associated with accountability. Despite Bangladeshi privatized healthcare growth, the study revealed that accountability mainly depends on government initiatives and effectively implementing existing laws.Research limitations/implications – The study covered one Bangladesh city (Dhaka) owing to resource constraints. Qualitative methods may have enriched the findings.Practi.
Effect of cortisol on blood pressure and the renin‐angiotensin system in fetal sheep during late gestation

1 The effects of cortisol on blood pressure and the circulating components of the renin‐angiotensin system (RAS) were investigated in sheep fetuses during late gestation and after exogenous cortisol infusion. 2 Plasma cortisol concentration was greater in fetuses at 140 ± 1 days of gestation (term 145 ± 2 days) compared to those studied earlier in gestation (128 ± 1 days), although, because of wide inter‐animal variation, no differences were observed in blood pressure or plasma angiotensin II (AII), renin or angiotensinogen (Ao) concentrations. 3 At 129 ± 1 days of gestation, an infusion of cortisol for 5 days (2‐3 mg kg−1 day−1 i.v.) increased plasma cortisol concentration to a value normally seen close to term. This rise in plasma cortisol was accompanied by increases in blood pressure and plasma concentrations of AII, renin and Ao. 4 When observations from all fetuses were considered, plasma cortisol concentration correlated with plasma AII and renin, and blood pressure correlated with plasma cortisol and AII concentrations. 5 Intravenous administration of an AII type 1 (AT1)‐specific receptor antagonist (3 mg kg−1 GR138950) caused a reduction in blood pressure in all fetuses; the hypotensive response was greatest in fetuses studied near term and in the cortisol‐treated fetuses. Overall, the magnitude of the hypotension induced by GR138950, and the concomitant rise in plasma renin, both correlated with the plasma cortisol concentration before GR138950 treatment. 6 These findings show that, in the sheep fetus during late gestation, the RAS becomes more important in the maintenance of resting blood pressure when plasma cortisol concentration is elevated, whether endogenously or exogenously.
INTRAVENOUS BOLUS OF SOLUBILIZED COENZYME Q10 INCREASED RAPIDLY ITS MYOCARDIAL AND BRAIN LEVEL: PP.13.483

Objective: Coenzyme Q10 (CoQ10) is recommended for long-term treatment as hypotensive and cardioprotective agent. Bioavailability of coenzyme Q10 (CoQ10) after per os administration is very poor. To facilitate the uptake of CoQ10 by peripheral tissues is necessary to raise its plasma level many times. The aim of the study was to examine the tissues distribution of CoQ10 following intravenous bolus administration of its solubilised form. Design and Methods: The experiments were carried out on male Wistar rats with venous and arterial catheters. Solubilized CoQ10 (Kudesan solution, “Akvion”, Russia) was administrated intravenously (30 mg/kg). The content of coenzymes Q was determined by HPLC with electrochemical detection in the serum, homogenates of myocardium, brain and liver in three groups of rats: 1) 30 min group (n = 5) – 30 min after i.v. bolus; 2) 48 h group (n = 5) – 48 h after i.v. bolus and 3) control rats (n = 7). Statistical analysis was performed with two-tailed t-test. Results: Administration of solubilized CoQ10 led to enhance in its tissue concentrations. Plasma level of CoQ10 dramatically increased by 2000-fold in 30 min and by 10-fold in 48 h after bolus. Myocardial level of CoQ10 was raised by 20% (p < 0.05) in 30 min and by 98% (p < 0.01) in 48 h versus control rats. CoQ9 myocardial level also increased by 10% (p < 0.01) in 30 min and by 14% in 48 h. In the brain increased CoQ10 content was found only in 30 min after administration (by 48% versus control rats, p < 0.0001). CoQ9 brain level was not changed compared with control group. CoQ10 level in the liver in 30 min and 48 h after administration was 4,5-fold and 37-fold higher, respectively, than those in the control rats. CoQ9 liver level was decreased by 57% in 30 min and was not different from control rats in 48 h. Conclusion: Iintravenous injection of solubilised CoQ10 ensures rapid growth of tissue CoQ10 content and gives occasion to investigation of CoQ10 efficiency at acute cardiovascular events.
Co-exposure of lipopolysaccharide and pseudomonas aeruginosa exotoxin A-induced multiple organ injury in rats

