A theory-based intervention delivered by an online social media platform to promote oral health among Iranian adolescents: a cluster randomized controlled trial

Objective: Based on the Health Action Process Approach, we tested the efficacy of a theory-based program using an online social media platform (Telegram) to promote good oral hygiene behaviour among Iranian adolescents. / Design: A three-arm randomized-controlled trial design was used, consisting of an adolescent only intervention group (A group; n = 253), an adolescent and mother intervention group (A + M group; n = 260), and a control group (n = 278). / Main outcome measures: Psychosocial variables, toothbrushing behaviour, Visual Plaque Index, and Community Periodontal Index. / Results: Increases in adolescent toothbrushing at the one- and six-month follow-ups in both intervention groups compared to the control group were observed. Adolescents in the A + M group showed significant greater improvements in their toothbrushing behaviour, Visual Plaque Index, and Community Periodontal Index scores than adolescents in the A group. Improvements to toothbrushing social cognitions were also observed. / Conclusions: Current results support the use of the theory-based program delivered by Telegram in improving good oral hygiene behaviour and oral health outcomes among Iranian adolescents. Involving mothers in an intervention can confer additional benefits for adolescent oral health

Mycoremediation of petroleum hydrocarbon polluted soil by Pleurotus pulmonarius

Mycoremediation of petroleum hydrocarbon polluted soil was investigated using Pleurotus pulmonarius for a period of 62 days. Hydrocarbon (Petrol + diesel + spent petrol engine oil + spent diesel engine oil in ratio 1:1:1:1) polluted soil in 2.5%, 5%, 10% and 20% concentration were inoculated and incubated with pure culture of P. pulmonarius obtained from commercial mushroom laboratory of Federal Institute of Industrial Research Oshodi (F.I.I.R.O.) Lagos Nigeria. Inoculation was done by adding 20 g of vigorously growing spawn of P. pulmonarius. A set of control treatment was used where different concentrations of the petroleum hydrocarbon were added to all soils but no inoculation with the fungus. The results showed that the initial organic matter content of the soil increased with increase in the concentration of petroleum mixture added to the soil.  The highest impact of P. pulmonarius on the organic matter content of the soil was noticed in soil with 10% concentration treatment (68.34%) and the least was in soil with 2.5% treatment concentration (22.12%). The initial nitrogen, potassium and phosphorus contents of the soils samples decreased with increase in the petroleum concentration. The difference was significant at 2.5%, 5%, 10% and 20% concentration of contamination for organic matter, nitrogen, potassium and phosphorus (p<0.05). A significant (p<0.05) reduction in concentration of the heavy metals (manganese, copper, and zinc) after 62 days of incubation with P. pulmonarius suggested that the mushroom is a good agent for heavy metal remediation. The highest reduction of Mn was at 10% concentration (24.00±0.04 to 1.73±0.10), Cu at 10% concentration (37.24± 0.02 to 0.00), and Zn was at 10% concentration (63.03±0.02 to 5.75±0.14). The percentage loss of the TPH due the growth of P. pulmonarius decreased with increase in the concentration of petroleum added to the soil. The percentage loss for 2.5%, 5%, 10% and 20% concentration are 52.60%, 38.71%, 27.20% and 8.31% respectively. Heptane, toluene, octane, M-p xylene, Alpha xylene, nonane, propylbenzene, decane, tridecane, tetradecane, anthracene and pentadecane had high reduction; however, the reduction is more significant (p<0.05) in soil inoculated with P. pulmonarius. Our results suggest that P. pulmonarius can be used to clean soils polluted with moderate level of petroleum products mixtureKey Word: Mycoremediation, petrol, diesel, spent engine oil, P. Pulmonarius, TP