Pseudomonas aeruginosa Exotoxin A (PEA) induces hepatotoxicity in experimental animals. Lipopolysaccharide (LPS) interacts synergistically with xenotoxics to induce severe organ injury. We examined the combination of non-injurious doses of LPS and sub-hepatotoxic PEA in the induction of multiple organ injury (MOI). Rats treated with 20 or 40 μg/kg LPS plus 10 μg/kg PEA developed severe liver, kidney, and lung injury; elevation of TNF-α, IFN-γ, and IL-2; and high mortality. Depletion of Kupffer cells or T-cells by pretreatment with Gadolinium Chloride or FK506, respectively, attenuated MOI. Thus LPS + PEA acted synergistically on Kupffer and T-cells to induce proinflammatory cytokines contributing to MOI.
Factors affecting the retention of learners following the degree in social work at a university in the south‐east of England

Changes to the education and training for social workers in England, UK since 2003 have increased the number and widened the pool of students encouraged to enter the profession via higher education. Social work education is very much linked to increasing diversity in work-force development where an agenda to build a well-motivated and skilled work-force can in turn provide good quality services and interventions reflecting the diverse needs of service users and carers. This paper reports on a small-scale study which explored factors affecting the potential success of students following a vocational education programme leading to the degree in social work. Using in-depth face-to-face interviews with a sample of seven students and a focus group with eight social work tutors, within a qualitative framework, the experiences of learning and teaching were explored from the participants’ subjective viewpoints. The study highlighted several factors found to potentially impact on student success in social work education and compared these with the published literature relating to both widening participation and diversity in learning. Factors impacting were student organization and time-management skills; access to study skill support; their relationships with tutors and peers; and the impact of affective factors on the learning process. This study forms a useful basis for determining areas for intervention to improve the potential of success on the degree and the challenges anticipated in implementing these for students from diverse and non-traditional backgrounds. Although this study related specifically to social work education, the findings may be transferable to other vocational education professions in the health and social care sector.
BENIGN TYPE OF ACANTHOSIS NIGRICANS: ETIOLOGY

The association of acanthosis nigricans and cancer in a great number of cases is well known. This association occurs in 45 per cent of the patients with acanthosis nigricans, according to Mukai;1in 45.3 per cent, according to Kuttner,2and in 54.5 per cent, according to Moncorps,3who included cases of definite and probable cancer. The form of acanthosis nigricans which is associated with cancer is called malignant.4 Patients with the benign type of acanthosis nigricans do not suffer from cancer. This negative fact alone, not any difference in the macroscopic or histologic features of the two forms, determines the diagnosis of the benign type. It is true that only in one or two cases has the malignant form been observed in infancy or childhood and that it is the benign type which usually appears in early life, but no sharp division can
Attitudes of health sciences students towards interprofessional teamwork and education

Relatively little is known about the specific attributes of health professional students which may influence their attitudes towards both interprofessional teamwork and interprofessional education. A survey was distributed to all pre-licensure health professional students from medicine, nursing, pharmacy and social work programmes at our institution. Respondents were asked to rate their attitudes towards interprofessional healthcare teams and interprofessional education using validated and reliable scales reported in the literature. Information on the respondents’ gender, profession, year of study and prior experience with interprofessional education was also collected. There was no significant difference between attitudes of medicine and nursing students towards interprofessional teamwork; however, both these student groups report significantly less positive attitudes towards interprofessional teams than pharmacy and social work students. Medicine students reported significantly less positive attitudes towards interprofessional education than nursing, pharmacy and social work students. Female students and senior undergraduate students reported significantly more positive attitudes towards interprofessional teamwork and interprofessional education, while students reporting prior experience with interprofessional education reported significantly more positive attitudes towards interprofessional teamwork. Profession, gender and year of study appear to be attributes which were related to more positive attitudes towards both interprofessional teamwork and education.
Randomized Treatment Withdrawal of Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea

Objectives: Describe the therapeutic effect of upper airway stimulation (UAS) therapy withdrawal on objective and subjective measures of sleep apnea severity. Methods: From a cohort of 126 participants in a prospective therapy effectiveness trial, 46 subjects were randomized to therapy “ON” and “OFF” groups. Primary outcomes measures were apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) changes and secondary outcome measures included Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), sleep architecture, hypoxemia, snoring, and blood pressure. Results: Groups did not differ at pretreatment baseline or at 12 months of therapy in polysomnography or self-reported measures. Following randomized controlled trial (RCT) therapy withdrawal, change in AHI and ODI significantly differed in “ON” and “OFF” groups (1.7 versus 18.2 and 1.6 versus 17.0 events/hour P < .0001). Therapy withdrawal worsened ESS, FOSQ, snoring, hypoxemia, and arousal index in the therapy “OFF” but no change was observed in the “ON” group (P < .001). The therapy “ON” group demonstrated a reduction in blood pressure at 12 months compared to baseline which was maintained through the RCT. Conclusions: Withdrawal of therapeutic UAS results in relapse of both subjective and objective measures of OSA.
Comparison of microcolony formation between Vibrio sp. strain S141 and a flagellum‐negative mutant developing on agar and glass substrata

A flagellum‐negative mutant, M8.2, of the marine bacterium Vibrio sp. S141 was produced by transposon mutagenesis. Time‐lapse video imaging of surface colonisation behaviour and microcolony formation of S141 compared to M8.2 cells was carried out to investigate the role of the flagellum of Vibrio sp. S141 in microcolony formation on agar and glass substrata. On an agar surface, S141 cells formed a tetrad pattern after the first two cell divisions, during initial surface colonisation. Developed microcolonies consisted of tight circular arrangements of cells with infrequent branching of cells from the main body. In contrast, M8.2 cells did not form tetrad patterns and micro‐colonies generally showed enhanced branching and did not develop circular arrangements of cells. On a glass surface under flow conditions, S141 cells displayed several types of movement behaviours at the surface which may have assisted microcolony formation. M8.2 cells appeared unable to develop micro‐colonies, but rather displayed a behaviour which enabled them to spread out across the substratum. Laser scanning confocal microscopy revealed S141 mature biofilms consisted of characteristic towers of bacterial growth with scattered troughs. The flagellum‐negative M8.2 biofilm did not form such architecture, displaying a homogeneous distribution of cells throughout the biofilm and across the entire substratum. Although not required for attachment to the glass substratum, the flagellum was required for alignment as well as specific movement behaviours by S141 cells.
Development and Validation of a Chromatographic Ultraviolet Method for the Simultaneous Quantification of Dolutegravir and Rilpivirine in Human Plasma

Background: We have developed and validated a high-performance liquid chromatographic method for the simultaneous quantification, in human plasma, of dolutegravir, a new human immunodeficiency virus (HIV) integrase inhibitor, and rilpivirine, a novel HIV nonnucleoside reverse transcriptase inhibitor. Methods: An internal standard (quinoxaline) was added to plasma aliquots (500 &mgr;L), and a simple solid-phase extraction procedure was applied. Chromatographic separation of the drugs and internal standard was achieved with a gradient of acetonitrile and acetate buffer, and with an analytical run time of 25 minutes using an XBridge C18 column. The column eluate was monitored at 260 nm for dolutegravir and the internal standard and at 305 nm for rilpivirine. Results: The method was linear in the range of 20–8000 and 20–2000 ng/mL for dolutegravir and rilpivirine, respectively (mean r2 ≥ 0.993 on 10 replicates for both analytes). Mean intraday and interday precision and inaccuracy were <15% for both compounds. The mean recovery was 73% and 80% for dolutegravir and rilpivirine, respectively. Conclusions: The high-performance liquid chromatography–ultraviolet method we developed showed a good analytical performance required for therapeutic drug monitoring of antiretrovirals, leading to potential improvements in HIV-infected patient care and laboratory management.
Effects of phenol and natural phenolic compounds on biofilm formation by Pseudomonas aeruginosa

A biofilm is formed as a result of adhesion of microorganisms to various surfaces with the production of extracellular polymers (polysaccharides and proteins). Biofilms cause serious problems in the chemical, medical and pharmaceutical industries. Recent findings indicate that some natural phenolic compounds found in plants have an anti-biofouling effect on biofilm formation by Gram-negative bacteria. The anti-biofouling activities of 14 selected phenol and natural phenolic compounds were tested against Pseudomonas aeruginosa, using a microtiter-plate. A modified microtiter-plate assay was used because it enabled indirect measurement of bacterial cells attached to the surface of the wells. This assay involved fixing the bacterial film with methanol, staining with crystal violet dye and then releasing the bound dye with 33% glacial acetic acid. The optical density (OD) of the solution was measured at 570 nm by using an automated ICN Flow Titertek Multiscan Plus reader. Phenol and natural phenolic compounds except ethyl linoleate and tocopherol showed a significant reduction in biofilm formation by P. aeruginosa.
Primary teachers and the national curriculum