Pseudoboehmite as a drug delivery system for acyclovir

Herpes simplex virus is among the most prevalent sexually transmitted infections. Acyclovir is a potent, selective inhibitor of herpes viruses and it is indicated for the treatment and management of recurrent cold sores on the lips and face, genital herpes, among other diseases. The problem of the oral bioavailability of acyclovir is limited because of the low permeability across the gastrointestinal membrane. The use of nanoparticles of pseudoboehmite as a drug delivery system in vitro assays is a promising approach to further the permeability of acyclovir release. Here we report the synthesis of high purity pseudoboehmite from aluminium nitrate and ammonium hydroxide containing nanoparticles, using the sol–gel method, as a drug delivery system to improve the systemic bioavailability of acyclovir. The presence of pseudoboehmite nanoparticles were verified by infrared spectroscopy, transmission electron microscopy, and X-ray diffraction techniques. In vivo tests were performed with Wistar rats to compare the release of acyclovir, with and without the addition of pseudoboehmite. The administration of acyclovir with the addition of pseudoboehmite increased the drug content by 4.6 times in the plasma of Wistar rats after 4 h administration. We determined that the toxicity of pseudoboehmite is low up to 10 mg/mL, in gel and the dried pseudoboehmite nanoparticles.The authors thank the Mackenzie Presbyterian University, Texas Tech University, Mack Pesquisa, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES), Cnpq, and FAPESP (grant 2010/19157-9 and grant 2017/22396-4) for the sponsorship to this project

Investigation of Atomization and Cavitation Characteristics in Nozzle

Abstract: The influence of fuel injector nozzle is critical to the performance and emissions of diesel engine. One of the most difficult problems encountered in the development of high-speed compression-ignition engine is to have the proper atomization of the fuel in the combustion chamber during the extremely short time available. Some of the important parameters including nozzle hole size, geometry, cavitations, convergence, velocity of fuel, density of air into which fuel is injected, affects to enhance the fuel atomization. Atomization is primarily occurs due to cavitation and turbulence in the vicinity of nozzle. In this paper discharge coefficient phenomenon is used, which accounts for the different orifice approach for the better atomization such as convergence. Numerical results shows that orifice having smaller outlet diameter gives increase in the coefficient of discharge with intent of increase in cavitations up to certain range causes to increase in atomization

Treatment response with potassium-competitive acid blockers based on clinical phenotypes of gastroesophageal reflux disease: A systematic literature review and meta-analysis

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) is typically managed based on the clinical phenotype. We evaluated the efficacy and safety of potassium-competitive acid blockers (PCABs) in patients with various clinical GERD phenotypes. METHODS: Core databases were searched for studies comparing PCABs and proton pump inhibitors (PPIs) in clinical GERD phenotypes of erosive reflux disease (ERD), non-erosive reflux disease (NERD), PPI-resistant GERD and night-time heartburn. Additional analysis was performed based on disease severity and drug dosage, and pooled efficacy was calculated. RESULTS: In 9 randomized controlled trials (RCTs) evaluating the initial treatment of ERD, the risk ratio for healing with PCABs versus PPIs was 1.09 (95% CI, 1.04-1.13) at 2 weeks and 1.03 (95% CI, 1.00-1.07) at 8 weeks, respectively. PCABs exhibited a significant increase in both initial and sustained healing of ERD compared to PPIs in RCTs, driven particularly in severe ERD (Los Angeles grade C/D). In 3 NERD RCTs, PCAB was superior to placebo in proportion of days without heartburn. Observational studies on PPI-resistant symptomatic GERD reported symptom frequency improvement in 86.3% of patients, while 90.7% showed improvement in PPIresistant ERD across 5 observational studies. Two RCTs for night-time heartburn had different endpoints, limiting meta-analysis. Pronounced hypergastrinemia was observed in patients treated with PCABs. CONCLUSIONS: Compared to PPIs, PCABs have superior efficacy and faster therapeutic effect in the initial and maintenance therapy of ERD, particularly severe ERD. While PCABs may be an alternative treatment option in NERD and PPI-resistant GERD, findings were inconclusive in patients with night-time heartburn

Korean National Health Insurance Value Incentive Program: Achievements and Future Directions

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poor-quality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics

Non-infectious Complications of Peritoneal Dialysis among Sudanese Patients: Five Years Experience

Introduction: The technique of Continuous Ambulatory Peritoneal Dialysis (CAPD) is known to be associated with various infectious and non-infectious complications. The latter term includes anatomical/mechanical complications as well as hemoperitoneum, inflow pain, electrolyte disturbances, metabolic derangements and delayed gastric emptying. Methods: We retrospectively evaluated all patients who were maintained on CAPD for a minimum of 90 days in Sudan, in the period between May 2005 and Apr 2010. We examined the incidence of various non-infectious complications and their possible associations. Results: The analysis included 296 patients including 71 children (24%). Males constituted 62.2% of the study population and 13.9% were diabetic. The incidence per 100 patient-years of various non-infectious complications was as follows: hypokalemia (30.4), catheter dysfunction (10.8), dialysate leak (5.3), hernia (4.7), hemorrhagic effluent (4.7), inflow pain (2.3), upper gastrointestinal symptoms (2) and cuff extrusion (0.9). Catheter block and hernia were diagnosed with a median duration after catheter insertion of 6 and 7.5 months, respectively. Catheter block was significantly more prevalent among children (22.5% versus 9.3%; P = 0.006). A high body mass index (BMI) was the only identified independent predictor for leak (OR 1.4, P = 0.005). More than half of the 16 hernias were umbilical, and four of the five inguinal hernias were bilateral. Non-infectious complications were responsible for 32% of technique failures. Conclusion: Non-infectious complications were fairly common among our CAPD patients and led to catheter removal in a considerable number of patients. Care is, therefore, needed to screen CAPD patients for these complications in order to timely address and manage problems. Keywords: Peritoneal Dialysis; Non-infectious Complications; Sudan; Herni

Synchronous mucosal Schwann-cell hamartomas in a young adult suggestive of mucosal Schwann-cell harmatomatosis: a case report

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Abstract Background Mucosal Schwann-cell hamartoma is a rare mesenchymal polyp that presents in the intestine. Despite lacking ganglion cells, it resembles a gastrointestinal ganglioneuroma. Case presentation We report a case of synchronous mucosal Schwann-cell hamartomas in a young male patient, who presented with a single discrete polyp in the mid-rectum and multiple polypoid mucosal lesions in the distal rectum. Conclusion To the best of our knowledge, this is the first report of a case of multiple mucosal Schwann-cell hamartomas

Influenza and Bacterial Coinfections in the 20th Century

To help understand the potential impact of bacterial coinfection during pandemic influenza periods, we undertook a far-reaching review of the existing literature to gain insights into the interaction of influenza and bacterial pathogens. Reports published between 1950 and 2006 were identified from scientific citation databases using standardized search terms. Study outcomes related to coinfection were subjected to a pooled analysis. Coinfection with influenza and bacterial pathogens occurred more frequently in pandemic compared with seasonal influenza periods. The most common bacterial coinfections with influenza virus were due to S. pneumoniae, H. influenzae, Staphylococcus spp., and Streptococcus spp. Of these, S. pneumoniae was the most common cause of bacterial coinfection with influenza and accounted for 40.8% and 16.6% of bacterial coinfections during pandemic and seasonal periods, respectively. These results suggest that bacterial pathogens will play a key role in many countries, as the H1N1(A) influenza pandemic moves forward. Given the role of bacterial coinfections during influenza epidemics and pandemics, the conduct of well-designed field evaluations of public health measures to reduce the burden of these common bacterial pathogens and influenza in at-risk populations is warranted

Influenza and Bacterial Pathogen Coinfections in the 20th Century

To help understand the potential impact of bacterial coinfection during pandemic influenza periods, we undertook a far-reaching review of the existing literature to gain insights into the interaction of influenza and bacterial pathogens. Reports published between 1950 and 2006 were identified from scientific citation databases using standardized search terms. Study outcomes related to coinfection were subjected to a pooled analysis. Coinfection with influenza and bacterial pathogens occurred more frequently in pandemic compared with seasonal influenza periods. The most common bacterial coinfections with influenza virus were due to S. pneumoniae, H. influenzae, Staphylococcus spp., and Streptococcus spp. Of these, S. pneumoniae was the most common cause of bacterial coinfection with influenza and accounted for 40.8% and 16.6% of bacterial coinfections during pandemic and seasonal periods, respectively. These results suggest that bacterial pathogens will play a key role in many countries, as the H1N1(A) influenza pandemic moves forward. Given the role of bacterial coinfections during influenza epidemics and pandemics, the conduct of well-designed field evaluations of public health measures to reduce the burden of these common bacterial pathogens and influenza in at-risk populations is warranted