Abstract A questionnaire survey of 901 primary teachers was undertaken by the Leverhulme Primary Project team. The sample was a national one which closely matched the national distribution of primary schools according to size and region. Teachers were asked to state how competent they felt to teach the national curriculum introduced by the 1988 Education Act with their existing subject knowledge. Whether results were analysed by the size of school, age of teacher, sex or age group taught, the rank order was similar. Teachers saw themselves as most competent in English with maths in second place. In last three places, with lowest perceived competence, were science, music and maths. The other subjects, art, geography, history, RE and PE were grouped in the middle. A similar response was found when teachers were asked to describe their competence on individual attainment targets in English, mathematics, music, science and design and technology. Greatest confidence in existing subject knowledge was expressed .
Pressure drop increase by biofilm accumulation in spiral wound RO and NF membrane systems: role of substrate concentration, flow velocity, substrate load and flow direction

In an earlier study, it was shown that biofouling predominantly is a feed spacer channel problem. In this article, pressure drop development and biofilm accumulation in membrane fouling simulators have been studied without permeate production as a function of the process parameters substrate concentration, linear flow velocity, substrate load and flow direction. At the applied substrate concentration range, 100–400 μg l−1 as acetate carbon, a higher concentration caused a faster and greater pressure drop increase and a greater accumulation of biomass. Within the range of linear flow velocities as applied in practice, a higher linear flow velocity resulted in a higher initial pressure drop in addition to a more rapid and greater pressure drop increase and biomass accumulation. Reduction of the linear flow velocity resulted in an instantaneous reduction of the pressure drop caused by the accumulated biomass, without changing the biofilm concentration. A higher substrate load (product of substrate concentration and flow velocity) was related to biomass accumulation. The effect of the same amount of accumulated biomass on the pressure drop increase was related to the linear flow velocity. A decrease of substrate load caused a gradual decline in time of both biomass concentration and pressure drop increase. It was concluded that the pressure drop increase over spiral wound reverse osmosis (RO) and nanofiltration (NF) membrane systems can be reduced by lowering both substrate load and linear flow velocity. There is a need for RO and NF systems with a low pressure drop increase irrespective of the biomass formation. Current efforts to control biofouling of spiral wound membranes focus in addition to pretreatment on membrane improvement. According to these authors, adaptation of the hydrodynamics, spacers and pressure vessel configuration offer promising alternatives. Additional approaches may be replacing heavily biofouled elements and flow direction reversal.
Monitoring Protein-Unbound Valproic Acid Serum Concentrations in Clinical Practice

Background: Valproic acid (VPA) is an effective antiepileptic drug and mood stabilizer. A key characteristic of VPA is its high and saturable protein binding at higher concentrations. Although the unbound concentration of VPA is responsible for its pharmacological activity, total drug concentrations are monitored in routine clinical practice. Therapeutic drug monitoring (TDM) of unbound VPA is recommended for specific clinical situations. The goal of this study was to evaluate TDM requests for unbound VPA in clinical practice. Methods: All TDM requests at our laboratory for unbound VPA in 2014 and 2015 were evaluated retrospectively. In patients with potentially toxic unbound VPA concentrations (ie, >12 mg/L), we evaluated whether toxicity was noted and whether the dose adjustment advice was followed. Total and unbound VPA concentrations were measured by means of a validated immunoassay. Results: A total of 273 unbound VPA serum concentrations in 132 different patients were analyzed. The main reasons for unbound VPA TDM were decreased renal function (34%) and a low serum albumin (27%). The median (range) unbound VPA concentration was 9.8 (2.5–47.6) mg/L. In 49 patients (37%), the initial unbound VPA concentration was above the threshold of 12 mg/L, potentially resulting in toxicity. Only 6 of these 49 patients had elevated total VPA concentrations. Clinical toxicity was noted in 38 of the 49 patients (77.6%) with elevated unbound VPA concentrations. Toxicities included drowsiness (n = 26), decreased consciousness (n = 4), rigidity (n = 2), and confusion (n = 2). In 36 of the 38 patients with elevated unbound VPA concentrations and clinical toxicity, a dose reduction was applied. In 27 of 36 patients who had their dose reduced, dose reduction was associated with improvement or resolution of VPA toxicity. Conclusions: TDM of unbound VPA is an important tool to manage VPA therapy in selected, vulnerable patients.